Prednisone is an anti-inflammatory and immunosuppressive steroid drug (partly immunosuppressive), which is an analogue of hormones that are produced by adrenal glands. Prednisone is a prodrug, because it is an inactive precursor of prednisolone. Once it gets into the body, prednisone is activated in the liver and converted into therapeutically active prednisolone. For this reason, prednisone is not recommended for people with severe liver disease because in this case, part of the drug will simply remain inactive and the target therapeutic dose will not be achieved.
Prednisone is used in the treatment of systemic connective tissue diseases (systemic lupus erythematosus, vasculitis, rheumatoid arthritis, etc.), severe allergic reactions (swelling), bronchial asthma, inflammatory eye diseases, skin diseases, many kidney diseases, brain edema, blood diseases, etc. Prednisone is also used to eliminate vomiting and nausea associated with chemotherapy and to stimulate appetite in people with cancer.
Prednisone is similar to cortisone by its nature of action, but has more active anti-inflammatory effect and less pronounced side effects.
Prednisone is by 4 times more effective than cortisone by its anti-inflammatory effect and requires lesser dose for treatment. This drug maintains the desired concentration in the blood longer than cortisone and its effect begins earlier. Specialists use this drug to treat a huge number of inflammatory, autoimmune and oncological diseases.
Both doctors and patients need to know the possible side effects of prednisone in order to take prophylactic measures and reduce health risks.
The side effects of Prednisone depend on:
1) The duration of treatment, that is, the time, during which the patient takes prednisone. The longer the treatment without a break, the greater the risk of side effects.
2) A daily corticosteroid dose – the quantity of the drug that the patient receives daily. The higher the prednisone doses taken, the greater the likelihood of side effects.
3) Keeping the circadian rhythm. Prednisone is best absorbed in the morning, because this is the time when natural glucocorticoids are released into the blood and the risks of side effects of treatment are reduced.
If you have any of the side effects mentioned above or other unusual reactions when taking prednisone, you should inform your doctor.
There are also some severe side effects. When they occur, you should immediately seek medical help:
Suppression of adrenal glands is one of the effects of prednisone in children. That is why the dependence of a young body on steroids increases, and the ability to produce its own corticosteroids is reduced. This can be prevented by gradual and not sudden withdrawal of the medicine. It is also possible for a child to develop type 2 diabetes, obesity, and hirsutism. Many side effects in children are associated with fast growth and development of the organism. Therefore, the targets of side effects are organs and systems that are mostly affected by developmental changes. This may result in loss of bone density, increased fractures, peptic ulcers, increased blood pH level (alkalosis).Children more often get neurological problems while taking prednisone: mood swings, insomnia, hyperactivity, and depression.
According to some studies, there is a very small risk of cleft lip or cleft palate in children whose mothers took prednisone during the first 13 weeks of pregnancy. There is also a very small risk of preterm birth. One study revealed a small risk of low-weight births in women treated with prednisone during pregnancy. The available data are insufficient for scientists to firmly determine whether these problems are caused by prednisone, or whether they arose because of the peculiarities of the organism and the health of the pregnant women.
In any case, pregnant women in need of corticosteroid therapy must not refuse prednisone treatment, because the probabilities of side effects usually do not exceed the health risk to women in case of refusal of treatment. It is important to consult your doctor before deciding to accept or refuse treatment.
Most of the side effects of prednisone are reversible. Unfortunately, it is not always possible to stop taking prednisone, even under severe side effects. So doctors have to additionally prescribe drugs for the treatment of the side effects of steroids. There are situations where a patient together with a doctor has to weigh the advantages and disadvantages of prednisone and make an informed decision about further treatment. Nevertheless, it is very important to remember that prednisone can not only cause side effects but also significantly improve life quality and life expectancy.
It is also worth remembering that every medicine can cause side effects, but many people may witness little or no side effects. When used properly, prednisone helps protect internal organs from damage caused by diseases, and in many cases even saves lives.