What is Prednisone?
Prednisone is a corticosteroid medication that can also be called prednisolone or cortisone. The human body produces natural corticosteroids in the adrenal glands. They are hormones that affect almost every body system. When the body is fighting an inflammatory condition, sometimes the adrenal glands cannot produce the amount of corticosteroids needed to calm the inflammation. Prednisone is a strong anti-inflammatory medication that is used for many medical maladies such as asthma, arthritis, skin diseases and rashes, adrenal diseases, blood disorders, gastrointestinal diseases, inflammatory disorders of organs, and more.
Even though doctors think of prednisone as somewhat of a miracle drug when needed, patients may encounter side effects listed below.
Effects on the Immune System
Even though prednisone is given to calm an inflammatory condition, this medication can impair the immune system, masking the symptoms of an infection and making it easier to contract a new one. Because of this situation, patients taking corticosteroids should avoid people with current infectious diseases. Contact your physician as soon as you feel symptoms of a viral, bacterial or fungal infection.
Taking doses of prednisone with food is important to prevent stomach and GI upset. Also, stay away from grapefruit juice as this doubles the amount of some corticosteroids in the blood.
Fluid Retention and Weight Gain
The use of prednisone may cause the body to retain salt and water. This fluid retention may cause the blood pressure to increase. Some patients may see an increase in weight, which may be part of the fluid retention. For some patients on long-term prednisone (over 20mg per day) may find their weight increasing, especially in the face, making it look round or “moon shaped." Weight gain may also be noticed in the abdomen and around the hips.
Patients may also find that they bruise easily while on corticosteroids. The tiny blood vessels under the skin break easily and leak fluid into the skin – because of this a bruise will appear.
Bone and Muscle Problems When Using Prednisone
A side effect of taking prednisone is muscle weakness. A patient may find that muscles in their body feel weaker, especially in the thighs and arms. This effect is reversible when levels are lowered or patients are weaned off this medication.
If a patient is on prednisone for a long period of time, this increases the likelihood of developing osteoporosis, which is brittle bones. Patients on prednisone for a lengthy time should have their physicians perform a DEXA scan to measure bone loss. If the bone density is very low and shows signs of osteoporosis, patients may be put onto prescribed medication to counteract the effects of the corticosteroids. All patients should make sure they consume several servings of dairy products or calcium supplements daily.
The most severe, but rare, side effect on bones is developing avascular necrosis of the hip for patients on long-term and high doses of prednisone. Severe pain develops in the hip due to a lack of blood supply. Sometimes a hip replacement will be needed.
Blood Chemistry May Change
When taking prednisone, patients should have their blood chemistry monitored by their physician. Corticosteroids may cause the body to lose potassium, which is necessary to maintain heart function and muscle contractions. A patient may need to eat more fruits which contain potassium such as bananas, prunes, and apricots. A physician may also prescribe a potassium supplement.
Another electrolyte that needs to be measured is glucose. It may elevate as a side effect of taking prednisone. Patients with diabetes must stay in contact with their physicians and monitor their blood levels in order to stabilize blood sugar. This condition is reversible when the dosage is lowered or a patient is taken off the medication.
Never suddenly stop taking prednisone and follow your physician’s instructions closely when weaning off this medication. While on corticosteroids, the body has stopped producing its own natural steroids. Weaning off slowly will allow the adrenal glands to begin production of the natural hormone that serves a necessary function in the body.
The side effects of taking prednisone may sound scary, but not all patients undergo all these symptoms. A patient has been given this medication to help a medical condition. Just make sure to follow the physician’s and pharmacy instructions.
The Pill Book 13th Edition by Harold M. Silverman; Bantam Books, 2008
The 24-Hour Pharmacist by Suzy Cohen, RPh; Rodale, 2008
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