|
GENERIC
NAME: prednisone
BRAND NAME:
Deltasone, Orasone, Prednicen-M, Liquid
Pred
DRUG CLASS AND MECHANISM:
Prednisone is an oral, synthetic (man-made)
corticosteroid used for suppressing the immune
system and inflammation. It has effects similar
to other corticosteroids such as triamcinolone
(Kenacort), methylprednisolone (Medrol),
prednisolone (Prelone) and dexamethasone
(Decadron). These synthetic corticosteroids
mimic the action of cortisol (hydrocortisone),
the naturally-occurring corticosteroid produced
in the body by the adrenal glands.
Corticosteroids have many effects on the body,
but they most often are used for their potent
anti-inflammatory effects, particularly in those
conditions in which the immune system plays an
important role. Such conditions include
arthritis, colitis, asthma, bronchitis, certain
skin rashes, and allergic or inflammatory
conditions of the nose and eyes. Prednisone is
inactive in the body and, in order to be
effective, first must be converted to
prednisolone by enzymes in the liver. Therefore,
prednisone may not work as effectively in people
with liver disease whose ability to convert
prednisone to prednisolone is
impaired
PRESCRIPTION:
yes
GENERIC AVAILABLE:
yes
PREPARATIONS: Tablets of
2.5, 5, 10, 20, and 50 mg. Oral solution or
syrup of 5mg/5ml
STORAGE: Store at room
temperature 20-25°C (68-77°F), and keep away
from moisture.
PRESCRIBED FOR: Prednisone
is used in the management of inflammatory
conditions or diseases in which the immune
system plays an important role. Since prednisone
is used in so many conditions, only the most
common or established uses are mentioned here.
Prednisone most often is used for treating
several types of arthritis, ulcerative colitis,
Crohn's disease, systemic lupus, allergic
reactions, asthma and severe psoriasis. It also
is used for treating leukemias, lymphomas,
idiopathic thrombocytopenic purpura and
autoimmune hemolytic anemia. Corticosteroids,
including prednisone, are commonly used to
suppress the immune system and prevent the body
from rejecting transplanted organs. Prednisone
is used as replacement therapy in patients whose
adrenal glands are unable to produce sufficient
amounts of cortisol.
DOSING: The initial dose of
prednisone varies depending on the condition
being treated and the age of the patient. The
starting dose may be from 5 to 60 mg per day and
often is adjusted based on the response of the
condition being treated. Corticosteroids
typically do not produce immediate effects and
must be used for several days before maximal
effects are seen. It may take much longer before
conditions respond to treatment. Prolonged
therapy with prednisone causes the adrenal
glands to atrophy and stop producing cortisol.
When prednisone is discontinued after a period
of prolonged therapy, the dose of prednisone
must be tapered (lowered gradually) to allow the
adrenal glands time to recover. (See side
effects.) It is recommended that prednisone be
taken with food.
DRUG INTERACTIONS:
Prednisone may interact with estrogens and
phenytoin (Dilantin). Estrogens may reduce the
action of enzymes in the liver that break down
(eliminate) the active form of prednisone,
prednisolone. As a result, the levels of
prednisolone in the body may increase and lead
to more frequent side effects. Phenytoin
increases the activity of enzymes in the liver
that break down (eliminate) prednisone and
thereby may reduce the effectiveness of
prednisone. Thus, if phenytoin is being taken,
an increased dose of prednisone may be
required.
PREGNANCY: Corticosteroids
cross the placenta into the fetus. Compared to
other corticosteroids, however, prednisone is
less likely to cross the placenta. Chronic use
of corticosteroids during the first trimester of
pregnancy may cause cleft
palate.
NURSING MOTHERS:
Corticosteroids are secreted in breast milk and
can cause side effects in the nursing infant.
Prednisone is less likely than other
corticosteroids to be secreted in breast milk,
but it may still pose a risk to the
infant.
SIDE EFFECTS: Side effects
of prednisone and other corticosteroids range
from mild annoyances to serious, irreversible
damage, and they occur more frequently with
higher doses and more prolonged treatment. Side
effects include retention of sodium (salt) and
fluid, weight gain, high blood pressure, loss of
potassium, headache and muscle weakness.
Prednisone also causes puffiness of the face
(moon face), growth of facial hair, thinning and
easy bruising of the skin, impaired wound
healing, glaucoma, cataracts, ulcers in the
stomach and duodenum, worsening of diabetes,
irregular menses, rounding of the upper back
("buffalo hump"), obesity, retardation of growth
in children, convulsions, and psychiatric
disturbances. The psychiatric disturbances
include depression, euphoria, insomnia, mood
swings, personality changes, and even psychotic
behavior.
Prednisone
suppresses the immune system and, therefore,
increases the frequency or severity of
infections and decreases the effectiveness of
vaccines and antibiotics. Prednisone may cause
osteoporosis that results in fractures of bones.
Patients taking long-term prednisone often
receive supplements of calcium and vitamin D to
counteract the effects on bones. Calcium and
vitamin D probably are not enough, however, and
treatment with bisphosphonates such as
alendronate (Fosamax) and risedronate (Actonel)
may be necessary. Calcitonin (Miacalcin) also is
effective. The development of osteoporosis and
the need for treatment can be monitored using
bone density
scans. |
