Prednisone- An immunosuppressant and anti-inflammatory medication

Prednisone is a corticosteroid that prevents the flow of substances in the body that cause inflammation. It also overpowers the immune system. It is used as immunosuppressant or anti-inflammatory medication. Prednisone is helpful in treating various health ailments like skin conditions, lupus, arthritis, ulcerative colitis, psoriasis, breathing disorders and allergic disorders.

Important Information

Avoid taking Prednisone if there is a fungal infection anywhere in your body. Steroid medications can make your immune system weak, which makes your body get an infection easily. Stay away from those who have infections or are sick. Do not opt for a live vaccine when you are on Prednisone.

Do not stop Prednisone suddenly and speak to your doctor regarding change in dosage.

To ensure whether Prednisone is suitable for you or not, let your doctor know if you have the following

  • any health problems that leads to diarrhoea
  • kidney disease
  • live disease
  • tuberculosis
  • osteoporosis
  • glaucoma/cataracts
  • thyroid disorder
  • history of malaria
  • mental illness/depression
  • muscle disorder like myasthenia gravis
  • history of stomach bleeding
  •  diabetes

Using steroids for a long term can lead to osteoporosis (bone loss) particularly if you smoke, if you do not work out, do not take adequate amount of calcium or vitamin D through your diet or you have a family history of osteoporosis. Speak to your doctor to know about the risks associated with osteoporosis.

Dosing information

Normal Adult dose – Nephrotic Syndrome

Initial dose: 2mg/kg/per day (maximum dose-80mg per day) in split dose of 3-4 times per day until urine gets protein free 3 consecutive days (maximum: 28 days) with 1-1.5mg/kg/per dose to be given every alternate day for almost 4 weeks.

Normal Paediatric dose – Asthma

Below 1 year

Acute: 10mg to be taken orally after every 12 hours

Maintenance: 10mg to be taken orally every alternate day

1-4 years

Acute: 20mg to be taken orally after every 12 hours

Maintenance: 20mg to be taken orally every alternate day

5-12 years

Acute: 30mg to be taken orally after every 12 hours

Maintenance: 30mg to be taken orally every alternate day

Above- 12 years

Acute: 40 mg orally every 12 hours.
Maintenance: 40 mg orally every alternate day.

 

Prednisone and pregnancy

Use of Prednisone during pregnancy can cause birth defects or low birth weight especially if you use Prednisone during the first three months of pregnancy. Speak to your doctor if you get pregnant or planning to get pregnant.

Prednisone and breastfeeding

Prednisone can secret in breast milk and can harm your baby. So talk to your doctor if you are a lactating mother.

 

Side effects

  • eye pain, blurred vision
  • tarry or bloody stools
  • pancreatitis
  • low potassium
  • fast weight gain, breathlessness
  • extreme sadness or happiness, severe, depression, change in behaviour or personality, convulsions
  • extremely high BP

Common side effects

  • increased appetite, slow weight gain
  • slow healing of wound
  • increases sweating, acne, dry skin, discoloration or bruising
  • sleep problems
  • bloating, nausea and stomach pain

Prednisolone- Helps treat many breathing and intestinal problems

Prednisolone is a corticosteroid used to treat breathing problems like asthma, some blood disorders, eye diseases, collagen diseases, cancer, intestinal problems, endocrine problems, skin conditions, swelling occurred as a result of certain conditions. It modifies the response of our immune system to different conditions thereby decreasing inflammation.

Avoid using Prednisolone if

  • If you have a fungal infection, optic nerve inflammation, malaria, or herpes eye infection
  • you are allergic to a specific ingredient present in Prednisolone
  • you are using mifepristone
  • you are going to have live vaccination

Some medical conditions can interact with Prednisolone. Speak to your doctor if you suffer from the following health ailments

  • Have a history of heart attack, heart problems, kidney or liver problems, seizures, diabetes, underactive thyroid, fluid retention, adrenal gland problems, mood or mental problems or high BP.
  • If your live viral vaccination or any other vaccination is scheduled
  • if you are planning to become pregnant, if you are pregnant or you are  a nursing mother
  • if you are using any prescription/non prescription medicine, dietary supplement or herbal preparation
  • If you are allergic to certain types of substances, food or medicines
  • If you recently had or have a viral, bacterial or fungal infection, measles, chickenpox or shingles.
  • If your bones are weak or have muscle problems.
  • If you had taken a vaccination recently

Pregnancy/Breastfeeding and Prednisolone

If you get pregnant, speak to your health care provider. You should discuss the risks and benefits of taking Prednisolone during pregnancy.

Prednisolone is secreted in breast milk. If you are breastfeeding or planning to breastfeed your baby, talk to your doctor to know the possible benefits and risks to your baby.

