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Prednisone (Generic)
Prednisone
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Prednisone

What is Prednisone?

Prednisone, a corticosteroid belonging to a group of such medications, can treat a variety of conditions. However, it is normally used for:

  • allergic reactions
  • skin conditions
  • severe asthma
  • arthritis

Prednisone is also used for:

  • steroid deficiency
  • some blood disorders
  • certain cancers
  • ulcerative colitis

How does it work?

Prednisone suppresses the body’s immune response and reduces swelling, inflammation, and irritation. When the body does not produce enough, it can also replace steroids.

It normally takes only one to two hours for prednisone to begin working, so it is quite quick. However, it can be up around six hours before the extended-release tablets start working.

While the therapeutic effects will end soon after prednisone has been discontinued, side effects may take a little longer to dissipate if you have been taking it for a long time.

While most patients may only take prednisone for a few days, some may need to take it for a longer period, or even for the rest of their lives.

If stopping treatment with prednisone after taking it for a long time, you may need to gradually taper off.

Dosage

The dose you are given by your doctor may vary according to the condition for which you have been prescribed prednisone, as well as your circumstances. Many things might affect the dose you are prescribed. Your weight, other medical factors, and other medications you are on can have an impact. Do not take anything other than the dose you have been given by your doctor without first discussing it with them.

Prednisone should be taken with food to avoid having an upset stomach. If you have been taking it for an extended period and want to stop using it, you should discuss it with your doctor. Do not suddenly stop using prednisone, it should be gradually reduced over time in keeping with your doctor’s advice.

You should take prednisone regularly, as your doctor has prescribed it to you. If you miss a dose you should seek guidance from your doctor. However, do not attempt to give yourself two doses to make up for the one you missed.

Overdose

Using prednisone over a long time, or receiving high doses of it can result in

  • thinning skin
  • easy bruising
  • increased acne
  • increased facial hair
  • menstrual issues
  • impotence
  • loss of sexual appetite
  • physical changes, especially around the face, neck, back, and waist

If you or someone else has taken an overdose of prednisone, you should contact a doctor. If someone has collapsed or is no longer breathing after using prednisone, emergency services should be called.

Side Effects

If you are concerned about experiencing side effects from taking prednisone, you should talk it over with your doctor and weigh up the risks against the benefits. Many of these side effects may disappear over time or can be managed. Your pharmacist should be able to make recommendations for managing these side effects, however, you should contact your doctor if they become severe or significantly uncomfortable.

The side effects of prednisone are not experienced by everyone who takes it, but at least 1% of people taking this medication have experienced those listed below.

  • abdominal pain
  • acne
  • bloating
  • changed sense of taste
  • decreased fertility in men
  • diarrhea
  • dizziness
  • a general feeling of being unwell
  • headache
  • heartburn
  • hiccups
  • increased appetite
  • increased sweating
  • irregular menstrual periods
  • nausea
  • reddish-purple lines on arms, face, groin, legs, or trunk
  • thin, shiny skin
  • thinning hair
  • trouble sleeping
  • unusual increase in hair growth
  • unusual tiredness or weakness
  • vomiting
  • weight gain

More serious side effects

These serious side effects are rare but can cause serious issues if they are not addressed. If you experience any of these, you should see your doctor as soon as possible.

