Prednisone 50mg (fifty Mg) 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, Anti-inflammatory, Immunosuppressant
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 medication that works by reducing inflammation and calming down your immune system. It's used to 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 take your medication once a day, it's best to 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
To keep your medication effective and safe, store it at room temperature, away from light and moisture. Avoid storing it in a bathroom. Keep all medications in a secure location, out of the reach of children and pets. When your medication is no longer needed or has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of your medication, and consider participating in a local drug take-back program.
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 dose, skip the missed dose and return to your regular schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
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 take your medication once a day, it's best to 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
To keep your medication effective and safe, store it at room temperature, away from light and moisture. Avoid storing it in a bathroom. Keep all medications in a secure location, out of the reach of children and pets. When your medication is no longer needed or has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best way to dispose of your medication, and consider participating in a local drug take-back program.
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 dose, skip the missed dose and return to your regular schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Take with food or milk to reduce stomach upset.
- Take your dose in the morning if prescribed once daily, to mimic the body's natural cortisol rhythm and reduce sleep disturbances.
- Do not stop taking this medication suddenly, especially if you've been on it for more than a few days. Your doctor will tell you how to slowly reduce the dose to prevent withdrawal symptoms.
- Avoid contact with people who are sick, especially with chickenpox or measles, as your immune system may be weakened.
- Discuss vaccinations with your doctor, as some vaccines may not be safe or effective while on prednisone.
- Consider calcium and vitamin D supplements, especially with long-term use, to help protect your bones.
- Limit sodium intake to help manage fluid retention and blood pressure.
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. For acute conditions, 20-80 mg/day, often tapered.
Dose Range:
5 - 100 mg
Condition-Specific Dosing:
acuteExacerbations:
20-80 mg/day, often for 3-10 days, then tapered.
chronicConditions:
5-60 mg/day, often lowest effective dose for maintenance.
immunosuppression:
0.5-2 mg/kg/day (up to 100 mg/day) for severe conditions.
Pediatric Dosing
Neonatal:
Not established (use with caution, specific conditions only)
Infant:
0.5-2 mg/kg/day, depending on condition and severity.
Child:
0.5-2 mg/kg/day, depending on condition and severity. Max 60-80 mg/day.
Adolescent:
0.5-2 mg/kg/day, depending on condition and severity. Max 60-80 mg/day, or adult dosing for larger adolescents.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No supplemental dose needed after dialysis as it is primarily metabolized by the liver.
Hepatic Impairment:
Mild:
Adjustment may be needed (prednisone is a prodrug converted to prednisolone in the liver).
Moderate:
Dose reduction may be necessary; monitor closely for efficacy and side effects.
Severe:
Significant dose reduction may be necessary; monitor closely for efficacy and side effects.
Pharmacology
Mechanism of Action
Prednisone is a synthetic glucocorticoid. It exerts its effects by binding to specific intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex then binds to glucocorticoid response elements (GREs) in the DNA, modulating gene transcription. This leads to altered protein synthesis, resulting in anti-inflammatory, immunosuppressive, and anti-allergic effects. It inhibits the synthesis of inflammatory mediators (e.g., prostaglandins, leukotrienes), suppresses the migration of leukocytes, and reduces capillary permeability.
Pharmacokinetics
Absorption:
Bioavailability:
70-90%
Tmax:
1-2 hours (for prednisolone, the active metabolite)
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 70-90% (primarily to albumin and corticosteroid-binding globulin)
CnssPenetration:
Limited (crosses blood-brain barrier to some extent)
Elimination:
HalfLife:
2-3 hours (for prednisolone)
Clearance:
Not available
ExcretionRoute:
Renal (primarily as inactive metabolites)
Unchanged:
<1% (prednisone); 10-25% (prednisolone)
Pharmacodynamics
OnsetOfAction:
Hours to days (depending on condition and dose)
PeakEffect:
Variable, often within days to weeks for full therapeutic effect in chronic conditions.
DurationOfAction:
18-36 hours (biological half-life, longer than plasma half-life)
Safety & Warnings
Side Effects
Urgent 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 experience 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 irregular heartbeat.
Signs of pancreatitis (pancreas problems): severe stomach pain, severe back pain, or severe nausea and vomiting.
Signs of high blood pressure: severe headache, dizziness, fainting, or changes in vision.
Signs of adrenal gland problems: 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 abdomen, moon face, severe headache, or slow wound healing.
Signs of high blood sugar: confusion, drowsiness, excessive 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 periods.
