Prednisone 2.5mg Tablets
It is used for many health problems like allergy signs, asthma, adrenal gland problems, blood problems, skin rashes, or swelling problems. This is not a list of all health problems that this drug may be used for. Talk with the doctor.
Drug Class
Corticosteroid
Pharmacologic Class
Glucocorticoid
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Prednisone is a type of steroid medicine that works like a natural hormone your body makes. It's used to reduce inflammation (swelling and redness) and to calm down an overactive immune system. This helps treat many conditions like asthma, allergies, arthritis, and certain skin conditions.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Take your medication with food or milk to help your body absorb it. If you're taking your medication once a day, take it in the morning. Continue taking your medication as directed by your doctor or healthcare provider, even if you're feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature, away from light and moisture. Keep it in a dry place, such as a closet or cupboard, and avoid storing it in the bathroom. Keep all medications out of the reach of children and pets to ensure their safety. When you're finished with your medication or it's expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless you're instructed to do so by your pharmacist or healthcare provider. If you're unsure about how to dispose of your medication, ask your pharmacist for guidance. You may also have access to a drug take-back program in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed dose.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Take your medication with food or milk to help your body absorb it. If you're taking your medication once a day, take it in the morning. Continue taking your medication as directed by your doctor or healthcare provider, even if you're feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature, away from light and moisture. Keep it in a dry place, such as a closet or cupboard, and avoid storing it in the bathroom. Keep all medications out of the reach of children and pets to ensure their safety. When you're finished with your medication or it's expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless you're instructed to do so by your pharmacist or healthcare provider. If you're unsure about how to dispose of your medication, ask your pharmacist for guidance. You may also have access to a drug take-back program in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed dose.
Lifestyle & Tips
- Take prednisone exactly as prescribed by your doctor. Do not stop taking it suddenly, especially after long-term use, as this can cause serious withdrawal symptoms. Your doctor will tell you how to slowly reduce your dose.
- Take prednisone with food or milk to reduce stomach upset.
- If you take it once daily, take it in the morning to mimic your body's natural hormone release and reduce sleep disturbances.
- Avoid contact with people who are sick or have infections (like chickenpox or measles) as prednisone can weaken your immune system.
- Report any signs of infection (fever, sore throat, body aches) to your doctor immediately.
- Discuss calcium and vitamin D supplementation with your doctor to protect your bones, especially with long-term use.
- Limit sodium intake to help prevent fluid retention.
- Monitor your blood sugar if you have diabetes, as prednisone can raise blood sugar levels.
- Carry a medical alert card or bracelet if you are on long-term prednisone, indicating your steroid use.
Available Forms & Alternatives
Available Strengths:
- Prednisone 5mg Tablets
- Prednisone 2.5mg Tablets
- Prednisone 20mg Tablets
- Prednisone Intensol 5mg/1ml Conc.
- Prednisone 1mg Tablets
- Prednisone Soln 5mg/5ml (1mg/1ml)
- Prednisone 50mg (fifty Mg) Tablets
- Prednisone 10mg** Tablets
- Prednisone 2.5mg Tablets
- Prednisone 5mg Pak 48
- Prednisone 5mg Tablets Pack 21's
- Prednisone 10mg Tabs Pack 21s
- Prednisone 10mg Tabs Pack 48s
- Prednisone 50mg (fifty Mg) Tablets
- Prednisone 1mg Tablets
- Prednisone 1mg Tablets
Dosing & Administration
Adult Dosing
Standard Dose:
Highly variable, depends on condition. Typical initial doses range from 5 mg to 60 mg orally once daily or in divided doses.