Side effects of Prednisolone

  • Agitation
  • anxiety
  • dizziness
  • headache
  • irritability
  • blurred vision
  • breathlessness
  • weight gain
  • trouble walking, speaking and thinking
  • rattling and noisy breathing
  • mood changes
  • nervousness
  • slow, fast, irregular or pounding pulse or heartbeat

 

Drug Interactions

Some medications that can interact with Prednisolone are as listed below. You can speak to your doctor if you are taking these medicines or any other medicine

  • cyclosporine, Clarithromycin, estrogens, ketoconazole and oral contraceptives as they can increase the side effects caused by Prednisolone.
  • Anticholinesterases, mifepristone, aspirin, ritodrine, methotrexate, quinolone antibiotics, diuretics or attenuated live/live vaccines as the risk caused due to the side of these medications can be increased by Prednisolone
  • Barbiturates, ephedrine, carbamazepine, hydantoins or rifampin as they can reduce the efficacy of Prednisolone.
  • Anticoagulants, hydantoins, inactivated or killed vaccines as their efficacy can be decreased by Prednisolone

Using Prednisolone the right way

Use Prednisolone exactly as prescribed by the doctor. You can also check the label to know about right dosing instructions. Take Prednisolone orally with food. In case you miss a dose of Prednisolone, take it as soon as you remember else if it is the time for you next dose, skip the missed dose. Do not take extra dose to make up for the missed dose.

 

Methylprednisolone- Treating different inflammatory conditions effectively

Methylprednisolone is a steroid that helps preventing the flow of substances in the body that cause inflammation. Methylprednisolone is used to treat different medical conditions like psoriasis, allergic disorders, lupus, arthritis, ulcerative colitis and conditions that can affect stomach, skin, lungs, eyes, blood cells and nervous system.

Important Information

Avoid using this medication if you have a fungal infection in your body. Before you use Methylprednisolone, discuss with your doctor about your medical conditions and other medication that you are using. There are several diseases that can be influenced by the use of steroid and many other drugs can interact with these steroids.

Methylprednisolone can make your immune system weak and your body tends to get an infection easily or it can make the existing infection worse. In case you have any infection or illness in the past couple of weeks or at present, tell your doctor without any hesitation.

Stay away from people who are having infections or are sick. Call your physician for preventive treatment if you come in contact with measles or chickenpox virus. Do not stop taking Methylprednisolone all of a sudden, talk to your doctor for dosage adjustments.

Let your doctor know if you have any of these health problems

  • encountered head injury recently
  • liver or kidney disease
  • blood pressure or heart disease
  • cataracts/glaucoma
  • thyroid disorder
  • tuberculosis
  • pinworms
  • epilepsy or seizures
  • if you use aspirin in high doses or on a daily basis
  • if you use oral medication for diabetes or insulin
  • high calcium levels in blood associated with cancer
  • mental illness or depression

Dosing Information

If you miss a dose of Methylprednisolone, you should seek medical help and in case of overdose, call poison control centre. An overdose of Methylprednisolone though doesn’t lead to any life threatening effects, still long term use of steroids or taking in high doses can lead to serious side effects like easy bruising, thinning skin, increased facial hair or acne, impotence or menstrual problems.

Normal Adult Dose – Allergic Rhinitis:

Acetate: 80 -120 mg intramuscular only.

Normal Adult Dose – Dermatologic Lesion:

Acetate: 40-120 mg intramuscular – weekly for 1-4 weeks.

Usual Adult Dose – Rheumatoid Arthritis:

Acetate: 40 -120 mg intramuscular- weekly
Large joints: 20-80 mg intraarticular
Medium joints: 10-40 mg intraarticular
Small joints: 4-10 mg intraarticular

 

Methylprednisolone and pregnancy

It is still known whether using Methylprednisolone during pregnancy can harm unborn baby or not. It is better to discuss with your doctor if you planning to become pregnant or you are pregnant.

Methylprednisolone and breastfeeding

There are still no evidences available that state whether using Methylprednisolone during breastfeeding is safe or not for the baby or whether the medication secretes in breast milk.

Side effects

  • eye pain, tunnel vision, blurred vision
  • unusual pain in back, leg or arm
  • changes in personality, unusual behaviour or thoughts, severe depression
  • breathlessness, fast weight gain, swelling
  • convulsions
  • tarry or bloody stools
  • low potassium

Common side effects

  • weakness or mild pain in muscles
  • headache
  • bloating or stomach discomfort

Hydrocortisone- A corticosteroid that treats many skin conditions too

Hydrocortisone is a corticosteroid that is used to treat severe allergies, multiple sclerosis, asthma, arthritis and various skin conditions. It prevents the tissues from reacting to inflammation. It also changes the response of our body to immune stimulation.

Avoid using Hydrocortisone if

  • If you have a fungal infection
  • you are allergic to a specific ingredient present in Hydrocortisone
  • you are using mifepristone

Some medical conditions can interact with Hydrocortisone. Speak to your doctor if the following medical conditions are applicable to you

  • If you are allergic to certain types of substances, food or medicines
  • Have a history of kidney or liver problems, overactive thyroid, high BP, oesophagus inflammation, stomach problems, heart attack, heart problems, bowel problems, bowel blockage, mood or mental problems gravis or ulcerative colitis.
  • If your live viral vaccination or any other vaccination is scheduled
  • if you are planning to become pregnant, if you are pregnant or you are  a nursing mother
  • if you are using any prescription/non prescription medicine, dietary supplement or herbal preparation

Dosing information

Normal Adult Dose – Adrenocortical Insufficiency

Acute Adrenal Gland Failure:
100 mg IV bolus, then 300 mg/day in split doses after every 8 hours

Or same like continuous dosing for about 48 hours.

