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Prednisone and muscle wasting

Prednisone is a corticosteroid - often called a steroid for types of steroids are different to the anabolic steroids abused by body builders or . Prednisone alternating with cyclosporine has been recommended at doses of prednisone 1 mg/kg/day PO plus cyclosporine (10 mg/kg/day PO in 2 divided doses) based on actual or ideal body weight, whichever is lower. Prednisone is available as a liquid, a concentrated liquid, and tablets of varying strengths. These include 1, , 5, 10, 20 and 50 milligrams (mg), but 5 mg daily is the usual physiologic dose.
Muscle problems have many possible causes. Inflammation of the muscle, called myositis, causes muscle weakness and wasting. Several types of drugs are linked to . Prednisone Tablets USP are available for oral administration containing either 1 mg, mg, 5 mg, 10 mg, 20 mg or 50 mg of Prednisone USP. Each tablet contains the following inactive ingredients: lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium starch glycolate and stearic acid (1 mg, mg, and 5 mg only). Find patient medical information for Prednisone Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

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Influence of exercise on muscle fibers in rats with steroid myopathy. Isometric handgrip strength was determined from a series of six maximal efforts. The red images indicate the area of muscle injury, which is reduced by prednisone. Prednisone and muscle wasting Since my posts last week I have found on the Web that long term prednisolone can cause muscle wastage.I have AIH and could not have Azathioprine so was kept on Pred. I am now on a maintenance dose. The weekly steroids also repaired muscles damaged by muscular dystrophy. The studies were conducted in mice, with implications for humans. One of the major problems of using steroids such as prednisone is they cause muscle wasting and weakness when taken long term. This is a significant problem for people who take steroids for many chronic conditions, and can often result in patients having to stop steroid treatments. But the new study showed weekly doses — rather than daily ones — promote muscle repair. Also called muscle wasting, muscle atrophy is usually a sign of an Muscle loss – Dogs – MedHelp3 Jun The prednisone does weaken their muscle mass. Reading your description sounds like my dog. There was no final explanation as to what was ailing him.  Author information: (1)Department of Clinical Studies-Phila, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA Myositis In Dogs | Davies Veterinary The signs caused by myositis in dogs can vary considerably depending on the muscles affected. Masticatory muscle myositis initially causes swelling of the muscles on the top of the head followed, a week or two later, by progressive muscle wasting (loss of muscles).

Many patients do experience side effects with prednisone, especially if it is taken longer than a few weeks. Due to the risks of prednisone therapy, many health care providers do not recommend using it for mild allergic reactions. In these cases, antihistamines are considered first line therapy. If you would like to submit another question, return to Everyday Health. Deltasone prednisone is a corticosteroid, not to be confused with anabolic steroids that body builders may use, used to reduce pain caused from inflammation and swelling.

For quick, acute cases, it is often given in a large dose, and then reduced in dose each day for approximately a week, until it is gone. For chronic conditions, it may be used at a constant, lower daily dose than the large burst.

Short-term side effects include stomach upset, increased blood sugar levels, and insomnia. Therefore, it is recommended to be taken first thing in the morning after breakfast. However, when taking the large burst, it can be hard on the stomach, even after a full meal. For this reason, the large burst dosing may be broken into half the daily dose after breakfast and half the daily dose after lunch.

The earlier in the day it is finished, the better, as it will not interfere with sleep if taken early. The dosepaks recommend it to be taken in spread out time periods throughout the day, including bedtime, to decrease the stomach upset.

However, studies have shown issues with sleep, so the earlier, the better. Side effects of long term use may include truncal weight gain, osteoporosis, glaucoma, type II diabetes mellitus, Cushing's syndrome which may cause a "moon" face and "buffalo hump" when fat grows along the collar bone and the back of the neck, and depression upon withdrawal it should always be tapered and not stopped suddenly.

Due to to long-term side effects, it is important to weigh the risks versus benefits with this medication. I've been taking prednisone for four days, and my blood pressure has dropped several points plus I am weak.

