Prednisone

What is prednisone?

Prednisone is used to treat many illnesses associated with inflammation, such as asthma, COPD, rheumatoid arthritis, gout, ulcerative colitis, Crohn's disease and other auto-immune diseases. 

Prednisone works by calming or suppressing the body's immune system and is especially effective for treating flare-ups of these conditions. Prednisone helps to reduce the symptoms associated with these conditions – it does not cure them.

Prednisone is in a class of medicines known as corticosteroids, which is similar to the steroid hormones your body naturally makes. In New Zealand prednisone is available as tablets in different strengths: 1 mg, 2.5 mg, 5 mg and 20 mg.  

Dose

• The dose of prednisone will be different for different people, depending on your condition.
• Doses range from 5 mg to 60 mg daily.
• Some people may need a short course of prednisone (such as 5 days), while others may need to take it for longer (weeks to months).   
• Prednisone tablets come in different strengths. Check the strength of your tablets and the dose you are prescribed. Often you may need to take more than one tablet. If you are unsure about your dose or the number of tablets to take, ask your pharmacist. 
• Always take your prednisone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much prednisone to take, how often to take it, and any special instructions.

How to take prednisone

• Timing: Take your prednisone tablets with food and with a full glass of water. If you take it once a day or every second day, then it is best taken at breakfast time. If it needs to be taken more than once a day, then space your doses out during the day. Try not to take it too close to bedtime because it may keep you awake.
• Missed dose: If you forget to take your dose, take it as soon as you remember. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose and try not to take it too close to bedtime because it may keep you awake.
• Stopping prednisone: If you have been taking prednisone regularly for longer than 2 weeks, do not stop it suddenly. Stopping suddenly can cause withdrawal symptoms, which can be serious, or even life-threatening. Instead, you will be given a tapering dose meaning your dose of prednisone will be gradually reduced over a few days or weeks.

Precautions when taking prednisone

Before starting prednisone

• Do you have problems with your heart or blood pressure?
• Do you have diabetes, epilepsy or osteoporosis?
• Do you have problems with your liver or kidneys?
• Do you have problems with your stomach such as ulcerative colitis or stomach ulcers?
• Do you have glaucoma?
• Are you pregnant?
• Do you play competitive sport?
• Are you taking or using any other medicines? This includes any medicines being taken which are available to buy without a prescription, as well as herbal and complementary medicines.

If so, it’s important that you tell your doctor or pharmacist before you start prednisone. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

While taking prednisone

• Tell any health professional: It's important to tell any health professional taking care of you that you are taking prednisone. 
• Increased risk of infections: Taking prednisone for a long time can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness such as chickenpox or measles, or feel unwell.  
• Vaccines:  It is safe to have most vaccines including the flu vaccine while you are taking prednisone. Protecting yourself against infection is important because prednisone suppresses your immune system. However, vaccination with 'live vaccines' should be postponed. Ask your doctor for advice before you have any vaccines while you are taking prednisone.  

Side effects

Like all medicines, prednisone can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking prednisone for. Read more about taking steroids long-term.

Interactions

Prednisone interacts with a number of medications and herbal supplements so check with your doctor or pharmacist before starting prednisone or before starting any new medicines. 

Learn more

The following links have more information on prednisone.

Prednisone Rheuminfo
Prednisone (Māori) New Zealand Formulary Patient Information

References

1. Prednisone New Zealand Formulary