Prednisone

Prednisone is a steroid that we sometimes use to control severe inflammation.  Since it is a medication that can causes side effects, it is important to use this medication responsibly.  We attempt to use prednisone in the lowest possible dosage, for the shortest period of time.  In asthma, rashes, persistent cough, or with eustachian tube dysfunction and ear blockage, we will often use 10 to 20 milligrams for seven to ten days.  We want patients to take this with food to minimize stomach upset, and since it can occasionally make people speedy, we tell patients to take it in the morning.  It rarely causes any side effects at this level, though it can occasionally cause mood swings, stomach upset, or jitteriness.  If you look in the PDR you will see that prednisone can cause all sorts of side effects, but these are usually in high doses when given for long periods of time.  Please realize that when we give you this medicine it is because we feel that the excellent benefits in reducing inflammation outweigh the downsides at the doses we are using.  We are not using this medicine without forethought!

Sometimes in inflammatory bowel disease,  or chronic asthma, we may use 60 mgs per day  for several months.  Under these circumstances we often see weight gain, bloating, facial swelling, acne, bone loss, and glucose elevations in the blood.

If given at high doses, prednisone must be tapered over a several week period.  An individual usually produces about 5 to 7 mgs of "prednisone" per day, naturally.  When a patient has been on prednisone for more than a month, natural cortisol production is suppressed, and it may take months for the adrenal glands to produce high doses of cortisol.  In an emergency the adrenals pump out large amounts of cortisol, so that an individual on chronic prednisone must be prepared to take extra prednisone in the case of  an emergency, especially when the natural adrenal glands have been suppressed by a month of steroids.

When given for only a couple of weeks this is not an issue!