Can prednisone cause this? Prednisone belongs to a class of drugs, called corticosteroids, that prevents the release of substances in the body that cause inflammation. Prednisone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders. Common side effects of prednisone include insomnia, mood changes, acne, dry skin, thinning skin, bruising or discoloration, slow wound healing, increased sweating, headache, dizziness, nausea, stomach pain, bloating, and changes in the shape or location of body fat.

These changes can be seen especially in your arms, legs, face, neck, breasts, and waist. Blood pressure changes can happen with prednisone. However, it usually causes hypertension high blood pressure because it tends to cause the body to retain fluids. Please consult with your health care provider regarding the symptoms you are experiencing. You may also get more information by using the Everyday Health Symptom Checker. This is not a complete list of side effects that can occur with prednisone.

Your doctor or health care provider is best able to properly evaluate your medical condition and make recommendations based on your specific circumstances. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications. Can prednisone cause you to be very emotional and cry a lot? Prednisone is a medication that is used to treat a variety of conditions.

It is a steroid that is used for inflammation or for suppressing the immune system. The prescribing information on prednisone lists the following as the most common side effects of the medication: If you are experiencing side effects that interrupt your daily activities you should consult with your physician to see if another medication may be chosen to help with your condition.

I was prescribed prednisone 5 mg 2 tablets 4 times a day, for discomfort of a root canal that was performed about 4 months ago. Is 2 tablets too much? Should it be 1 tablet? The doctor told me 1 tablet in the morning at 1 at night for 5 days. But when I received the prescription it said 2 tablets 4 times a day. Prednisone belongs to a class of drugs called corticosteroids that prevents the release of substances involved in inflammation.

It is used to treat inflammation from a variety of conditions, including allergic reactions, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, and breathing disorders.

This is not a complete list of prednisone uses. The dosing of prednisone can vary widely. Always follow your doctor's instructions and the directions on your prescription label. If you have questions or concerns about these instructions or if they do not match, contact your doctor or local pharmacist for help. If prednisone was prescribed by your dentist, contact your dentist to clarify the instructions for taking it.

My wife had a mild stroke last night, she has problems on the left side of her face, her face dropped, and she slurs her words when she is talking. She went to the doctor's office and he prescribed prednisone 5mg.

Please, could you tell me if this is the right medication for her? Prednisone prevents the release of substances in the body that cause inflammation.

Prednisone is used to treat many different conditions such as allergic disorders, arthritis, skin conditions, ulcerative colitis, lupus, psoriasis, and breathing disorders. According to the FDA approved drug information, prednisone is not indicated for the treatment or prevention of stroke. A stroke occurs when the blood supply to the brain is interrupted depriving brain of oxygen.

When a stroke occurs, brain cells begin to die within minutes. The use of drugs like cocaine and amphetamines, birth control pills, estrogen replacement therapy, and binge drinking can increase the risk of having a stroke.

The most common type of stroke is an ischemic stroke which is caused by the blockage of an artery. People who have high blood pressure and high cholesterol are at an increased risk for having a stroke. Obesity and smoking are also risk factors. Lifestyle modifications may help prevent stroke. Studies suggest that a healthy diet of whole grains, vegetables, and fruits; and moderate exercise can lower blood pressure and cholesterol. Medications that lower blood pressure are often used to treat and prevent strokes.

If the stroke is caused by a blot clot, blood thinning medications are often used. Consult with your physician for more information about treating stroke. I took 60 mg of prednisone for Myasthenia Gravis daily for almost 5 months. I became very fatigued. I just layed around for days with no energy, and gained 27 lbs. I had several infections. My doctor said my body was not compatible with prednisone. What did he mean by this and what long term damage has been done to my body?

There is not a concern about long term damage unless you are experiencing some unwanted adverse events. Consult with your doctor if you have any concerns or are experiencing any problems. I'm currently taking prednisone 20mg twice a day for my gout attack.