  • confusion
  • decreased or blurred vision
  • eye pain
  • false sense of well-being
  • filling or rounding out of the face
  • forgetfulness
  • hallucinations
  • increased blood pressure
  • irregular heartbeat
  • mood or behavior changes, such as:
    • aggression
    • rage
    • anxiety
    • excitation
  • muscle cramps or spasms
  • muscle weakness
  • pain in arms, back, hips, legs, ribs, or shoulders
  • signs of heart problems, such as:
    • fast, irregular heartbeat or pulse
    • chest pain
    • sudden weight gain
    • difficulty breathing
    • leg swelling
  • signs of infection, such as:
    • fever or chills
    • severe diarrhea
    • shortness of breath
    • prolonged dizziness
    • headache
    • stiff neck
    • weight loss
    • listlessness
  • skin rash
  • slowed growth in children
  • fluid retention symptoms, such as:
    • rapid weight gain
    • swelling of feet or lower legs
  • symptoms of depression, such as:
    • poor concentration
    • changes in weight
    • changes in sleep
    • decreased interest in activities
    • thoughts of suicide
  • symptoms of high blood sugar, such as:
    • frequent urination
    • increased thirst
    • excessive eating
    • unexplained weight loss
    • poor wound healing
    • infections
    • fruity breath odor
  • symptoms of a stomach ulcer, such as:
    • persistent abdominal or stomach pain
    • burning, bloody, black, or tarry stools
  • symptoms of tuberculosis reactivation, such as:
    • coughing blood
    • chest pain
  • unusual bruising
  • wounds that heal slowly

Side effects requiring urgent medical attention

If you experience any of the following side effects, discontinue the treatment and immediately seek the attention of a medical professional.

  • seizures
  • signs of scleroderma renal crisis, such as:
    • increased blood pressure
    • decreased urine production
  • symptoms of a severe allergic reaction, such as:
    • difficulty breathing
    • hives
    • swelling of the face, mouth, tongue, or throat

Side effects other than those listed above are possible. If any symptoms develop that worry you whilst taking prednisone, you should discuss them with your doctor.

Warnings & Precautions

Always check the ingredients of any medication you take for anything you may be allergic to. You should not take prednisone if you are allergic to it or any of its ingredients.

Make sure your doctor is aware of any medical conditions or allergies you have as this may impact whether or not they recommend prednisone for you.

You should not take prednisone if you:

  • are allergic to prednisone or any of its ingredients
  • have an internal fungal infection
  • have herpes simplex of the eye, are taking large immunosuppressive doses of prednisone, and will be given a live virus vaccine, such as:
    • measles
    • mumps
    • rubella
    • yellow fever
    • BCG
  • have measles or chickenpox, except for short-term or emergency treatment of allergic-type reactions
  • have stomach ulcers
  • have diverticulitis
  • have non-specific colitis
  • have a viral or bacterial infection that is not controlled by anti-infectives

Blood pressure

If you have or are at risk of developing high blood pressure your doctor should advise you as to how prednisone may affect your condition, and whether special monitoring is necessary.

Electrolytes and fluid

When taking large doses, salt intake may need to be limited and potassium supplements may be required. Your doctor will advise and monitor you with blood pressure checks and blood tests.

Eye problems

Use of prednisone over an extended time may lead to glaucoma, cataracts, or optic nerve damage. Tell your doctor of any eye pain, eye irritation, redness, discharge, or vision change.

Drug Interactions

Prednisone may interact with any of the following drugs, so if you are taking any of them you should let your doctor know or seek guidance from your pharmacist.

  • acetylsalicylic acid (ASA)
  • aldesleukin
  • amphotericin B
  • androgens, such as testosterone
  • antacids, such as:
    • aluminum hydroxide
    • calcium carbonate
    • magnesium hydroxide
  • anticholinesterase medications, such as:
    • neostigmine
    • pyridostigmine
  • aprepitant
  • aripiprazole
  • “azole” antifungals, such as:
    • itraconazole
    • ketoconazole
    • voriconazole
  • BCG
  • calcitriol
  • carbamazepine
  • celecoxib
  • cholestyramine
  • clarithromycin
  • cobicistat
  • colestipol
  • conivaptan
  • cyclosporine
  • deferasirox
  • delavirdine
  • denosumab
  • diabetes medications, such as:
    • chlorpropamide
    • glyburide
    • insulin
    • metformin
    • rosiglitazone
    • saxagliptin
  • diltiazem
  • diuretics (water pills), such as:
    • furosemide
    • hydrochlorothiazide
  • donepezil
  • echinacea
  • enzalutamide
  • estrogens, such as:
    • conjugated estrogen
    • estradiol
    • ethinyl estradiol
    • estrogen-containing birth control pills
  • fingolimod
  • galantamine
  • HIV protease inhibitors, such as:
    • atazanavir
    • darunavir
    • lopinavir
    • ritonavir
  • hyaluronidase
  • indacaterol
  • isoniazid
  • leflunomide
  • mifepristone
  • mitotane
  • natalizumab
  • nivolumab
  • nonsteroidal anti-inflammatory medications (NSAIDs), such as:
    • diclofenac
    • ibuprofen
    • ketorolac
    • naproxen
  • phenobarbital
  • phenytoin
  • pimecrolimus
  • primidone
  • quinolone antibiotics, such as:
    • ciprofloxacin
    • norfloxacin
    • ofloxacin
  • rifabutin
  • rifampin
  • roflumilast
  • salicylates, such as: ASA
  • somatropin
  • tacrolimus
  • tofacitinib
  • trastuzumab
  • vaccines or toxoids, such as:
    • BCG
    • measles
    • mumps
    • rubella
    • varicella
  • warfarin