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 aren't 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. Many people experience no side effects or only mild ones. If you experience any of the following side effects or any other symptoms that bother you or don't go away, contact your doctor:
Nausea or vomiting.
Increased appetite.
Weight gain.
Sleep disturbances.
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 experience 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 irregular heartbeat.
Signs of pancreatitis (pancreas problems): severe stomach pain, severe back pain, or severe nausea and vomiting.
Signs of high blood pressure: severe headache, dizziness, fainting, or changes in vision.
Signs of adrenal gland problems: 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 abdomen, moon face, severe headache, or slow wound healing.
Signs of high blood sugar: confusion, drowsiness, excessive 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 periods.
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 aren't 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. Many people experience no side effects or only mild ones. If you experience any of the following side effects or any other symptoms that bother you or don't go away, contact your doctor:
Nausea or vomiting.
Increased appetite.
Weight gain.
Sleep disturbances.
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, sore throat, body aches, unusual fatigue, painful urination)
- Severe stomach pain, black or tarry stools, or vomiting blood (signs of GI bleeding)
- Swelling in your hands, ankles, or feet (fluid retention)
- Unusual weight gain
- Extreme mood changes (severe depression, anxiety, confusion, hallucinations)
- Blurred vision or eye pain
- Increased thirst or urination (signs of high blood sugar)
- Muscle weakness or severe fatigue
- Shortness of breath
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 allergic reaction you experienced, including any symptoms that occurred.
If you have an active infection, including bacterial, viral, or fungal infections, such as amoeba infections (e.g., traveler's diarrhea), herpes infections of the eye, cerebral malaria, threadworm infestations, or any other type of infection.
Additionally, if you have a history of nerve problems in the eye, please discuss this with your doctor.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your complete medical history, including any health problems you have or have had in the past
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting 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 allergic reaction you experienced, including any symptoms that occurred.
If you have an active infection, including bacterial, viral, or fungal infections, such as amoeba infections (e.g., traveler's diarrhea), herpes infections of the eye, cerebral malaria, threadworm infestations, or any other type of infection.
Additionally, if you have a history of nerve problems in the eye, please discuss this with your doctor.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your complete medical history, including any health problems you have or have had in the past
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
Important Information About Your Medication
It is crucial that you 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 undergo eye pressure and bone density tests.
Potential Side Effects and Risks
High blood pressure is a possible side effect of this medication. Your doctor will monitor your blood pressure regularly.
Long-term use of this medication may increase your risk of developing cataracts or glaucoma. Discuss this risk with your doctor.
Prolonged use may also lead to weak bones (osteoporosis). Talk to your doctor about your individual risk factors and any concerns you may have.
This medication may interfere with allergy skin tests. Be sure to inform your doctor and laboratory personnel 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 essential to closely monitor your blood sugar levels while taking this medication.
Before consuming alcohol, discuss the potential risks with your doctor.
Prior to receiving any vaccines, consult with your doctor, as some vaccines may not be effective or may increase your risk of infection when taken with this medication.
Infection Risks
Chickenpox and measles can be severe or even life-threatening in individuals taking steroid medications like this one. Avoid close contact with anyone who has these illnesses, and inform your doctor if you have been exposed.
Steroid medications, including this one, increase the risk of infection. They can exacerbate existing infections and make it more challenging to detect signs of infection. The risk of infection is typically higher with higher doses of steroids.
To minimize your risk of infection, practice good hygiene by washing your hands frequently, and avoid close contact with individuals who have infections, colds, or flu. Inform your doctor if you experience any signs of infection.
Reactivation of Infections
In some cases, this medication may reactivate latent infections, such as tuberculosis or hepatitis B. Inform your doctor if you have a history of these infections.
Adrenal Insufficiency
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 steroid doses.
Stopping the Medication
Do not abruptly stop taking this medication without consulting your doctor, as this may increase your risk of side effects. If you need to discontinue the medication, your doctor will guide you on how to gradually taper off the dose.
If you have missed 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.
Additional Risks
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this 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 may affect growth in children and adolescents. Regular growth checks may be necessary. Consult with your doctor.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as this medication may pose risks to the unborn baby or infant. Your doctor will help you weigh the benefits and risks.
If you took this medication during pregnancy, inform your baby's doctor.
It is crucial that you 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 undergo eye pressure and bone density tests.
Potential Side Effects and Risks
High blood pressure is a possible side effect of this medication. Your doctor will monitor your blood pressure regularly.