Would the drug have anything to do with why I've been feeling so bloated in my stomach lately? It feels tight even though I have not eaten anything. I don't think it is gas. Prednisone Deltasone is classified as a corticosteroid medication. Prednisone works in the body by preventing the release of substances that are responsible for causing inflammation.

Prednisone is used to treat various medical conditions including gout. According to medical references, abdominal distension is a possible side effect reported by studied patients taking prednisone. If you think that you are experiencing a possible side effect from your medication, talk with your physician.

Do not stop taking or change the dose of your medication without talking to your physician first. Prednisone is a corticosteroid anti-inflammatory medication, not to be confused with anabolic steroids that some athletes use, which is given to block the immune system somewhat, and reduce swelling it can cause.

Prednisone can also be used as an antitumor medication, along with other anticancer drugs. Prednisone suppresses the adrenal glands, so it can also be used to treat congenital adrenal hyperplasia, where the adrenal glands become very large. Migraines and cluster headaches have also been successfully treated by prednisone. Patients with MS Multiple sclerosis can have a periodic attack of cerebral inflammation which improves with IV prednisone.

When taking the tablets, it is usually given in a large burst in dose, and then decreased over approximately 7 days. A major side effect is insomnia, so the sooner in the day that the doses can be taken, the better. On the first few days, the dose is large and could be taken all at once in the morning, but the other major side effect is stomach upset. Therefore, taking half of the daily dose after a good breakfast and then again after a good lunch would could down on the side effect of an upset stomach.

If a person is going to be put on the medication longer, and on a daily basis, it is usually given at a lower dose, which can be taken after breakfast each day. There are long term side effects which may occur, so it is best to stop taking the medication when it is possible.

What is in prednisone that makes one put on weight, causes joints to hurt and eyesight to be impaired? Prednisone, like all steroids, has significant side effects especially when taken long term. It is always best to only use prednisone and other steroids for a short time if possible, however some conditions may require long term use. For more information on Prednisone: Corticosteroids are used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, Crohn's Disease, arthritis, lupus, psoriasis, or breathing disorders.

Prednisone is converted in your body, by the liver, into prednisolone. I want to join Weight Watchers. I'm taking prednisone and will be downsizing it until at least December. Can I lose weight while taking that? I think that it is great that you are joining Weight Watchers.

While I do not know the dosage that you are taking, many patients do retain salt and water and have difficulty building muscle while on prednisone. I usually recommend lighter exercise including walking, light bike riding and using an elliptical trainer. Keep in mind that recovery times for people on steroids is longer than normal and that on occasion prednisone may interfere with sleep patterns, which may also affect recovery.

While we usually recommend that patients on prednisone continue to exercise, we usually recommend that they keep the weight training very light and to eliminate strength training until you have concluded your prednisone course. Prednisone is killing my full stomach even with food and Pepto-Bismol.

My stomach hurts so much I can't breathe. What else can I do? If you are having this much problem when taking prednisone, then you should let your health care provider know. They will want to know that you are having this problem and see what may be causing this. I am not sure if the predinsone is interacting with any other medications you may be taking but once again talk to your provider. Before taking any OTC medications, check with your pharmacist to be sure they do not interact with any medications you may be taking.

Prednisone is an oral corticosteroid that mimics cortisol, which is secreted by the adrenal gland. The clinical use of prednisone started around , and it has literally saved thousands of lives since that time. While oral prednisone therapy does have its drawbacks, some weight gain, salt and water retention, increased chance of infection.

The anti-inflammitory properties and its ease of use have not been paralleled in the field of pharmacology since. When given for a specific purpose, prednisone is one of the safest, most tolerated medications in the compendium.

Can taking prednisone have anything to do with pancreatic cancer? Prednisone belongs to a class of medications called corticosteroids, and it prevents the release of substances in the body that cause inflammation. Prednisone is used to treat a variety of conditions, including skin conditions, allergy conditions, asthma, and inflammation. Its side effects include sleep problems, dry skin, dizziness, nausea, and changes in the shape of body fat.