Dose Range:
2.5 - 60 mg
Condition-Specific Dosing:
antiInflammatory:
5-60 mg/day, often tapered
immunosuppressive:
20-60 mg/day, often tapered
acuteExacerbation:
Higher doses (e.g., 40-60 mg/day) for short courses, then tapered
multipleSclerosis:
200 mg/day for 1 week, then 80 mg every other day for 1 month (for acute exacerbations)
Pediatric Dosing
Neonatal:
Not established (use with extreme caution, specific conditions only)
Infant:
0.05-2 mg/kg/day orally in 1-4 divided doses, depending on condition and severity.
Child:
0.05-2 mg/kg/day orally in 1-4 divided doses, depending on condition and severity. Max 80 mg/day.
Adolescent:
0.05-2 mg/kg/day orally in 1-4 divided doses, depending on condition and severity. Max 80 mg/day, or adult dosing if weight/size appropriate.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed.
Dialysis:
Not significantly removed by dialysis; no supplemental dose needed.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
Consider dose reduction or use prednisolone directly, as prednisone is a prodrug converted to prednisolone in the liver. Monitor closely.
Severe:
Consider dose reduction or use prednisolone directly, as prednisone is a prodrug converted to prednisolone in the liver. Monitor closely.
Pharmacology
Mechanism of Action
Prednisone is a synthetic glucocorticoid. It is a prodrug that is converted in the liver to its active metabolite, prednisolone. Prednisolone exerts its effects by binding to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex then binds to specific DNA sequences (glucocorticoid response elements), modulating the transcription of various genes. This leads to widespread effects, including potent anti-inflammatory and immunosuppressive actions, metabolic effects (e.g., gluconeogenesis), and mineralocorticoid effects (though less pronounced than aldosterone). It inhibits the synthesis of inflammatory mediators (prostaglandins, leukotrienes), suppresses immune cell function (lymphocytes, macrophages), and stabilizes lysosomal membranes.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 70-90%
Tmax:
1-2 hours (for prednisolone, after prednisone administration)
FoodEffect:
Food may slightly delay absorption but does not significantly affect the extent of absorption.
Distribution:
Vd:
0.22-0.7 L/kg
ProteinBinding:
Approximately 90-95% (primarily to albumin and corticosteroid-binding globulin)
CnssPenetration:
Limited (crosses blood-brain barrier, but less than some other corticosteroids)
Elimination:
HalfLife:
Prednisone: 3-4 hours; Prednisolone: 2-4 hours (biological half-life is longer, 18-36 hours)
Clearance:
Not readily available, but primarily hepatic metabolism and renal excretion of metabolites.
ExcretionRoute:
Renal (as inactive metabolites)
Unchanged:
<5% (prednisone); <10% (prednisolone)
Pharmacodynamics
OnsetOfAction:
Hours to days (depending on condition and dose)
PeakEffect:
Days to weeks (for chronic conditions)
DurationOfAction:
18-36 hours (biological effect, allowing for once-daily or alternate-day dosing)
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or changed sputum production, painful urination, mouth sores, or a wound that won't heal
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an abnormal heartbeat
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe nausea and vomiting
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision
Signs of a weak adrenal gland: severe nausea and vomiting, severe dizziness or fainting, muscle weakness, fatigue, mood changes, decreased appetite, or weight loss
Signs of Cushing's syndrome: weight gain in the upper back or belly, moon face, severe headache, or slow wound healing
Signs of high blood sugar: confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath
Shortness of breath, sudden weight gain, or swelling in the arms or legs
Skin changes: acne, stretch marks, slow healing, or excessive hair growth
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth
Abnormal heartbeat (fast, slow, or irregular)
Chest pain or pressure
Swelling, warmth, numbness, color changes, or pain in a leg or arm
Changes in menstrual period
Bone or joint pain
Feeling extremely tired or weak
Changes in vision
Confusion, difficulty focusing, or changes in behavior
Memory problems or loss
Hallucinations (seeing or hearing things that are not there)
Seizures
Burning, numbness, or tingling sensations that are not normal
Severe stomach pain
Unexplained bruising or bleeding
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or don't go away, contact your doctor:
Upset stomach or nausea
Increased appetite
Weight gain
Trouble sleeping
Restlessness
Excessive sweating
Dizziness or headache
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or changed sputum production, painful urination, mouth sores, or a wound that won't heal
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an abnormal heartbeat
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe nausea and vomiting