Long-term use of this medication may increase your risk of developing cataracts or glaucoma. Discuss this risk with your doctor.
Prolonged use may also lead to weak bones (osteoporosis). Talk to your doctor about your individual risk factors and any concerns you may have.
This medication may interfere with allergy skin tests. Be sure to inform your doctor and laboratory personnel 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 essential to closely monitor your blood sugar levels while taking this medication.
Before consuming alcohol, discuss the potential risks with your doctor.
Prior to receiving any vaccines, consult with your doctor, as some vaccines may not be effective or may increase your risk of infection when taken with this medication.
Infection Risks
Chickenpox and measles can be severe or even life-threatening in individuals taking steroid medications like this one. Avoid close contact with anyone who has these illnesses, and inform your doctor if you have been exposed.
Steroid medications, including this one, increase the risk of infection. They can exacerbate existing infections and make it more challenging to detect signs of infection. The risk of infection is typically higher with higher doses of steroids.
To minimize your risk of infection, practice good hygiene by washing your hands frequently, and avoid close contact with individuals who have infections, colds, or flu. Inform your doctor if you experience any signs of infection.
Reactivation of Infections
In some cases, this medication may reactivate latent infections, such as tuberculosis or hepatitis B. Inform your doctor if you have a history of these infections.
Adrenal Insufficiency
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 steroid doses.
Stopping the Medication
Do not abruptly stop taking this medication without consulting your doctor, as this may increase your risk of side effects. If you need to discontinue the medication, your doctor will guide you on how to gradually taper off the dose.
If you have missed 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.
Additional Risks
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this 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 may affect growth in children and adolescents. Regular growth checks may be necessary. Consult with your doctor.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as this medication may pose risks to the unborn baby or infant. Your doctor will help you weigh the benefits and risks.
If you took this medication during pregnancy, inform your baby's doctor.
Overdose Information
Overdose Symptoms:
- Severe nausea or vomiting
- Stomach pain
- Weakness
- Drowsiness
- Confusion
- Agitation
- Seizures
What to Do:
Seek immediate medical attention or call Poison Control at 1-800-222-1222. Overdose is rare but can lead to acute adrenal crisis or severe electrolyte imbalances.
Drug Interactions
Contraindicated Interactions
- Live or live attenuated vaccines (in immunosuppressed patients)
- Systemic fungal infections (unless used for specific indications like adrenal insufficiency)
Major Interactions
- CYP3A4 inducers (e.g., rifampin, phenytoin, barbiturates, carbamazepine): May decrease prednisone levels, reducing efficacy.
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin): May increase prednisone levels, increasing toxicity.
- NSAIDs (e.g., ibuprofen, naproxen): Increased risk of gastrointestinal ulceration and bleeding.
- Anticoagulants (e.g., warfarin): May alter anticoagulant effect (increase or decrease), requiring close INR monitoring.
- Diuretics (e.g., thiazides, loop diuretics): Increased risk of hypokalemia.
- Antidiabetic agents (e.g., insulin, oral hypoglycemics): Prednisone can increase blood glucose, requiring dose adjustments of antidiabetics.
- Digoxin: Increased risk of digoxin toxicity due to hypokalemia.
Moderate Interactions
- Oral contraceptives/estrogens: May increase prednisone levels.
- Cyclosporine: Increased risk of seizures and other CNS effects.
- Vaccines (non-live): Reduced antibody response.
- Cholestyramine, colestipol: May decrease prednisone absorption.
- Antacids: May decrease prednisone absorption (separate administration).
Minor Interactions
- Grapefruit juice: May slightly increase prednisone levels (CYP3A4 inhibition).
Monitoring
Baseline Monitoring
Blood Pressure
Rationale: Corticosteroids can cause hypertension.
Timing: Before initiation
Blood Glucose (Fasting)
Rationale: Corticosteroids can induce hyperglycemia/diabetes.
Timing: Before initiation
Electrolytes (Potassium, Sodium)
Rationale: Risk of hypokalemia and fluid retention.
Timing: Before initiation
Bone Mineral Density (DEXA scan)
Rationale: For patients anticipated to be on long-term therapy (>3 months) due to osteoporosis risk.
Timing: Before initiation
Ophthalmologic Exam
Rationale: For patients anticipated to be on long-term therapy (>6 months) due to risk of cataracts and glaucoma.
Timing: Before initiation
Weight
Rationale: Fluid retention and appetite changes.