Pancreatitis, or inflammation of the pancreas, are also listed as possible side effects of prednisone, but pancreatic cancer is not. My wife had a mild stroke last night and now has drooping on the left side of her face, as well as slurred speech. Her doctor prescribed prednisone.

Is this the right medication for her? It's used to treat many different conditions, including allergic disorders, arthritis, skin conditions, ulcerative colitis, lupus, psoriasis, and breathing disorders.

Prednisone is not generally prescribed for the treatment or prevention of stroke. A stroke occurs when the blood supply to the brain is interrupted, depriving the brain of oxygen. The use of drugs such as cocaine and amphetamines, birth control pills, estrogen replacement therapy, and binge drinking can increase the risk of having a stroke. The most common type of stroke is an ischemic stroke, which is caused by the blockage of an artery.

Studies suggest that a healthy diet of whole grains, vegetables, and fruits, plus moderate exercise, can lower blood pressure and cholesterol. If the stroke is caused by a blot clot, blood-thinning medications are often used. My doctor gave me prednisone for chronic pain. Can this be taken more than just that pack I got, like one or two pills a day instead of that pack?

It has helped my pain so much. I dread when I am finished with the pack. Prednisone is a corticosteroid medication that is used to treat a variety of pain and inflammatory conditions. You should take the prednisone pack exactly as it was prescribed by your physician. If the pain returns when you have completed the course of prednisone, call your physician.

There are many possible risks to long-term corticosteroid therapy. Long-term use of corticosteroids can cause high blood pressure, osteoporosis, diabetes, and depression. Discuss the risks and benefits of prednisone therapy with your physician. Mobic meloxicam and Celebrex celecoxib are prescription non-steroidal anti-inflammatory drugs NSAIDs that are effective in relieving pain and inflammation.

They can increase your risk of serious gastrointestinal problems including bleeding and ulcers, but this side effect can be minimized by taking them with proton pump inhibitors PPIs such as Prilosec omeprazole or Prevacid lansoprazole. Can a small amount of prednisone mg taken daily for myasthenia gravis cause dizziness? Yes, there is a possibility that even small doses of prednisone may cause dizziness. Dizziness is listed as one of the more common side effects of prednisone.

Usually, this side effect will go away with time as your body gets adjusted to the medication. If this is not the case for you, try speaking with your doctor to see if there is another drug that you may be able to try. What is the highest dose of prednisone I can take safely? There is actually no absolute maximum dosage for prednisone. However, it is not unsafe to take higher doses. It just depends on how your body reacts to the medication and how the side effects impact you.

Will prednisone raise my blood sugar? Mine has actually come down. I have reviewed your question regarding prednisone and your blood glucose level. It is used to treat certain inflammatory diseases. Short-term side-effects include high blood glucose levels, especially in patients who already have diabetes mellitus.

Continue to monitor your blood glucose levels and if you notice an increase, contact your physician. I take prednisone and wonder what its side effects are over time. There are many possible side effects with prednisone, but they're patient specific. You should consult your doctor if you think you're having a reaction to prednisone.

I've been on prednisone for more than a year. Could it be causing my extra-dry skin and hair, and the bruises I now get easily? Prednisone packaging does list dry skin and easy bruising as side effects. Is prednisone working at the dose you're on? Maybe you can reduce how much you take, but consult your doctor first to find out. Are you using moisturizers to help with the dry skin? If not, you could start using one multiple times of day, as needed.

I take prednisone but am looking for an alternative. Are there any good substitutes? Prednisone is a corticosteroid not an anabolic, which is what bodybuilders use that reduces inflammation. That having been said, NSAIDs nonsteroidal anti-inflammatory drugs can also be used for inflammation, but they're usually not as strong.

If you aren't tolerating your prednisone, you can try dividing the dose between morning and afternoon, and take it after a meal. It can interfere with sleep, so the earlier in the day you take it, the better.

About 3 weeks ago, I got poison ivy. I went to a clinic so it could be controlled. The prescription that was given was prednisone. After taking it, my rash was slowly clearing, but I started itching on my back and around the creases of my body.