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision
Signs of a weak adrenal gland: severe nausea and vomiting, severe dizziness or fainting, muscle weakness, fatigue, mood changes, decreased appetite, or weight loss
Signs of Cushing's syndrome: weight gain in the upper back or belly, moon face, severe headache, or slow wound healing
Signs of high blood sugar: confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath
Shortness of breath, sudden weight gain, or swelling in the arms or legs
Skin changes: acne, stretch marks, slow healing, or excessive hair growth
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth
Abnormal heartbeat (fast, slow, or irregular)
Chest pain or pressure
Swelling, warmth, numbness, color changes, or pain in a leg or arm
Changes in menstrual period
Bone or joint pain
Feeling extremely tired or weak
Changes in vision
Confusion, difficulty focusing, or changes in behavior
Memory problems or loss
Hallucinations (seeing or hearing things that are not there)
Seizures
Burning, numbness, or tingling sensations that are not normal
Severe stomach pain
Unexplained bruising or bleeding
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or don't go away, contact your doctor:
Upset stomach or nausea
Increased appetite
Weight gain
Trouble sleeping
Restlessness
Excessive sweating
Dizziness or headache
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of infection (fever, chills, body aches, sore throat, cough, painful urination)
- Severe stomach pain, black/tarry stools, or vomiting blood (signs of GI bleeding)
- Unusual swelling of the face, hands, or ankles
- Extreme fatigue, weakness, dizziness, or nausea/vomiting (signs of adrenal insufficiency if stopped too quickly)
- Blurred vision, eye pain, or halos around lights
- Increased thirst or urination (signs of high blood sugar)
- Severe mood changes (depression, anxiety, confusion, euphoria)
- Muscle weakness or severe muscle pain
- Easy bruising or unusual bleeding
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have any type of infection, including bacterial, viral, or fungal infections, as well as specific conditions like:
+ Amoeba infection (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Any other infection
Additionally, notify your doctor if you have nerve problems in the eye.
To ensure safe treatment, it is crucial to disclose all of your:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Health problems
Your doctor and pharmacist need this information to assess potential interactions between this medication and your other treatments or health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have any type of infection, including bacterial, viral, or fungal infections, as well as specific conditions like:
+ Amoeba infection (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Any other infection
Additionally, notify your doctor if you have nerve problems in the eye.
To ensure safe treatment, it is crucial to disclose all of your:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Health problems
Your doctor and pharmacist need this information to assess potential interactions between this medication and your other treatments or health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so.
Precautions & Cautions
Important Warnings and Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are taking this medication for an extended period, your doctor will likely recommend regular blood tests, weight checks, and other laboratory tests to monitor your health. You may also need to have your eye pressure and bone density checked regularly.
Be aware that medications like this one can cause high blood pressure. Your doctor will monitor your blood pressure and advise you on how often to have it checked.
Long-term use of this medication may increase your risk of developing cataracts or glaucoma. Discuss this potential risk with your doctor.
Prolonged use of this medication can also lead to weak bones (osteoporosis). Talk to your doctor to determine if you are at a higher risk of developing osteoporosis or if you have any concerns.
This medication may interfere with allergy skin tests. Ensure that your doctor and laboratory personnel are aware that you are taking this medication.
You may need to reduce your salt intake and increase your potassium consumption. Consult with your doctor for personalized advice.
If you have diabetes, it is crucial to closely monitor your blood sugar levels while taking this medication.
Before consuming alcohol, discuss the potential risks with your doctor.
Additionally, consult with your doctor before receiving any vaccinations, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you are taking this medication, it is essential to avoid close contact with individuals who have chickenpox or measles, as these infections can be severe or even life-threatening. If you have been exposed to chickenpox or measles, inform your doctor immediately.