Timing: Before initiation
Routine Monitoring
Blood Pressure
Frequency: Regularly (e.g., weekly initially, then monthly)
Target: <130/80 mmHg (individualized)
Action Threshold: >140/90 mmHg or significant increase from baseline
Blood Glucose (Fasting or HbA1c)
Frequency: Weekly initially, then monthly or quarterly (HbA1c) for chronic use.
Target: <100 mg/dL (fasting); <7% (HbA1c)
Action Threshold: >126 mg/dL (fasting) or symptoms of hyperglycemia
Electrolytes (Potassium)
Frequency: Periodically, especially with concomitant diuretics.
Target: 3.5-5.0 mEq/L
Action Threshold: <3.5 mEq/L
Weight
Frequency: Weekly to monthly
Target: Stable
Action Threshold: Significant weight gain (>2 kg in a week)
Signs of Infection
Frequency: Ongoing clinical assessment
Target: Absence of fever, localized pain, redness, swelling
Action Threshold: Any signs of new infection
Growth (Pediatric Patients)
Frequency: Regularly (e.g., every 3-6 months)
Target: Normal growth velocity for age
Action Threshold: Growth retardation
Ophthalmologic Exam
Frequency: Annually for long-term therapy
Target: Normal intraocular pressure, absence of cataracts
Action Threshold: Increased intraocular pressure, cataract formation
Symptom Monitoring
- Signs of infection (fever, sore throat, unusual fatigue, localized pain/redness)
- Hyperglycemia (increased thirst, urination, hunger)
- Fluid retention (swelling in ankles/feet, weight gain)
- Mood changes (irritability, anxiety, depression, insomnia)
- Gastrointestinal upset (stomach pain, heartburn, black/tarry stools)
- Muscle weakness or pain
- Vision changes
- Easy bruising or thinning skin
- Bone pain
Special Patient Groups
Pregnancy
Prednisone is generally considered Category C in pregnancy. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. It crosses the placenta.
Trimester-Specific Risks:
First Trimester:
Some studies suggest a possible association with oral clefts, but data are inconsistent and overall risk appears low.
Second Trimester:
Generally considered safer than first trimester, but still used with caution.
Third Trimester:
May be associated with fetal growth restriction, adrenal suppression in the neonate, and premature delivery. Neonates should be monitored for signs of hypoadrenalism.
Lactation
Prednisone is excreted into breast milk in small amounts. It is generally considered compatible with breastfeeding, especially at doses up to 20 mg/day. For higher doses, waiting 4 hours after the dose before breastfeeding can minimize infant exposure.
Infant Risk:
Low risk of adverse effects in breastfed infants, but monitor for signs of adrenal suppression (e.g., poor weight gain, irritability) with prolonged high-dose maternal use.
Pediatric Use
Children are more susceptible to growth retardation and adrenal suppression with long-term corticosteroid use. Monitor growth velocity and consider alternate-day therapy or lowest effective dose. Increased risk of cataracts and glaucoma with prolonged use.
Geriatric Use
Elderly patients may be at increased risk for adverse effects such as osteoporosis, diabetes, hypertension, fluid retention, and cataracts. Use the lowest effective dose for the shortest duration possible. Close monitoring is essential.
Clinical Information
Clinical Pearls
- Always taper prednisone doses gradually, especially after prolonged therapy, to prevent adrenal insufficiency crisis. The rate of taper depends on the dose, duration of therapy, and individual patient response.
- Administer prednisone with food or milk to minimize gastrointestinal irritation.
- For once-daily dosing, administer in the morning (e.g., 8 AM) to align with the body's natural diurnal cortisol rhythm and reduce insomnia.
- Patients on long-term prednisone therapy should carry a steroid card or wear medical alert identification.
- Monitor for signs of infection, as corticosteroids can mask symptoms and increase susceptibility.
- Consider prophylactic measures for bone health (calcium, vitamin D, bisphosphonates) in patients on long-term therapy.
- Patients may experience mood changes, including euphoria, depression, or psychosis; educate patients and caregivers about these potential side effects.
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) or biologics for autoimmune diseases (long-term management)
- Immunosuppressants (e.g., azathioprine, methotrexate, cyclosporine) for severe autoimmune or inflammatory conditions (often used as steroid-sparing agents)
- Topical corticosteroids (for localized skin conditions)
- Inhaled corticosteroids (for asthma/COPD)
Cost & Coverage
Average Cost:
$10 - $50 per 30 tablets (50mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it is a good idea to consult with your pharmacist. If you have any questions or concerns about this medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.