How does prednisone work in your body?

Prednisolon is a synthetic corticosteroid, which is metabolised in the liver to its active form Prednisolone. After converting into prednisolone, it crosses the cell membrane and strongly binds to cytoplasmic receptors which results the infiltration of leukocyte at the site of the inflammation. These leukocytes then interfere or stops the functions of the mediators which is responsible for the inflammatory response. This whole process causes the suppression of the humoral immune response which decrease the edema or swelling and the scar tissue.

Corticosteroid or prednisone acts by involving with phospholipaseA2 or lipoprotien and control the biological synthesis of inflammatory mediators like prostaglandin or leukotriene. Prednisone can also cause the release of gastric juice and can pause the production of corticoprotien which further, stops the production of endogenous corticosteroids.

Prednison also has a mineralocorticoid action which stimulates the entry of sodium ions into the cells and cause the loss of intracellular potassium. Because of this activity, ion exchanges in your body become faster which influence the sodium retention in the kidney and cause hypertension. 

Who should use prednisone?

Prednisone can be used for many diseases. Some of the important indications are discussed here:

Endocrine disease:

• Primary and secondary adrenocortical insufficiency
• Congenital adrenal hyperplasia
• Hypercalcemia associated with cancer
• Nonsuppurative thyroiditis.

Rheumatic disease:

• Psoriatic arthritis
• Rheumatic arthritis
• Juvenile arthritis
• Ankylosing spondylitis
• Acute and subacute bursitis
• Acute nonspecific tenosynovitis
• Acute gouty arthritis
• Post-traumatic osteoarthritis
• Synovitis of osteoarthritis
• Epicodylitis

Collagen related diseases:

• Systemic lupus erythematous
• Systemic dermatomyositis
• Acute rheumatic carditis

Dermatological disease

• Pemphigus
• Bullous dermatitis
• Severe erythema 
• Steven Johnson's syndrome
• Exfoliative dermatitis
• Mycosis fungoides
• Severe psoriasis
• Seborrhea dermatitis

Allergy related diseases:

• Seasonal allergic rhinitis
• Bronchial asthma
• Contact dermatitis
• Atopic dermatitis
• Drug hypersensitivity reactions

Opthalmic problems:

• Allergic corneal ulcer 
• Herpes zoster opthalmicus
• Allergic conjunctivitis
• Keratitis
• Chorio-retinitis
• Irityis or infection of iris of the eye

Respiratory disease:

• Sarcoidosis
• Disseminated pulmonary tuberculosis

Blood disorder:

• Thrombocytopenia
• Autoimmune haemolytic anaemia
• Erythrocytopenia (decreased RBC)
• Congenital hypoplastic anaemia
• Leukomia in children and adults
• Lymphomas in child

Swelling or edematous state:

• Nephrotic syndrome
• Lupuserythmatosus

Gastrointestinal disease:

• Ulcerative colitis
• Enteritis

Central nervous system disease like acute multiple sclerosis.

Other diseases like tuberculosis meningitis, trichinosis etc.

Contraindication of Prednisone:

Prednisone is contra-indicated in the patients with following conditions:

• Do not use prednisone if you are suffering from peptic ulcer.
• Always avoid prednisone you suffer from bone disease such as osteoporosis.
• You should always avoid prednisone if you are suffering psychoses or severe psychoneuroses.
• You should strongly avoid prednisone if there is any acute infection, and ask your doctor's advise before starting the dose.
• You should not take any vaccines related to virus when you are taking prednisone.

What are the dosage of Prednisone:

Always consult with your physician before starting prednisone, because it varies according to the age and the disease and of the patient, like:

Dose for adult in nephrotic syndrome:
Strength of of the prednisone for adult in nephrotic syndrome varies from 2mg to 80mg, taken in divided doses three or four times in a day, which is followed by the strength of 1.5mg in every alternat day for 4 weeks.
The maintainace dose is refered to prevent relaps by following .5 to 1mg every alternat day for 3- 6 months.

Dose for inflammation in adult:
Dose of prednisone for inflammation varies from 5mg to 60mg, in diveded doses, 1 to 3 times in a day.

Dose for nephrotic syndrom in children:
dose will be same as adult.

Dose of prednisone as pediatric anti-inflammatory:
0.5 to 2mg in diveded doses, 3-4 times in a day.

Dose as immunosuppresant in children:
0.5 to 2mg in 3-4 divided dose.