Steroid medications, including this one, can increase the risk of infection, which can be mild, severe, or even life-threatening. The risk of infection is typically higher with higher doses of steroids. To minimize the risk of infection, wash your hands frequently, avoid close contact with individuals who have infections, colds, or flu, and inform your doctor if you experience any signs of infection.
In some cases, medications like this one can reactivate latent infections, such as tuberculosis or hepatitis B. Inform your doctor if you have a history of these infections.
This medication can suppress your body's natural production of steroids. If you experience fever, infection, surgery, or injury, inform your doctor, as your body's response to these stresses may be affected. You may require additional doses of steroids in these situations.
Do not stop taking this medication abruptly without consulting your doctor, as this can increase the risk of side effects. If you need to discontinue this medication, your doctor will advise you on how to gradually taper off the dosage.
If you miss a dose or recently stopped taking this medication and experience symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor promptly.
Long-term use of medications like this one has been associated with an increased risk of a type of cancer called Kaposi's sarcoma. Discuss this potential risk with your doctor.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. This medication can also affect growth in children and adolescents, and they may require regular growth checks. Consult with your doctor to discuss the potential risks and benefits.
This medication can harm an unborn baby if taken during pregnancy. If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential risks and benefits. If you took this medication during pregnancy, inform your baby's doctor.
Important Reminders
Inform all your healthcare providers that you are taking this medication.
Attend regular check-ups and follow your doctor's advice to minimize potential risks.
Monitor your blood pressure, blood sugar levels, and overall health while taking this medication.
Avoid close contact with individuals who have infections, and inform your doctor if you experience any signs of infection.
Do not stop taking this medication without consulting your doctor.
Discuss any concerns or questions with your doctor to ensure safe and effective use of this medication.
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are taking this medication for an extended period, your doctor will likely recommend regular blood tests, weight checks, and other laboratory tests to monitor your health. You may also need to have your eye pressure and bone density checked regularly.
Be aware that medications like this one can cause high blood pressure. Your doctor will monitor your blood pressure and advise you on how often to have it checked.
Long-term use of this medication may increase your risk of developing cataracts or glaucoma. Discuss this potential risk with your doctor.
Prolonged use of this medication can also lead to weak bones (osteoporosis). Talk to your doctor to determine if you are at a higher risk of developing osteoporosis or if you have any concerns.
This medication may interfere with allergy skin tests. Ensure that your doctor and laboratory personnel are aware that you are taking this medication.
You may need to reduce your salt intake and increase your potassium consumption. Consult with your doctor for personalized advice.
If you have diabetes, it is crucial to closely monitor your blood sugar levels while taking this medication.
Before consuming alcohol, discuss the potential risks with your doctor.
Additionally, consult with your doctor before receiving any vaccinations, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you are taking this medication, it is essential to avoid close contact with individuals who have chickenpox or measles, as these infections can be severe or even life-threatening. If you have been exposed to chickenpox or measles, inform your doctor immediately.
Steroid medications, including this one, can increase the risk of infection, which can be mild, severe, or even life-threatening. The risk of infection is typically higher with higher doses of steroids. To minimize the risk of infection, wash your hands frequently, avoid close contact with individuals who have infections, colds, or flu, and inform your doctor if you experience any signs of infection.
In some cases, medications like this one can reactivate latent infections, such as tuberculosis or hepatitis B. Inform your doctor if you have a history of these infections.
This medication can suppress your body's natural production of steroids. If you experience fever, infection, surgery, or injury, inform your doctor, as your body's response to these stresses may be affected. You may require additional doses of steroids in these situations.
Do not stop taking this medication abruptly without consulting your doctor, as this can increase the risk of side effects. If you need to discontinue this medication, your doctor will advise you on how to gradually taper off the dosage.
If you miss a dose or recently stopped taking this medication and experience symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor promptly.
