Prednicot

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• amphotericin B (Ambisome and Amphotec)
• potassium depleting diuretics such as acetazolamide (Diamox) and methazolamide (Neptazane)
• anticholinesterases such as neostigmine (Prostigmin) and pyridostigmine (Mestinon)
• warfarin (Coumadin)
• medications to treat diabetes
• isoniazid
• bupropion (Zyban and Wellbutrin)
• cholestyramine (Prevalite)
• cyclosporine (Neoral, Sandimmune, Gengraf)
• digoxin (Lanoxin)
• estrogens and oral contraceptives
• fluoroquinolone antibiotics such as ciprofloxacin (Cipro) and levofloxacin (Levaquin)
• barbituates such as phenobarbital (Donnatal)
• phenytoin (Dilantin)
• carbamazepine (Tegretol, Carbatrol, Equetro, Teril, Epitol)
• rifampin (Rifadin, Rimactane)
• ritonavir (Norvir)
• indinavir (Crixivan)
• macrolide antibiotics such as erythromycin and azithromycin (Zithromax)
• non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and aspirin (Ecotrin)
• quetiapine (Seroquel)
• thalidomide (Thalomid)
• vaccines

This is not a complete list of prednisone drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with prednisone including:

• Hypersensitivity reaction:  Prednisone may trigger an allergic response.  Symptoms of a hypersensitivity reaction include:

  • hives
  • difficulty breathing or swallowing
  • swelling
  • rash
  • itching

• Cardiac and renal problems: Prednisone can increase blood pressure, cause water and sodium retention, and increase potassium and calcium excretion. Tell your doctor if you have a history of heart or kidney disease.

• Corticosteroid deficiency after drug withdrawal: Once you stop taking prednisone, your body’s ability to produce certain steroid hormones may be impaired.

• Immunosuppression: Prednisone decreases your body’s immune response to infections. In addition, prednisone can increase sensitivity to vaccines since the immune response is reduced with prednisone use.

• Reactivation of tuberculosis: Tell your doctor if you have had tuberculosis.

• Ophthalmic (eye) problems: Prednisone can lead to cataracts and glaucoma.

• Perforation of the gastrointestinal tract:  Prednisone can cause holes in the stomach or intestinal lining.  Tell your doctor if you have a history of ulcers or other digestive system problems.

• Decreased bone formation:  Prednisone can prevent the formation of bones, which may result in decreased bone density and osteoporosis.

Prednisone can cause dizziness. Do not drive or operate heavy machinery until you know how prednisone affects you.

Do not take prednisone if you:

• have a fungal infection
• are allergic to prednisone

Take prednisone exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Your doctor will determine the appropriate dosage and schedule of prednisone depending the disease being treated and your response to the medication.  The usual dosage range is 5 to 60 mg per day.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Less than 12 years old:
0.25 mg/kg to 2 mg/kg orally once a day or every other day

12 years or older:
7.5 to 60 mg orally once a day or every other day

Comments:
-Titrate dose to the lowest dose needed for control
-Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.
-Administer single dose in the morning or on alternate days in the morning; alternate-day therapy may produce less adrenal suppression.

Use: Recommended for long-term treatment of severe persistent asthma by the NHLBI National Heart, Lung and Blood Institute.