It then started to itch like crazy. My job is very physical, so I sweat all day. I really started to break out. I finally finished the medication 2 days ago but still have the rash and still itch but not as bad. What do you recommend?

There are different things that could cause the rash and itching. You could be allergic to the prednisone. Your poison ivy could have spread. You could have a reaction to all the sweating you have done recently. Or it could be something completely different.

The recommendation is for you to talk to your health care provider regarding the rash. Your health care provider can properly diagnose what it is causing it and recommend specific treatment.

If you start noticing any difficulty breathing or swelling of the throat or tongue, seek immediate emergency medical help as this would be signs of an anaphylactic reaction. Attached is a link to additional information provided by Everyday Health regarding rash. Can you still lose weight with diet and exercise while on prednisone for COPD? My face and stomach swell up so bad that it hurts, and I just lose all my desire to go to the gym.

And prednisone makes me so hungry. According to Lexi-Comp, prednisone Deltasone has the associated adverse effects including fluid retention and abdominal distention. These side effects could be the cause of your swelling and discomfort. If you are experiencing pain, then it is important for you to talk to your physician regarding your symptoms.

If you are eating unhealthy or in excess, then changing your diet could help you shed some pounds. Exercises can also help with weight control.

Make sure that you talk with your physician before beginning an exercise program, especially since you have COPD. Please talk with your health care provider regarding your medical conditions and possible medication side effects. I am 63 years old. For the past year I have had constant discomfort in my neck, shoulders, hips and all up and down my back. The left side of my back was recently swollen so I went to a doctor who prescribed a 5 day series of prednisone.

For a couple of weeks I felt great! No muscle-joint discomfort and my psoraisis almost cleared up. What is wrong with me that prednisone fixed? Can you take prednisone long term? Prednisone, in a class of drugs called steroids, prevents the release of substances in the body that cause inflammation, and is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

Prednisone may also be used for other purposes not mentioned here. Less frequent, but more serious, side effects from prednisone include diabetes, hypertension high blood pressure , osteoporosis, suppressed immunity, impaired wound healing, peptic ulcer disease, suppression of the adrenal glands, cataracts, depression, and psychosis. Prednisone is almost never intended for long-term use. This is not a complete list of the side effects associated with prednisone. Prednisone is a commonly used oral corticosteroid to suppress inflammation and the immune response.

It is approved to treat a number of different conditions. According to the prescribing information, the most common side effects of prednisone include sleep problems, mood changes, acne, dry skin, increased sweating, nausea, stomach pain and bloating, headache, dizziness, and changes in body shape or location of body fat especially in face and neck. Corticosteroids can cause some serious side effects, especially with longer-term use. Patients taking prednisone may not be able to respond to a stressful situation, such as surgery, and they may be more likely to get an infection.

Prednisone can cause high blood pressure and fluid retention, which can lead to swelling and weight gain. This effect can also lead to low levels of potassium and calcium in the blood. Patients should be aware of the signs of low potassium, such as confusion, thirst, muscle weakness or irregular heartbeat, and if they occur, contact their healthcare provider.

Patients taking long-term corticosteroids are at an increased risk for osteoporosis, high blood sugar levels, high cholesterol levels, and development of cataracts. I have prednisone induced diabetes. Will I always have diabetes, even if I get off prednisone? Some of the side effects of prednisone may include: Prednisone may alter glucose regulation which can lead to high blood sugar. The risk for developing high enough blood sugar levels to warrant treatment is dependent on the dose of the corticosteroid.

The higher the dose, the more likely a person is to develop high blood sugars that need to be treated. Treatment of high blood sugar or diabetes brought on by prednisone is the same as treatment for an individual with non-corticosteroid induced diabetes. Corticosteroid induced diabetes improves when the dose of the steroid is decreased.

The diabetes may also go away after several months once the steroid is stopped. Prednisone is used alone or combined with other medicines to treat symptoms from having low corticosteroid levels in the body. I have been prescribed prednisone for hives.

