Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders.

General Information

Steroid drugs, such as prednisone, work by lowering the activity of the immune system. The immune system is your body’s defense system. Steroids work by slowing your body’s response to disease or injury. Prednisone can help lower certain immune-related symptoms, including inflammation and swelling.

Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders. Prednisone belongs to a class of drugs known as corticosteroids. It decreases your immune system's response to various diseases to reduce symptoms such as swelling and allergic-type reactions. Prednisone can also help avoid organ rejection after a kidney transplant, because of its ability to lower your immune system’s response to the new kidney. The body recognizes a transplanted organ as a foreign mass. This triggers a response by the body’s immune system to attack it.

How should I take?

Take this medication by mouth, with food or milk to prevent stomach upset, as directed by your doctor. Take the tablet form of this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you are prescribed only one dose per day, take it in the morning before 9 A.M. Take this medication exactly as directed by your doctor. Follow the dosing schedule carefully. The dosage and length of treatment are based on your medical condition and response to treatment. If you are taking this medication on a different schedule than a daily one (such as every other day), it may help to mark your calendar with a reminder. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away. Tell your doctor if your condition persists or worsens.

Dosage and Administration

Glucocorticoid-Responsive Conditions

5-60 mg/day PO in single daily dose or divided q6-12hr

Dosing considerations

Acute Asthma

40-60 mg/day PO in single daily dose or divided q12hr for 3-10 days

Giant Cell Arteritis

40-60 mg PO qDay (1-2 years usual duration of treatment)

Idiopathic Thrombocytopenic Purpura

1-2 mg/kg/day PO

Dose Tapering

Day 1: 10 mg PO before breakfast, 5 mg after lunch and after dinner, and 10 mg at bedtime

Day 2: 5 mg PO before breakfast, after lunch, and after dinner and 10 mg at bedtime

Day 3: 5 mg PO before breakfast, after lunch, after dinner, and at bedtime

Day 4: 5 mg PO before breakfast, after lunch, and at bedtime

Day 5: 5 mg PO before breakfast and at bedtime

Day 6: 5 mg PO before breakfast

Rheumatoid Arthritis

Immediate-release: ≤10 mg/day PO added to disease-modifying antirheumatic drugs (DMARDs)

Delayed-release: 5 mg/day PO initially; maintenance: lowest dosage that maintains clinical response; may be taken at bedtime to decrease morning stiffness with rheumatoid arthritis

Advanced Pulmonary/Extrapulmonary Tuberculosis

40-60 mg/day PO, tapered over 4-8 weeks

Autoimmune Hepatitis

60 mg PO qDay for 1 week; THEN 40 mg qDay for 1 week; THEN 30 mg qDay for 2 weeks; follow by 20 mg qDay; give half this dose if giving in combination with azathioprine

COVID-19 (Off-label)

NIH guidelines recommend corticosteroids (preferably dexamethasone) to reduce mortality in hospitalized patients with COVID-19 disease who are receiving either invasive mechanical ventilation or oxygen alone, but not among those receiving no respiratory support

If dexamethasone is unavailable, use alternant glucocorticoids (eg, prednisone, methylprednisolone, or hydrocortisone)

Prednisone 40 mg PO qDay for up to 10 days or discharge, whichever comes first; use in addition to standard of care

Consider prednisone use as follows

Pneumocystis (carinii) jiroveci Pneumonia in Patients With AIDS (Off-label)

40 mg PO q12hr for 5 days, then 40 mg PO q24hr for 5 days, then 20 mg q24hr for 11 days

Crohn Disease (Off-label)

40-60 mg PO qDay until resolution and resumption of weight gain (7-28 days usual duration)

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.If this medication is used for an extended time, laboratory and/or medical tests (such as blood mineral levels, blood glucose, complete blood count, height/weight measurements, bone density tests, blood pressure, eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.This medication may cause bone problems (osteoporosis) when taken for an extended time. Lifestyle changes that may help reduce the risk of bone problems include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. Discuss with your doctor lifestyle changes that might benefit you.

Missed Dose

If you are taking this medication daily and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.If you are taking this medication on a different schedule than a daily one (such as every other day), ask your doctor ahead of time about what you should do if you miss a dose.

Side Effects

Nausea, vomiting, loss of appetite, heartburn, trouble sleeping, increased sweating, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if any of these unlikely but serious side effects occur: muscle pain/cramps, irregular heartbeat, weakness, swelling hands/ankles/feet, unusual weight gain, signs of infection (such as fever, persistent sore throat), vision problems (such as blurred vision), symptoms of stomach/intestinal bleeding (such as stomach/abdominal pain, black/tarry stools, vomit that looks like coffee grounds), mental/mood changes (such as depression, mood swings, agitation), slow wound healing, thinning skin, bone pain, menstrual period changes, puffy face, seizures, easy bruising/bleeding. This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet. A very serious allergic reaction to this product is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: aldesleukin, mifepristone, drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, "blood thinners" such as dabigatran/warfarin, NSAIDs such as aspirin/celecoxib/ibuprofen). If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details. This medication may interfere with certain laboratory tests (including skin tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Pregnancy & Lactation

Pregnancy

Based on findings from human and animal studies, therapy can cause fetal harm when administered to a pregnant woman

Published epidemiological studies suggest a small but inconsistent increased risk of orofacial clefts with use of corticosteroids during first trimester; intrauterine growth restriction and decreased birth weight have also been reported with maternal use of corticosteroids during pregnancy; however, underlying maternal condition may also contribute to these risks

Infants born to pregnant women who have received corticosteroids should be carefully monitored for signs and symptoms of hypoadrenalism

Animal data

Lactation

Prednisolone has been found to be present in human milk following administration to lactating women; published reports suggest infant daily doses are estimated to be less than 1% of maternal daily dose; no adverse effects in breastfed infant have been reported following maternal exposure of prednisolone during breastfeeding

There are no available data on effects of drug on milk production; high doses of drug administered to lactating women for long periods could potentially produce problems in breastfed infant including growth and development and interfere with endogenous corticosteroid production

Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed child from drug or from mother’s underlying condition

In order to minimize exposure, prescribe lowest dose to lactating women to achieve desired clinical effect.

Warnings

Before taking prednisone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: current/past infections (such as fungal infections, tuberculosis, herpes), heart problems (such as heart failure, recent heart attack), high blood pressure, thyroid problems, kidney disease, liver disease, stomach/intestinal problems (such as ulcer, diverticulitis), bone loss (osteoporosis), mental/mood disorders (such as psychosis, anxiety, depression), eye diseases (such as cataracts, glaucoma), diabetes, mineral imbalance (such as low level of potassium/calcium in the blood), seizures, blood clots, bleeding problems. Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details. The liquid form of this medication may contain sugar and/or alcohol. Caution is advised if you have diabetes, liver disease, or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely. This medication may cause vaccines not to work as well. Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose). This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. Limit alcoholic beverages. Consult your doctor or pharmacist for more information. Older adults may be more sensitive to the side effects of this drug, especially bone loss/pain, stomach/intestinal bleeding, and mental/mood changes (such as confusion). This medication may slow down a child's growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child's height and growth can be checked. During pregnancy, this medication should be used only when clearly needed. It may rarely harm an unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended period of time may have hormone problems. Tell your doctor right away if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn. This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

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