Long-term use of medications like this one has been associated with an increased risk of a type of cancer called Kaposi's sarcoma. Discuss this potential risk with your doctor.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. This medication can also affect growth in children and adolescents, and they may require regular growth checks. Consult with your doctor to discuss the potential risks and benefits.
This medication can harm an unborn baby if taken during pregnancy. If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential risks and benefits. If you took this medication during pregnancy, inform your baby's doctor.
Important Reminders
Inform all your healthcare providers that you are taking this medication.
Attend regular check-ups and follow your doctor's advice to minimize potential risks.
Monitor your blood pressure, blood sugar levels, and overall health while taking this medication.
Avoid close contact with individuals who have infections, and inform your doctor if you experience any signs of infection.
Do not stop taking this medication without consulting your doctor.
Discuss any concerns or questions with your doctor to ensure safe and effective use of this medication.
Overdose Information
Overdose Symptoms:
- Acute overdose is rare but may include: nausea, vomiting, stomach upset, fluid retention, hypertension, and electrolyte disturbances. Chronic overdose leads to Cushingoid features (moon face, buffalo hump, central obesity).
What to Do:
Call 911 or your local poison control center immediately (e.g., 1-800-222-1222 in the US). Treatment is generally supportive and symptomatic. There is no specific antidote.
Drug Interactions
Contraindicated Interactions
- Live or live-attenuated vaccines (in immunosuppressed patients)
Major Interactions
- Barbiturates (e.g., phenobarbital)
- Phenytoin
- Rifampin
- Ephedrine
- Aminoglutethimide (may decrease corticosteroid effect)
- Ketoconazole (may increase corticosteroid effect)
- Non-steroidal anti-inflammatory drugs (NSAIDs) - increased risk of GI ulceration/bleeding
- Warfarin (effects can be variable, monitor INR closely)
- Antidiabetic agents (insulin, oral hypoglycemics) - may require increased doses
- Diuretics (thiazide, loop) - increased risk of hypokalemia
- Cardiac glycosides (e.g., digoxin) - increased risk of toxicity with hypokalemia
Moderate Interactions
- Oral contraceptives/Estrogens (may increase corticosteroid effect)
- Cyclosporine (increased risk of seizures)
- Fluoroquinolones (increased risk of tendon rupture)
- Isoniazid (decreased isoniazid levels)
- Cholestyramine (may decrease prednisone absorption)
- Antacids (may decrease prednisone absorption)
Minor Interactions
- Grapefruit juice (potential minor increase in exposure)
Monitoring
Baseline Monitoring
Blood pressure
Rationale: Risk of hypertension
Timing: Before initiation
Blood glucose (fasting)
Rationale: Risk of hyperglycemia/diabetes
Timing: Before initiation
Serum electrolytes (especially potassium)
Rationale: Risk of hypokalemia, fluid retention
Timing: Before initiation
Bone mineral density (DEXA scan)
Rationale: Risk of osteoporosis with long-term use
Timing: Before initiation (if long-term use anticipated)
Ophthalmologic exam (intraocular pressure)
Rationale: Risk of glaucoma/cataracts with long-term use
Timing: Before initiation (if long-term use anticipated)
Routine Monitoring
Blood pressure
Frequency: Regularly (e.g., weekly to monthly, depending on dose/duration)
Target: Individualized
Action Threshold: Sustained elevation requiring intervention
Blood glucose (fasting or HbA1c)
Frequency: Regularly (e.g., monthly to quarterly, depending on dose/duration)
Target: Individualized
Action Threshold: Persistent hyperglycemia
Serum electrolytes (especially potassium)
Frequency: Periodically (e.g., monthly, or more frequently with high doses/diuretics)
Target: Within normal limits
Action Threshold: Hypokalemia, significant electrolyte imbalance
Weight and fluid balance
Frequency: Regularly
Target: Stable
Action Threshold: Significant weight gain, edema
Signs of infection
Frequency: Ongoing clinical assessment