I had lost 10 pounds over a two month period of eating very carefully. In only 3 days on the prednisone I have gained back 5 of those hard to lose pounds! Is there anything I can do to the stop the rapid weight gain? Prednisone is a corticosteroid medication which is used to treat various inflammatory conditions including temporary use for relief of allergic reactions.

Side effects associated with short term use of prednisone include insomnia, stomach upset, mood changes, increased appetite, and weight gain. Prednisone can increase appetite which may lead to higher calorie intake and it may lead to fluid retention both of which can lead to weight gain.

Increasing physical activity exercise can help compensate for increased caloric intake which may be associated with prednisone use. It is recommended for most individuals to get at least 30 minutes of physical activity walking, swimming, gardening, etc. Decreasing caloric intake can also help to prevent weight gain. Any water weight gained while on prednisone will likely go away once the medication is stopped. You may wish to talk with your doctor about options for weight loss.

A registered dietician can provide specific dietary advice. If prednisone is taken once daily, it should be taken in the morning. Take prednisone with food to prevent stomach upset.

Take prednisone as directed by your doctor. Do not suddenly stop prednisone unless directed by your doctor to do so. Be sure to inform your doctor and pharmacist of all the medications you take, including over the counter medications, vitamins, and herbal supplements so they can monitor for drug interactions. It is also important to discuss any adverse effects from medications with your doctor. When my eczema and dermatitis worsen, prednisone gets it under control. I was told by a doctor that if I did not take it long term and had 30 days or more in between the times I needed to take it, it would not cause any major side effects.

Am I better off with a steriod shot or the pills for 10 days? Studies have shown that patients taking prednisone may experience possible side effects such as weight gain, risk of infections, headache, high blood pressure, fluid retention, bruising of the skin and possible insomnia. Prednisone belongs to a class of medications called corticosteroids. Corticosteriods are usually used for the anti-inflammatory effects. Whether the formulation is by oral administration or by injection, possible side effects will primarily be the same as mentioned above.

Talk to your doctor or pharmacist about any side effects you may be experiencing or your concerns regarding repeated use of prednisone. Consult with them regarding all other prescription or over-the-counter medications you may be taking in combination which can cause other potential side effects or drug interactions. Your healthcare provider should be able to discuss the best treatment options with you.

Does prednisone interact with any prescription drugs? I take it when I have hives. Prednisone is classified in a class of drugs called steroids. The medication prevents the release of substances in the body that cause inflammation. Steroids can interact with other medications. Some drugs include aspirin taken on a daily basis or at high doses , diuretics water pills , a blood thinner such as warfarin Coumadin , cyclosporine Gengraf, Neoral, Sandimmune , insulin or diabetes medications you take by mouth, ketoconazole Nizoral , rifampin, or certain seizure medications, such as phenytoin Dilantin or phenobarbital.

There may be other drugs that can interact with prednisone. Tell your doctor about all the prescription and over-the-counter medications you take.

This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. I have hives from a drug reaction and have been given prednisone to clear it up. However, the hives continue to reappear.

I have been taking the prednisone for three days. A drug allergy occurs when the body's immune system reacts to the medication as if it were a foreign invader. These reactions can range from a mild skin rash to a severe life-threatening condition called anaphylaxis.

For severe reactions, emergency medical treatment is needed. However, other reactions, such as hives, can usually be managed at home. The first step in treating a drug reaction is to stop the medication that has caused the reaction.

Prednisone is a corticosteroid that prevents the release of substances in the body that cause inflammation. The length of treatment can depend on a few factors, for example, how long it takes the body to clear out the offending drug. Corticosteroids may be needed for an extended period up to a week to 10 days in order to clear a drug reaction.

Sometimes, your doctor may prescribe a corticosteroid taper that starts with a high dose and slowly decreases the dose over a few days. Follow your doctor's instructions and the directions on your prescription label. If your hives continue, consult your doctor for specific treatment recommendations.

