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Prednisone

Many doses (1 mg to 50 mg)

Purpose

To reduce inflammation; to suppress immunological responses.

 

Indications

For suppression of serious systemic manifestations of connectivetissue disease, such as kidney involvement. In selected cases, low-dose use for suppressing the inflammation of rheumatoid arthritis.

 

Dosage

The normal body makes the equivalent of about 5 to 7.5 mg of prednisone each day. "Low-dose" prednisone treatment is from 5 to 10 mg. A "moderate dose" ranges from 15 to 30 mg per day and a "high dose" from 40 to 60 mg per day, or even higher. The drug is often most effective when given in several doses throughout the day, but side effects are least when the same total daily dose is given as infrequently as possible.

 

Side effects

Prednisone causes all of the corticosteroid side effects listed above. Allergy is extremely rare. Side effects are related to dose and to duration of treatment. The side effects are major and include fatal complications. Psychological dependency often occurs and complicates efforts to get off the drug once you have begun.

 

Special hints

Discuss the need for prednisone very carefully with your doctor before beginning. The decision to start steroid treatment for a chronic disease is a major one and you want to be sure that the drug is essential. You may want a second opinion if the explanation does not completely satisfy you. When you take prednisone, follow your doctor's instructions very closely. With some drugs it does not make much difference if you start and-stop them on your own, but prednisone must be taken extremely regularly and exactly as prescribed. You will want to help your doctor decrease your dose of prednisone whenever possible, even if this does cause some increase in your symptoms.

 

A strange thing happens when you reduce the dose of prednisone; a syndrome called steroid fibrositis can cause increased stiffness and pain for a week to ten days after each dose reduction. Sometimes this is wrongly interpreted as a return of the arthritis and reduction in dosage is unnecessarily stopped. If you are going to take prednisone for a long time, ask your doctor about taking some vitamin D along with it There is some evidence that the loss of bone, the most critical long-term side effect, can be reduced if you take vitamin D (usually prescribed as 50,000 units once or twice a month) together with adequate calcium.

If you are having some side effects, ask your doctor about once-a-day or every-other-day use of the prednisone. Watch your salt and sodium intake and keep it low, since there is already a tendency to retain fluid with prednisone. Watch your diet as well, since you will be fighting a tendency to put on fat. If you stay active and limit the calories you take in, you can minimize many of the ugly side effects of the steroid medication and can improve the strength of the bones and the muscles. If you are taking a corticosteroid other than prednisone by mouth, ask your physician if it is all right to switch to the equivalent dose of prednisone.

         
         

     

         

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