Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Prednisone FAQs

Frequently Asked Questions About Prednisone

About 25 years ago, a large-scale study[1] was conducted on approximately 4000 subjects, some of whom were regular prednisone users, while others had never consumed the drug.

The results of the trial suggested that prednisone use is associated with a moderate degree of side effects and long term complications. It was identified that 12.7% of the entire study population developed infections, as opposed to only 8% of the controlled population, with higher incidence in patients with neurological diseases and those who received a dose of over 10 mg/day for extended periods of time.

Steroids like prednisone are used to manage a wide variety of medical conditions. It is therefore crucial to understand both the positive and negative aspects of prednisone therapy.

Unfortunately, very few people know about the complications and potential side effects associated with prednisone intake.

Below is a list of frequently asked questions about prednisone:

1. What is prednisone and why is it recommended?

Prednisone is classified as an anti-inflammatory drug. It is used to treat a wide variety of infections, diseases, inflammatory processes and other ailments.

2a. What happens if I miss a dose?

Prednisone is often administered on an hourly basis (in the form of multiple divided doses).

If you have missed a dose, you can take it as soon as you remember. However, if you remember at or around the time the next dose is due, skip the missed dose. Do not consume a double dose to cover your missed dose.

2b. What happens if I overdose?

There is no life threatening sequelae of consuming prednisone in high doses. However, if a high dosage is consumed for longer periods of time, you may develop complications such as easy bruising, thinning of the skin, redistribution of fat in the body, menstrual abnormalities, impotence, increased growth of facial hair and acne.

3. What to do if my symptoms have resolved?

In cases of acute exacerbation of certain infections or diseases like asthma, rheumatoid arthritis or other similar ailments, prednisone is advised as an "attack aborting" or remission-inducing treatment regimen. You may experience rapid resolution of symptoms, but it is still advised to complete the advised regimen according to the recommendations of your doctor.

4. What will happen if I instantaneously stop taking prednisone?

Healthcare professionals advise taking prednisone for acute conditions to prevent life threatening complications. However, it is absolutely recommended to taper off the dose rather than withdrawing abruptly.

In case of abrupt withdrawal from corticosteroids like prednisone, you may experience severe symptoms like pseudo-rheumatism. Some classic symptoms of pseudo-rheumatism include nausea, vomiting, changes in blood pressure, arthralgias, fever, myalgias, headaches and lethargy.

5. What is adrenal suppression?

Endocrinological hormones are under strict biofeedback regulation from higher brain centers and if you are consuming excess glucocorticoids (like prednisone) from exogenous or outside sources, your body decreases the production of endogenous steroids from the adrenal gland. This phenomenon is referred to as adrenal suppression. It may take a few months or even a year to resume normal functioning of the adrenal gland if prednisone is consumed for a longer period of time.

6. How can I decrease the chances of developing adrenal suppression?

Due to the serious nature of complications and adverse effects following prednisone withdrawal due to adrenal suppression, the following actions can be taken at the time of therapy:

  • Modification of dosing regimen (for example, alternate day intake instead of daily dosage)
  • Tapering off the dose as soon as the disease symptoms are in control

7. Can I develop an addiction to prednisone?

Prednisone dependence is not the same as an addiction to drugs like cocaine or opiates. However, long-term intake is associated with changes in the production of glucocorticoids in the body, which may lead to abnormal symptoms when prednisone intake is suddenly stopped. (See Is Prednisone Addictive for more information.)

8. What type of monitoring do I need with prednisone?

In most cases, prednisone use is reserved only for acute conditions (like asthma, COPD exacerbation, osteoarthritis, rheumatoid arthritis, inflammatory bowel disease and similar ailments). Depending upon your age, general physical health and comorbid medical conditions, your doctor may request frequent medical visits to check blood sugar levels, blood pressure, disease status and other lab investigations.

9. Can I develop depression or mood changes with prednisone therapy?

It has been observed that 15-20% of all prednisone users (who consume at least 5mg/day for more than 6 months) can develop moderate changes in mood, personality and behavior. Symptoms respond positively to dosage modification.

Keeping yourself up to date with your medical condition and medications can help in preventing a number of complications. Feel free to ask as many questions as you like from your healthcare provider to avoid complications later on.

References:

  1. Stuck, A. E., Minder, C. E., & Frey, F. J. (1989). Risk of Infectious Complications in Patients Taking Glucocorticosteroids. Review of Infectious Diseases, 11(6), 954-963.

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