For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. According to the prescribing information, prednisone is used for multiple sclerosis during acute exacerbations relapses of the disease. Multiple Sclerosis is a chronic, inflammatory, demyelinating autoimmune disease of the central nervous system.

Prednisone works for MS by helping to decrease the inflammation in the central nervous system. Prednisone is not the only steroid that may be used to treat the exacerbations of MS. According to the National Multiple Sclerosis Society, dexamethasone, betamethasone, and prednisolone are also used. Methylprednisolone, another corticosteroid, has also been used to treat MS exacerbations.

There is no set course of therapy determined for corticosteroid use in MS. Some people are given intravenous corticosteroids over a period of a few days, while other people take oral by mouth corticosteroids. Prednisone works by changing the way the immune system works to decrease inflammation, redness, and pain. Some of the other conditions prednisone can be used for include: Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy; trichinosis with neurologic or myocardial involvement.

Prednisone tablets and oral solutions are contraindicated in systemic fungal infections and known hypersensitivity to components. Increased dosage of rapidly acting corticosteroids is indicated in patients on corticosteroid therapy subjected to any unusual stress before, during and after the stressful situation. Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium.

These effects are less likely to occur with the synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary.

All corticosteroids increase calcium excretion. Literature reports suggest an apparent association between use of corticosteroids and left ventricular free wall rupture after a recent myocardial infarction; therefore, therapy with corticosteroids should be used with great caution in these patients.

Corticosteroids can produce reversible hypothalamic-pituitary adrenal HPA axis suppression with the potential for corticosteroid insufficiency after withdrawal of treatment.

Adrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for up to 12 months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted.

If the patient is receiving steroids already, dosage may have to be increased. Metabolic clearance of corticosteroids is decreased in hypothyroid patients and increased in hyperthyroid patients.

Changes in thyroid status of the patient may necessitate adjustment in dosage. Patients who are on corticosteroids are more susceptible to infections than are healthy individuals.

There may be decreased resistance and inability to localize infection when corticosteroids are used. Infection with any pathogen viral, bacterial, fungal, protozoan or helminthic in any location of the body may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function.

With increasing doses of corticosteroids, the rate of occurrence of infectious complications increases. Corticosteroids may exacerbate systemic fungal infections and therefore should not be used in the presence of such infections unless they are needed to control life-threatening drug reactions.

Latent disease may be activated or there may be an exacerbation of intercurrent infections due to pathogens, including those caused by Amoeba, Candida, Cryptococcus, Mycobacterium, Nocardia, Pneumocystis, Toxoplasma.

It is recommended that latent amebiasis or active amebiasis be ruled out before initiating corticosteroid therapy in any patient who has spent time in the tropics or any patient with unexplained diarrhea. Similarly, corticosteroids should be used with great care in patients with known or suspected Strongyloides threadworm infestation. In such patients, corticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia.

The use of Prednisone in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for management of the disease in conjunction with an appropriate antituberculous regimen.

If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.

Killed or inactivated vaccines may be administered. However, the response to such vaccines may be diminished and cannot be predicted. Indicated immunization procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids as replacement therapy e.

Chickenpox and measles can have a more serious or even fatal course in pediatric and adult patients on corticosteroids. In pediatric and adult patients who have not had these diseases, particular care should be taken to avoid exposure. How the dose, route and duration of corticosteroid administration affect the risk of developing a disseminated infection is not known.

If exposed to chickenpox, prophylaxis with varicella zoster immune globulin VZIG may be indicated. If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin IG may be indicated.

If chickenpox develops, treatment with antiviral agents may be considered. Use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to bacteria, fungi or viruses. The use of oral corticosteroids is not recommended in the treatment of optic neuritis and may lead to an increase in the risk of new episodes.

Corticosteroids should not be used in active ocular herpes simplex because of possible corneal perforation. The lowest possible dose of corticosteroids should be used to control the condition under treatment. When reduction in dosage is possible, the reduction should be gradual. Discontinuation of corticosteroids may result in clinical improvement.