Dose for children in Asthma:
The dose should be 10mg to 40 mg for the childrenbetween the age group of 6 months to 18 years.

What should you do if you overdose Prednisone?

You should always seek for medical assistance or talk to your doctor if you overdose the drug to avoid any complication. However, there is no history of any life threatening complication of prednisone, you may catch some problems due to long term therapy, like increased acne or facial hair, impotence, loss of libido or menstrual problem.

What should you do if you miss a dose of prednisone?

• You should always take the missed dose as soon as you remember it.
• Do not take the missed dose almost near to the time of the next dose
• Do not take any Extra dose to compensate the missed dose.

What are the side effects of Prednisone?

Always consult with your doctor if you develop any side effects after taking the drug prednisone.The prednisone has many types of side effects, such as:

The most common side effects:

• Anxiety
• Agitation
• Aggression
• Headache
• Irritation
• Dizziness
• Irritation
• Mental depression
• Mood swing
• Blurred vision
• Depression
• Nervousness
• Numbness of legs
• Shortness of breath
• Edema or swelling of hand, foot, face.
• Obesity

Other side effects:

• Abdominal pain
• Dry mouth
• Eye pain
• Diarrhea
• Heart burn or acidity
• Increased thirst
• Increased hunger
• Nausea
• Skin problem
• Sweating
• Fever
• Back pain

Some important systemic side effects:

Effect on cardiovascular system:
Prednisone has some cardiovascular effects like hypertension and heart failure which occurs due the retention of fluid and vascular effect. Prednisone may cause systolic hypertension if you take this drug as a long term therapy.

Effect on endocrine system:
Endocrine complication like glucose intolerance and hyperglycemia may occur in some patient who take prednisone. Long term therapy may cause to develop cushingoid symptoms in some patients. Chronic therapy of prednisone may cause impotence and menstrual irregularities in many patients.

Effects on GIT or gastrointestinal system:
A patient who takes prednisone may catch any gastri-intestinal symptoms like nausea, vomiting, anorexia etc. The patient who are under long-term therapy have the highest risk of developing a peptic ulcer. Gastrointestinal perforation and infection in the pancreas are also reported in patients who take long-term therapy of prednosone.

Effect on muscles and bone:
According to the scientists, it is reported that about 10% patients have bone who take prednisone on the strength of 10mg. The bone problem is more common in women who are under prednisone. Some other problems like myopathy, osteoporosis, chronic bone infection are very common in patients who take prednisone for longer period.

Effect on the eye:
Prednisone has a strong effect on the eye if you take it for long periods. Cataract is the major side effect of prednisone. Increased intra-ocular pressure is also one of the frequently occurred side effect of prednisone.

What are the drug interactions with prednisone?

Prednisone can interact with many other drugs. It is not possible to mention all drugs here, some of the important drug names are mentioned here, like:

• Amphotericin B
• Digoxine
• Diuretics
• Antibiotic like Clarithromycin
• Cyclosporine
• Anticoagulants like Warfarine
• Any birth control pills
• Drugs used in hepatitis C
• Oral anti-diabetic drug
• Antifungal drugs like ketoconazole, itraconazole, voriconazole etc.
• Anti-convulsion drugs like carbamazepine, phenytoin, barbiturates etc.
• Drugs used for HIV/AIDS
• Drugs used in tuberculosis like rifampicin, isoniazid.

Since prednisone is a corticosteroid, there is always a chance to interact with other medication which can cause very serious complication. So always take the advise from your doctor if you are taking any other medication before you start any strength of prednisone or cortcosteroid.

Precautions and warnings for Prednisone:

Prednisone is a anti-inflammatory medication. Since it has also a capacity to weaken your immunity, it is advised use prednisone by following the instructions of your heath care provider. The patient who has a ill health, should always avoid to taking the drug. Some of the precautions you can take when you take prednisone, such as:

Always inform your doctor before taking the drug if you have a disease like diabetes, high blood pressure, mental depression, any infection etc.

• Don't forget to inform the physician if you have any muscle or bone problem.
• Ask advice from your doctor if you have heart problem, tuberculosis, epilepsy, liver disease or kidney problem.
• You should always avoid any vaccination related to virus if you are going to take any strength of prednisone.
• Always avoid smoking if are taking prednisone, because it may lead bone loss or osteoporosis.
• Prednisolon should aways be avoided in pregnancy and lactation period.
• Prednisone should always be used with cautious in children.