When patient is stable, the dose can be changed to oral, 50 mg after every 8 hours for 6 doses,

Then adjust the dose to 30 – 50 mg per day

Usual Adult Dose – Anti-inflammatory

Oral, Intravenous or, Intramuscular: 15-240 mg  per day

Usual Adult Dose- Shock

200 mg/day by continuous intravenous dosing

Side effects- Major

More common

  • blurred vision
  • agitation
  • Aggression
  • blurred vision
  • anxiety
  • nervousness
  • weight gain
  • breathlessness
  • rattling or noisy breathing
  • headache
  • irritability
  • trouble speaking, walking or thinking

Drug Interactions

Discuss with your health care provider if you are using any other medications apart from Hydrocortisone. They can be illegal drugs, herbal, dietary, nutritional, dietary drugs especially

  • Aspirin
  • Arthritis medications
  • Cyclosporine
  • Estrogen
  • Digoxin
  • Theophylline
  • Phenytoin
  • Phenobarbital
  • Ketoconazole
  • Vitamins
  • Rifampin
  • Anticoagulants

You should also restrict the amount of alcohol you take while using oral Hydrocortisone especially if you take aspirin in large doses, take arthritis medicines or have a history of stomach ulcers.

Hydrocortisone and pregnancy

Since there are no evidences available that explain whether use of Hydrocortisone is safe or not during pregnancy, it is recommended that pregnant should avoid using Hydrocortisone during pregnancy. Check with your doctor to make sure if it is safe to use this medication while you are pregnant.

Hydrocortisone and breastfeeding

There are not adequate studies available to justify the use of Hydrocortisone during breast feeding, so breastfeeding moms should avoid using Hydrocortisone. Get in touch with your doctor to find out more.

Make sure you discuss about your medical conditions and the medicines you are using before you start using Hydrocortisone and take Hydrocortisone as recommended by the doctor.

 

Cortisone- A steroid that helps fight inflammation effectively

Cortisone is a steroid that helps to treat inflammation and many other health problems like skin conditions, allergic disorders, arthritis, ulcerative colitis, lupus, breathing disorders and psoriasis.

Important information

Avoid using Cortisone if you are allergic to the medication or if there is a fungal infection in your body. Before you start using Cortisone, let your doctor know about your medical conditions and other medicines that you use. There are certain diseases that can be affected by the use of steroids and similarly some other drugs can interact with steroids.

You might need a change in dosage if you have undergone a surgery, or you are ill, have an infection or fever or you are under stress. Do not change the dose of this medication without asking your doctor. Try to stay away from people having infections or who are sick. You should call your physician for preventive treatment if you come in contact with virus causing measles or chicken pox. These conditions can be severe               or fatal in patients using steroids.

To make sure whether Cortisone is safe for you or not tell your physician if you have

  • osteoporosis
  • kidney disease
  • diabetes
  • thyroid disorder
  • glaucoma/cataracts
  • tuberculosis
  • history of malaria
  • mental illness/depression
  • high BP

Dosing information

Normal Adult Dose – Adrenal Insufficiency

25 mg – 300 mg/day to be taken orally or IM, in 1 to 2 split doses.

Normal Adult Dose – idiopathic (Immune) – Thrombocytopenic Purpura:

25 mg – 300 mg/day to be taken orally or IM, in 1 to 2 split doses.

Normal Usual Adult Dose – Shock

25 mg – 300 mg/day to be taken orally or IM, in 1 to 2 split doses.

If you miss a dose of Cortisone, take it as soon as you recollect, else if it is almost the time for your next scheduled dose, then do not take the missed dose. Do not take extra dose to make up for the dose you missed.

Overdose

Call poison control centre in case of overdose.  Though overdose of Cortisone is not life threatening, but taking high doses of steroids for a long term can lead to some serious symptoms like easy bruising, thinning skin, increased facial hair or acne and menstrual problems.

Cortisone and Pregnancy

There is still no documented data available that clarifies whether use of Cortisone during pregnancy can harm the unborn baby. Inform your health care provider if you get pregnant, planning to conceive while you are on this medication.

Cortisone and breastfeeding

Cortisone can secrete in breast milk and can harm the breastfeeding baby. Avoid breastfeeding while you are on Cortisone.

Side effects – Cortisone

  • vision problems
  • low potassium
  • unusual thoughts, behaviour, severe depression or convulsions
  • tarry or bloody stools
  • high BP
  • breathlessness, fast weight gain or swelling
  • pancreatitis

Less serious- Side effects

  • increased sweating
  • sleep problems
  • dry skin, acne, discoloration, thinning skin or bruising
  • stomach pain, nausea or bloating
  • mood changes
  • slow healing of wound
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