As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, or renal insufficiency.

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for up to 12 months after discontinuation of therapy following large doses for prolonged periods; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Steroids should be used with caution in active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since they may increase the risk of a perforation.

Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent. There is an enhanced effect due to decreased metabolism of corticosteroids in patients with cirrhosis. Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation i. This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism, and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age.

Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. Special consideration should be given to patients at increased risk of osteoporosis e. Inclusion of therapy for osteoporosis prevention or treatment should be considered.

To minimize the risk of glucocortoicoid-induced bone loss, the smallest possible effective dosage and duration should be used. Lifestyle modification to reduce the risk of osteoporosis e. Calcium and vitamin D supplementation, bisphosphonate e.

Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that they affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect.

An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission e. This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis. Elevation of creatinine kinase may occur.

Clinical improvement or recovery after stopping corticosteroids may require weeks to years. Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations.

Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Intraocular pressure may become elevated in some individuals. If steroid therapy is continued for more than 6 weeks, intraocular pressure should be monitored. Patients should be warned not to discontinue the use of corticosteroids abruptly or without medical supervision. As prolonged use may cause adrenal insufficiency and make patients dependent on corticosteroids, they should advise any medical attendants that they are taking corticosteroids and they should seek medical advice at once should they develop an acute illness including fever or other signs of infection.

Following prolonged therapy, withdrawal of corticosteroids may result in symptoms of the corticosteroid withdrawal syndrome including, myalgia, arthralgia, and malaise. Persons who are on corticosteroids should be warned to avoid exposure to chickenpox or measles.

Patients should also be advised that if they are exposed, medical advice should be sought without delay. When corticosteroids are administered concomitantly with potassium-depleting agents e. In addition, there have been cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure.

Hepatic Enzyme Inducers, Inhibitors and Substrates. Concomitant use of anticholinesterase agents e. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy. If concomitant therapy must occur, it should take place under close supervision and the need for respiratory support should be anticipated.

Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.

Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. Since systemic steroids, as well as bupropion, can lower the seizure threshold, concurrent administration should be undertaken only with extreme caution; low initial dosing and small gradual increases should be employed. Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently.

Convulsions have been reported with this concurrent use. Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia. Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.

Post-marketing surveillance reports indicate that the risk of tendon rupture may be increased in patients receiving concomitant fluoroquinolones e. Tendon rupture can occur during or after treatment with quinolones.

Drugs which inhibit CYP 3A4 e. Glucocorticoids are moderate inducers of CYP 3A4. Co-administration with other drugs that are metabolized by CYP 3A4 e. In addition, ketoconazole alone can inhibit adrenal corticosteroid synthesis and may cause adrenal insufficiency during corticosteroid withdrawal. Concomitant use of aspirin or other nonsteroidal anti-inflammatory agents and corticosteroids increases the risk of gastrointestinal side effects.

Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids; this could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn. In post-marketing experience, there have been reports of both increases and decreases in phenytoin levels with dexamethasone co-administration, leading to alterations in seizure control.

Phenytoin has been demonstrated to increase the hepatic metabolism of corticosteroids, resulting in a decreased therapeutic effect of the corticosteroid.

Increased doses of quetiapine may be required to maintain control of symptoms of schizophrenia in patients receiving a glucocorticoid, a hepatic enzyme inducer. Co-administration with thalidomide should be employed cautiously, as toxic epidermal necrolysis has been reported with concomitant use.

Patients on corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response. Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines.

This allows your pharmacist to keep a complete record of all your prescription drugs and advise you about drug interactions and side effects. Corticosteroids are used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, Crohn's disease, arthritis, lupus, psoriasis, and breathing disorders. This is because prednisone needs to be converted by liver enzymes into prednisolone before it can work. Medications for mood disorders, diabetes, high blood pressure and seizures can all add on unwanted weight, but many of these medications are vital, so what can we do? The recommendation is for you to talk to your health care provider regarding the rash. Prednisone and muscle wasting
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