This substance is a hormone secreted by the adrenal cortex.
Prednisone is a synthetic, anti-inflammatory glucocorticoid. Such compounds are more active than natural substances, and they are used at lower doses. Prednisone doesn’t affect salt and water metabolism and rarely causes side effects.
Indications for use
Prednisone is used to treat:
- acute pancreatitis, eczema, acute adrenal insufficiency, hepatitis B and androgenital syndrome;
- rheumatism, rheumatoid arthritis and polyarteritis nodosa;
- dermatomyositis, scleroderma and Bekhterev’s disease;
- different allergic diseases, bronchial asthma and Addison’s disease;
- hepatic encephalopathy, hypoglycemia and agranulocytosis;
- treatment and prevention of shock;
- different types of leukemia, lymphogranulomatosis and hemolytic anemia;
- immune thrombocytopenic purpura;
- pemphigus, itchy skin, psoriasis and dermatitis;
- rash, systemic lupus erythematosus, alopecia and erythroderma;
- false croup in children.
The dosage should be established individually according to the type of disease and the patient’s response. After achieving the desired clinical response, the dosage should be gradually reduced until the lowest effective dose is reached. It is also recommended to taper off Prednisone to avoid withdrawal syndrome.
Total daily dose (or most of it) of Prednisolone should be administered in the morning to coincide with circadian rhythm. Some patients may need to take the drug more frequently than others.
- Recommended daily dosage: 5 to 60 mg; maximum daily dosage: 250 mg.
- Recommended daily dosage: 0.14 to 2 mg/kg/day (given in 4 to 6 divided doses).
The short-term use of prednisolone (like other corticosteroids) can cause transient side effects. Adverse effects mentioned below are more common in patients taking prednisolone on a long-term basis. However, not all patients experience these side effects.
- Hypotonia, steroid myopathy (it usually affects women; the disease causes weakness in the hip muscles, and then extends to the muscles of the shoulder and arm but rarely affects respiratory muscles), loss of muscle mass, tendon rupture, osteoporosis and pathological fractures of the long bones.
- Increased or decreased appetite, digestive disorders, sickness, vomiting and pancreatitis.
- Abdominal striae, acne, hyper- or hypopigmentation, slow wound healing, bruises, erythema, excess sweating and increased risk of Candida infections.
- Allergic dermatitis, urticaria, angioedema and anaphylactic reaction.
- Increased intracranial pressure, seizures, vertigo and headache.
- Cushing’s syndrome, stunted growth in children, delayed sexual development and menstrual irregularities.
- Cataract, elevated intraocular pressure, neurotrophic corneal ulcer and eye infections.
- Manic-depressive disorder, hallucinations, delirium, disorientation, euphoria, depression, nervousness, anxiety and sleep disorder.
Such side effects usually affect women and patients with erythema (especially during the first weeks of therapy).
Prednisone speeds up the elimination of barbiturates, digitoxin, penicillin and levomycetin. Phenobarbital, diphenin, diphenhydramine and ephedrine increase the excretion rate of Prednisone. Co-administration of Prednisone and amphotericin/cardiac glycosides increases the risk of hypokalemia. NSAIDs increase the ulcerogenic potential of Prednisone. A combination of Prednisone with acetylsalicylic acid can cause hypoprothrombinemia.
Prednisone has been used for the treatment of different acute and chronic diseases for several decades. This drug has unique properties, such as anti-inflammatory and immunosuppressive action. Despite its numerous benefits, Prednisone has many side effects. The risk of adverse effects is higher in patients taking the drug in higher doses and for a long time.