Although it can be used in the treatment of high blood calcium resulting from cancer-related conditions, prednisone still remains a glucocorticoid medication that is majorly used to alleviate inflammation through its immune system suppression characteristics. It is a glucocorticoid of synthetic origins that is used for its immunosuppressive and accompanying anti-inflammatory effects. Prednisone just like other members of the corticosteroid drug type (such as hydrocortisone and cortisone) is highly effective in the treatment of a wide variety of medical conditions such as asthma, lupus and even rashes. The ability of prednisone to alleviate inflammation is especially appreciated by patients suffering from obstructive lung diseases (such as chronic obstructive pulmonary disease, also known commonly as COPD), asthmatic patients and those with rheumatic related disorders (which are over 200 currently). It is also useful in the treatment of adrenal insufficiency when taken in collaboration with steroids. It is administered orally. It has a chemical formula of C21H26O5, and some of its most common trade names include Orasone, Deltasone, Adasone and a lot more.
Generally, corticosteroids imitate the effects of hormones produced in the adrenal glands. So, when the amount of corticosteroids in the body exceeds the normal levels (due to the intake of prescribed doses), a suppression effect is produced. The adrenal glands are located on top of the kidney. Although prednisone is metabolized by the liver, it needs to, first of all, be converted to prednisolone before activating. Before this conversion to prednisolone is done, prednisone could be said to exhibit no biological effect of significant value. This prednisolone would proceed to bind to the glucocorticoid receptors which leads to the activating of the receptors. The metabolites of prednisone or prednisolone (after conversion) are excreted via the bile and urine. But with a half-life of about 2 to 3 hours, it is absorbed in the gastrointestinal tract and is removed with the aid of hepatic metabolism while Cytochrome P450 serves as the active enzyme.
Its use for medical purposes was approved in the year 1995, but it was patented a year earlier in 1994. Its widespread use became quite evident in the United States of America in the year 2016, when it was found to be the 31st most prescribed drug with an average of more than 23 million registered prescriptions.
These drugs could be used to minimize the chances of organ rejection occurring in cases of transplant recipients by suppressing the immune system. Addison disease is also one that could be treated by use of these drugs because this disease is a situation where the body (precisely the adrenal glands) cannot on its own produce the minimum amount of corticosteroids it needs. Although corticosteroids have a wide range of therapeutic used, they are also associated with a wide range of risks or side effects. But this is not really much of a concern as long as one adheres vehemently to the directives offered by the doctor or physician while withholding no health-related information and regularly visiting the doctor for check-up sections.
Prednisone medications are preferably taken with food or in some cases milk; it all depends on what exactly the physician directs. Use of this medication requires that you strictly abide by the requirements and directives of your physician. Also, bear in mind that whatever dosage is currently prescribed to you is based on your medical history and that the future development of the administered dosages would be based on the improvements shown by the current treatment regimen. It would be advisable to take the oral doses or tablet with a sufficient quantity of water (about 240 milliliters, which is one full glass). The use of sufficient water should not be neglected unless otherwise stated by the doctor or physician. While the use of the solution or liquid forms would require that you use a specific measuring spoon or device in order to get the appropriate dosage. Assuming you are told to take only one dose per day, ensure to take it before 9 in the morning.
Like some other medications, the use of prednisone needs to be carefully and strictly monitored. This means that the use of the medication should not be terminated suddenly based on the whims of the patient. If there is a need to stop usage of the drug, the doctor or physician would most likely do that by slowly reducing the dosage administered or prescribed. This is because the sudden termination of use could lead to further complications that could serve as a massive set back to the development and advancement already achieved by the treatment. Moreover, sudden termination of use could lead to some unpleasant symptoms such as nausea, dizziness, weakness, muscle pain, weight loss tiredness and even sudden bouts of headaches.
Additionally, the use of prednisone should be closely monitored because, after a certain amount of time (about seven days), critical adrenal suppression would set in. This is a serious case because this would temporarily deprive the body of the ability to naturally manufacture corticosteroids, most especially cortisol. This deprivation would eventually lead to a sort of dependence of the body on the drug (prednisone). This is not so bad if it occurs as a result of the doctor`s instructions. But those instructions must be strictly followed. This is the reason why the use of the drug is not to be suddenly stopped if used longer than seven days. Instead, according to the directions of the doctor, it should be slowly withdrawn to give the system a chance to break free of this dependence and slowly revert to the process of naturally manufacturing corticosteroids. This process of reverting to its original state could be as short as a few days or as long as some months. But this process should be kept under strict professional watch to ensure that a relapse does not occur. Patients eligible for this slow withdrawal are those that their conditions have negligible or zero chances of relapsing and have:
- More than 3 weeks of treatment
- Above 40 mg of prednisone (or its equivalent) on a daily bases for more than a week.