Frequently Asked Questions

Prednisone may be prescribed for conditions other than those mentioned above. If you do not know why your doctor has prescribed it for you, you should ask them. It is important not to stop taking prednisone without discussing it with your doctor.

You mustn’t give your prescribed prednisone to anyone else. Even if they have the same symptoms as you, it can be harmful to them if they have not been prescribed it.

An interaction does not necessarily mean you need to stop taking one. You should speak with your doctor and they will be able to help you manage your medications.

It depends on the situation, but your doctor might suggest:

  • you stop taking the medication
  • you change to a different medication
  • change your dosage of prednisone, the other medication, or both
  • leave things as they are.

Other medications may interact with prednisone, you should inform your doctor of all prescription, over-the-counter and herbal medicines. They should be made aware of any supplements you’re taking. You should also tell your doctor if you smoke, use street drugs or consume caffeine products.

Prednisone should not be disposed of in wastewater or thrown out in the rubbish. You should seek the recommendations of your pharmacist to determine how best to dispose of the medication in your area.

The side effects of using prednisone may be complicated by consuming alcohol. Since steroids and alcohol both suppress the immune system, they can make fighting infections more difficult.

For those who are at risk of developing type 2 diabetes, consuming more than one or two alcoholic drinks each day while taking prednisone can further increase the risk.

The digestive tract can become irritated by alcohol and prednisone and potentially lead to peptic ulcers, particularly amongst those who are prone to stomach upsets.

Excessive alcohol consumption while taking prednisone can increase the likelihood of developing osteoporosis, especially since prednisone can lead to bones becoming thin and brittle.

There are tips you can use to try to offset some of the effects of prednisone.

  • Take it with a full meal to mitigate the potential damage to your digestive system. Antacids can also help.
  • You can keep your blood sugar levels stable by eating smaller meals throughout the day. Adopting a diabetic meal plan can help avoid steroid-induced diabetes.
  • Steroids can stop you from feeling full, even though you have eaten enough. So do not overeat, eat sensible portions.
  • Prednisone can make food seem bland, so avoid using additional salt and prevent water retention by limiting your salt intake.
  • Avoid sleep issues by cutting back on caffeine and nicotine.

Everyone’s situation is different, but a daily 40 mg dose may be considered high. Generally, a low dose is less than 7.5 mg daily, a moderate dose is between 7.5 mg and 40 mg daily and a high dose is between 40 mg and 60 mg daily.

There is no particular limit on how long it is safe to take prednisone. It depends on your dose and your condition. Your doctor will advise you based on how well you respond to the medication.

Straight after breakfast is a good time to take your single dose.

Prednisone may stay in your system for between 16.5 to 22 hours. Some factors can affect how long it remains in your system. These include:

  • How much you take and how often
  • Your metabolic rate
  • Your age and condition
  • Your body mass

Prednisone should be stored at room temperature and should be kept away from children.

You should be cautious about taking prednisone and ibuprofen if you have had a history of stomach issues since they can affect the gastric lining leading to severe gastric issues.

However, you can mitigate the risk by taking the tablets with a meal.

If you experience side effects, you should let your doctor know. They may be able to prescribe another medication.