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Prednisone

WHAT IS PREDNISONE?

Prednisone is a synthetic hormone commonly referred to as a "steroid". Prednisone is very similar to the hormone Cortisone, which your own body manufactures. Prednisone is used to treat many illnesses.

HOW DOES PREDNISONE WORK?

  1. Prednisone acts in part as an immunosuppressant. "Immune" refers to the immune system. The immune system protects you against foreign bacteria, virus, etc. In some illnesses, the immune system produces antibodies which become overactive and cause undesirable effects. Prednisone suppresses the production of antibodies. This can make it slightly harder for your to fight off infection, but also stabilizes the immune system if it is overactive.
  2. Prednisone also works against inflammation to reduce the heat, redness, swelling, and pain.
  3. When beginning Prednisone, there is a small chance that it may cause increased weakness for a short period of time. It therefore may be necessary for you to be hospitalized for the first few days for observation.

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WHAT ARE THE POSSIBLE SIDE EFFECTS OF PRDNISONE?

Side effects do not occur in all patients and are usually related to the amount and length of time Prednisone is used. Potential side effects will be monitored by your physician and include:

  1. Weight gain. Prednisone increases your appetite. Follow a diet to maintain your weigh. Develop and eating schedule and stick to it. If you eat when you feel hungry, you will be eating all of the time.
  2. Susceptible to infections. Prednisone slightly decreases your resistance to infection. Avoid individuals with infectious illnesses if possible. Notify you physician if you develop persistent signs of an infection.
  3. Stomach upset or ulcer. Prednisone may increase acid secretion in your stomach. Take Prednisone with meals, milk or antacids. Do not take on an empty stomach.
  4. Insomnia and mood changes. The cause is uncertain. It is best to take prednisone at least 3 hours before bedtime. If you are on a daily schedule it is best to take it in the morning.
  5. Hyperglycemia. Prednisone may increase the amount of sugar in your blood to rise. This can be treated by your physician.
  6. Hypertension. Prednisone may cause your blood pressure to rise. This can be treated by your physicians, if necessary.
  7. Fluid retention. Prednisone can cause you to retain fluid. This will be monitored by your physician.
  8. Osteoporosis. Prednisone can make your bones become brittle. This usually occurs after taking Prednisone for a prolonged time. It may be recommended that you take a calcium supplement or increase the amount of milk products in your diet.
  9. Alterations in hair growth. Prednisone can cause a darkening and/or increase in hear growth. This disappears when the dose of Prednisone is decreased.
  10. Cataracts. After prolonged use of Prednisone, cataracts may develop occasionally. This will be monitored by your physicians by periodic examinations.
  11. Skin changes. Prednisone can cause a change in the condition of your skin. Y may notice that your skin bruises more easily.
  12. Nausea, vomiting, pain, fever, and/or flare-up of disease. Rapid withdrawal or stopping of Prednisone may cause these side effects. Never stop or change your Prednisone dose without your doctor’s consent. If you are planning a vacation, always carry an extra supply.
  13. Asceptic necrosis of the hip. An unusual reaction.

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HOW LONG WILL THE SIDE EFFECTS LAST?

If side effects develop, they usually will persist as long as the medication is continued. As the dose decreases so will the side effects. It is recognized that an alternate day schedule with gradual tapering reduces the likelihood of developing these side effects. Some side effects are permanent and will not reverse after medication is discontinued.

ARE THERE ANY SPECIAL DIETARY CONSIDERATIONS?

You should try to avoid missing a dose of Prednisone! If you do, follow these guidelines.

  1. If you forget to take your Prednisone at the usual time but remember later on the same day, take the missed dose then.
  2. If you forgot to take yesterday’s dose, skip yesterday’s dose and take your usual dose for the day.
  3. If you are on an alternate day schedule and forgot yesterday’s dose, take yesterday’s dose today. Tomorrow resume alternate day schedule.

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IS IT IMPROTANT FOR OTHERS TO KNOW THAT I AM TAKING PREDNISONE?

Yes, any doctor or dentist who is taking care of you should know you are taking prednisone. In case of an emergency, your family or close friends should also know you are taking Prednisone. You should carry an identification card stating that your are taking Prednisone and any other medications, plus your doctor’s name and phone number. This is valuable information should an emergency occur.

WHAT IS A HIGH DAY, LOW DAY, OFF DAY, ALTERNATE DAY?

These are terms used to describe the dosage pattern of Prednisone. Alternate day is when you take Prednisone every other day. High day and Low day refer to the dosage you take on the alternate day schedule. High day is the day when you take the higher dose of Prednisone. Low day is the day when you take the lower dose of Prednisone. Off day describes a day when your Prednisone dose is 0 mg., ( when you don’t take any prednisone).

Example:

Sun

Mon.

Tue.

Wed.

Thurs.

Fri.

Sat.

Sun

60

20

60

20

60

20

60

20

High

Low

High

Low

High

Low

High

Low

The above does would be describes as 60/20: 60 being the dose on the high day, 20 being the dose on the low day.

If may be helpful to write the dosage on a calendar to help remember the correct dosage for the day.

HOW ARE THE DOSAGES OF PREDNISONE DETERMINED?

Schedules are determined by the body’s response to the Prednisone.

Written by the Nurse’s Advisory Committee of the Myasthenia Gravis Association of Detroit chapter.

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