- A short duration of use within a year of having previously terminated use of the drug.
- Another reason for the occurrence of adrenal suppression.
Prednisone has about three other sources of administration exempting oral. These routes all have their benefits as well as associated side effects. They are:
- Oral administration of prednisone: This route is one that is most likely to cause an effect on a systemic level as it gives access to your entire body. That is to say, if this route has any side effects, the entire body is likely to be affected. Syrups or tablets or capsules are associated with this route. It is majorly used in the treatment of chronic conditions such as lupus, rheumatoid arthritis. Some effects that the use of this route could elicit due to short term use of prednisone include:
- Increased or high blood pressure
- Depositing of fat in the abdomen, posterior region of the neck and even the face. This leads to a general weight gain.
- Glaucoma or significant increment in pressure in the eyes
- Occasional mood swings together with memory, behavioral and other psychological issues
- Swelling in the lower legs caused by an excessive degree of fluid retention, etc.
While the longer duration of usage could cause effects such as:
- Increased blood sugar levels which could worsen or even trigger diabetes.
- Longer time is taken to heal injuries accompanied by thin skin and occasional signs of bruising.
- Cataract in one or both eyes (indicated by the presence of “clouds” in the eyes).
- The severe case of fatigue, muscle weakness, loss of appetite and even nausea, all point to a suppression of the hormones of the adrenal glands.
- Parenteral route (inhalation) of administration: The use of this route involves employing inhalers and nasal sprays. The use of this route is usually associated with nasal allergies and asthma occurrences. But the use of this inhalers could lead to the drug depositing in the mouth and in the throat, as not all would make it to the lungs. Some effects of this could include:
- Hoarseness of voice
- The occurrence of oral thrush which is related to fungal infections.
But these effects could be controlled to some extent by simply rinsing the mouth with water after each use of your inhaler. Do not swallow the water used for the rinsing.
- Topical route: This is associated to use of ointments and creams for the treatment of dermal conditions. This could lead to conditions that are evident on the skin such as acne, thin skin and also red skin lesions.
- Parenteral route (majorly injections): Muscles and joint related issues are majorly targeted via this route. The issues treated via this route could include inflammation of the tendinitis and associated pain. This route is rarely used as physicians try to limit its use to a minimum of three times a year. The side effects associated with this route are based on the injection itself such as post-injection flares, skin thinning and even loss of color in the skin. Other effects include:
- High blood sugar and
Most of the above-mentioned side effects are applicable to corticosteroids in general. Side effects that are specific and common to prednisone include:
- Insomnia or difficulty sleeping
- Increased secretion of sweat
- Gain of appetite
- Increased sensitivity of teeth
- Truncal weight gain
- Changes to the menstrual cycle
- Dry skin
Some more severe side effects of prednisone (in addition to the ones general to corticosteroids) include:
- Excretion of bloody stool.
- Irregular heartbeat
- Mouth sore and dryness of mouth
- Leukocytosis (above average white blood cell count)
- Numbness and tingly feeling
- Cushing`s syndrome
- Peptic ulcer
- Stretch marks
- Increased thirst and urination.
The occurrence of some side effects require immediate medical attention and could be incredibly rare. These include:
- Increased difficulty breathing
- Allergic reactions such as swelling. This is more so if the reactions occur on the face, tongue or in the throat)
- Blood clot found in the vein
- Total stoppage of heart.
- Liver enlargement
These lists are to a large extent somewhat comprehensive but do not contain every possible side effect. So if you notice anything unusual, it would be wise to immediately consult your doctor.
Ways to Reduce risk of Experiencing Side Effects of Short Term Use of Prednisone
- If nonoral forms of your treatment are available, they would be a wiser choice. These nonoral forms include inhalers (especially for asthmatic patients) and have little interaction with the rest of the body as they go straight to the lungs. Hence they are less likely to elicit a side effect that affects the body as a whole (drastically).
- Consider using vitamin supplements (especially vitamin D supplements) and also calcium supplements.
- Get regular check-ups.