Target: Absence of infection
Action Threshold: Fever, malaise, localized signs of infection
Growth (pediatric patients)
Frequency: Regularly (e.g., every 3-6 months)
Target: Normal growth velocity
Action Threshold: Growth retardation
Adrenal function (e.g., morning cortisol)
Frequency: Consider if tapering or discontinuing after prolonged use
Target: Normal adrenal response
Action Threshold: Signs of adrenal insufficiency
Symptom Monitoring
- Mood changes (irritability, depression, euphoria)
- Sleep disturbances (insomnia)
- Fluid retention (swelling in ankles, hands)
- Increased appetite/weight gain
- Muscle weakness or pain
- Easy bruising or thinning skin
- Vision changes (blurred vision, halos)
- Increased thirst or urination
- Signs of infection (fever, sore throat, cough)
- Stomach pain or black/tarry stools (GI bleeding)
Special Patient Groups
Pregnancy
Prednisone is classified as Pregnancy Category C. Studies in animals have shown adverse effects on the fetus. There are no adequate and well-controlled studies in pregnant women. Prednisone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
Trimester-Specific Risks:
First Trimester:
Potential for increased risk of oral clefts (though data is conflicting and overall risk is low).
Second Trimester:
Risk of fetal growth restriction, premature delivery, and adrenal suppression in the neonate.
Third Trimester:
Risk of fetal growth restriction, premature delivery, and adrenal suppression in the neonate.
Lactation
Prednisone is excreted into breast milk. The amount is generally considered low, and adverse effects in breastfed infants are unlikely with typical doses. However, high doses or prolonged use may lead to growth suppression or other adverse effects in the infant. The American Academy of Pediatrics considers corticosteroids compatible with breastfeeding. Monitor infant for signs of adrenal suppression (e.g., poor weight gain).
Infant Risk:
Low risk with typical doses; moderate risk with high doses or prolonged use.
Pediatric Use
Corticosteroids can cause growth retardation in children. The lowest effective dose for the shortest possible duration should be used. Monitor growth and development closely. Also at risk for adrenal suppression, increased intracranial pressure, and other systemic side effects.
Geriatric Use
Elderly patients may be at increased risk for adverse effects, including osteoporosis, diabetes, hypertension, fluid retention, and cataracts. Use the lowest effective dose and monitor closely for side effects.
Clinical Information
Clinical Pearls
- Always taper prednisone doses gradually after prolonged therapy (typically >2-3 weeks) to prevent adrenal insufficiency. The rate of taper depends on the dose, duration, and individual patient response.
- Administer once-daily doses in the morning (before 9 AM) to minimize adrenal suppression and sleep disturbances.
- Patients on long-term prednisone should be advised about the risk of adrenal crisis during stress (e.g., surgery, severe illness) and may require stress-dose steroids.
- Prednisone can mask signs of infection; monitor patients closely for any subtle signs of infection.
- Consider prophylactic measures for osteoporosis (calcium, vitamin D, bisphosphonates) in patients on long-term prednisone.
- Educate patients about potential mood changes and psychiatric effects, which can range from euphoria to severe depression or psychosis.
- Patients should avoid live vaccines while on immunosuppressive doses of prednisone.
Alternative Therapies
- Other systemic corticosteroids (e.g., methylprednisolone, dexamethasone, hydrocortisone)
- Non-steroidal anti-inflammatory drugs (NSAIDs) for inflammatory conditions (less potent)
- Disease-modifying antirheumatic drugs (DMARDs) for autoimmune conditions (e.g., methotrexate, biologics)
- Immunosuppressants (e.g., azathioprine, cyclosporine, mycophenolate mofetil)
- Specific therapies for underlying conditions (e.g., bronchodilators for asthma, antihistamines for allergies)
Cost & Coverage
Average Cost:
$10 - $50 per 30 tablets (2.5mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.