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What is Prednisone?

Prednisone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It often is used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Prednisone also is used with other drugs to prevent rejection of transplanted organs and to treat certain types of cancer.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Precautions with Prednisone

Before taking prednisone,

• tell your doctor and pharmacist if you are allergic to prednisone, aspirin, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.

• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), arthritis medications, aspirin, cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), diuretics ('water pills'), estrogen (Premarin), ketoconazole (Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.

• if you have a fungal infection (other than on your skin), do not take prednisone without talking to your doctor.

• tell your doctor if you have or have ever had liver, kidney, intestinal, or heart disease; diabetes; an underactive thyroid gland; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; tuberculosis (TB); or ulcers.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking prednisone, call your doctor.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking prednisone.

• if you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit your consumption of alcoholic beverages while taking this drug. Prednisone makes your stomach and intestines more susceptible to the irritating effects of alcohol, aspirin, and certain arthritis medications. This effect increases your risk of ulcers.

Prednisone Dosage

Prednisone comes as a tablet, solution, concentrate, and syrup to be taken by mouth. Your doctor will prescribe a dosing schedule that is best for you. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use the specially marked dropper that comes with the concentrate to measure the dose. You may mix it with fruit juice or semisolid food (e.g., applesauce).

If you are to take prednisone every other day, take it at breakfast on the first day and do not take it at all on the second day. Then take it at breakfast on the third day, do not take it at all on the fourth day, and so on.

If you are to take prednisone once a day, take it in the morning with breakfast.

If you are to take prednisone more than once a day, take it at evenly spaced intervals between the time you wake up in the morning and the time you go to bed at night. For example, if your doctor tells you to take it three times a day, take it at 7 a.m., 3 p.m., and 11 p.m.

Do not stop taking prednisone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, nausea, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. Watch for these side effects if you are gradually decreasing your dose and after you stop taking the tablets or oral liquid. If these problems occur, call your doctor immediately. You may need to increase your dose of tablets or liquid temporarily or start taking them again.

Take prednisone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

What special dietary instructions should I follow?

Your doctor may instruct you to follow a low-sodium, low-salt, potassium-rich, or high-protein diet. Follow these directions.

If you experience stomach pain or upset stomach, you may take this medication with food or milk.

Prednisone -Missed Dose

When you start to take prednisone, ask your doctor what to do if you forget a dose. Write down these instructions so that you can refer to them later.

In general, if you take prednisone every other day and remember a missed dose on the morning of the day you should have taken it, take the missed dose as soon as you remember it. If you remember a missed dose on that afternoon (or later), start a new schedule. Take the missed dose on the next morning (day one), do not take it at all on day two, and take the next dose on the morning of day three.

If you take prednisone once a day, take the missed dose as soon as you remember it. If you do not remember a missed dose until it is time for your next dose, skip the missed dose completely and take only the regularly scheduled dose.

If you take more than one dose a day, take the missed dose as soon as you remember it; then take any remaining doses for that day at evenly spaced intervals. If you remember a missed dose when it is time for you to take another, you may take both doses at one time.

Prednisone Side Effects

Although side effects from prednisone are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• stomach irritation
• vomiting
• headache
• dizziness
• insomnia
• restlessness
• depression
• anxiety
• acne
• increased hair growth
• easy bruising
• irregular or absent menstrual periods

If you experience any of the following symptoms, call your doctor immediately:

• skin rash
• swollen face, lower legs, or ankles
• vision problems
• cold or infection that lasts a long time
• muscle weakness
• black or tarry stool

What storage conditions are needed for this medication?

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to prednisone. Checkups are especially important for children because prednisone can slow bone growth.

If your condition worsens, call your doctor. Your dose may need to be adjusted.

Carry an identification card that indicates that you may need to take supplementary doses (write down the full dose you took before gradually decreasing it) of prednisone during periods of stress (injuries, infections, and severe asthma attacks). Ask your pharmacist or doctor how to obtain this card. List your name, medical problems, drugs and dosages, and doctor's name and telephone number on the card.

This drug makes you more susceptible to illnesses. If you are exposed to chicken pox, measles, or tuberculosis (TB) while taking prednisone, call your doctor. Do not have a vaccination, other immunization, or any skin test while you are taking prednisone unless your doctor tells you that you may.

Report any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment.

Your doctor may instruct you to weigh yourself every day. Report any unusual weight gain.

If your sputum (the matter you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, call your doctor; these changes may be signs of an infection.

If you have diabetes, prednisone may increase your blood sugar level. If you monitor your blood sugar (glucose) at home, test your blood or urine more frequently than usual. Call your doctor if your blood sugar is high or if sugar is present in your urine; your dose of diabetes medication and your diet may need to be changed.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.