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Doctors' Answers to "Frequently Asked Questions" - Prednisone
Prednisone Withdrawal [posted
Answer:Sure, as to the withdrawal, you need to ensure that your adrenal glands have become active again or you will experience symptoms of Adrenal Insufficiency (Addison's Disease). Have your doctor perform an ACTH stimulation to see if they're working. If not you need a regimen to get them back (usually every other day or every third day omission).
Prednisone [posted 1/6/99]
Answer: Not usually constipating, but occasionally affects the skin and hair. The drug coming out in February is a whole new class of anti-inflammatory, which will decrease inflammation without the GI risk.
Prednisone taken with
Anti-Depressants [posted 1/5/99]
Answer: They will still work, but potentially modified by the psychological effects that prednisone has on some patients.
Prednisone [posted 1/5/99]
Answer: No, but steroids do have mental status changes in about 10-20% of patients unto themselves.
Anti-depressants taken with
Prednisone [posted 1/4/99]
Answer: Steroids clearly cause mental status changes in some patients. It is variable and seems dosage dependent. Whether it helps/alters the depression would vary a lot from patient to patient. So, maybe yes, maybe no.
Prednisone Dosage for Sarcoidosis [posted
Answer: A little longer than average;but, they are describing the potential course. In fact, it will depend a lot on how your individual disease responds. You can block some of the osteoporosis with drugs like Fosamax and Miacalcin, the other side effects will be present and will be dose and duration dependent. However, there is no other treatment and this can be a fatal disease. If you need a second opinion, the University of Michigan (Ann Arbor) has a world class dept of Rheumatology.
Can Prednisone Be Causing Mood Swings
Answer: Probably the prednisone and it should revert to normal as the dosage is decreased.
Prednisone Withdrawal Concerns[posted
Answer: Morning is the best time to avoid adrenal suppression, evening the worst. That is the reason that we don't split doses, although as an antiinflammatory, it probably works somewhat better in split doses. While taking these doses of prednisone, most physicians recommend calcium, vitamin d and either fosamax or miacalcin to avoid bone loss, discuss this with your physician.
Prednisone Withdrawal Concerns[posted
Answer: Hard to know sometimes if you have steroid deficiency or a return of the PMR. Has your sedimentation rate been rechecked? If normal, then could be adrenal insufficiency. This can be checked by a cortrysn stimulation test to test adrenal response. However, if your sed rate is up sounds like the PMR is still active.
Does Prednisone Cause Severe
Headaches [posted 10/28/98]
Answer: Possibly, but unlikely. Check with your doctor.
Prednisone & MS [posted
Answer: Unfortunately not at this time. But, there are other alternatives to MS, interferon etc. Are you on these?
Prednisone Effects on Sex Drive [posted
Answer: Not usually, but, there are many personality changes that have been described
Prednisone Information [posted
Answer: Steroids are great anti-inflammatories, but, tend to age the body more rapidly. That is cause cataracts, hardening of the arteries, diabetes, etc. This is dose and duration related. But, your dosing etc. will be dictated by your disease. There should be an attempt to minimize the osteoporotic causing effects of steroids by using drugs such as Fosamax, Miacalcin, etc. You need a long discussion with your doctor
Prednisone & Weight Gain [posted
Answer: In the early stages, it will go back to normal. After extended use, it tends not to.
Prednisone Effects [posted
Answer: Steroids main side effect is to increase many parameters of aging. This includes arthritis, degenerative changes of joints, etc. These are all well documented. As to the specifics of your problem, it would be hard to say without examining the problem. There would be little problem with the pregnancy at the dosage you were taking.
Prednisone [posted 7/30/98]
Answer: It appears that they inhibit specific functions of white blood cells. This limits the production of factors necessary to initiate and continue the inflammatory response. This includes inhibition or decreased production of histamine, leukotriene, cytokines, arachidonic acid byproducts, and different acute phase reactants. This occurs in basophils, fibroblasts, lymphocytes, macrophages and endothelial cells.
Prednisone and Cataracts [posted
Answer: Everyone is different, but it will speed up cataracts - depending on your current age and your history of family cataracts. It is dose and time dependent. This means use as little as possible for as short as possible. However, if it is effective you will need it. I assume you are receiving treatment for steroid induced osteoporosis while you are taking steroids. This is necessary to decrease the risk of the osteoporosis seen with steroid use.
Prednisone [posted 7/24/98]
Answer: This drug should be avoided if there is any other treatment option available. However, for many medical conditions there are no alternatives. Side effects depend on dosage and length of time taken and generally are equivalent to early aging: cataracts, osteoporosis, diabetes mellitus, muscle weakness, etc.
Prednisone [posted 7/21/98]
Answer: Prednisone is a steroid and this steroid (and most of them) are strong anti-inflammatories. Since her disease is a disease of inflammation/immune system, this medication will reduce the inflammation, thickening and pain of the disease. Hopefully, inducing a remission which will last for a while-depending on the severity of her UC. However, there is a price- steroids speed up the aging process. That is, cause cataracts, hardening of the arteries, thinning of the bones, muscle weakness, etc. Unfortunately, there is no drug alternative that reduces the inflammation without these side effects. We try to use the least steroid to achieve the needed result. She should be taking Fosamax or something equivalent while she is on the steroid to reduce the bone loss. They are not addicting, but will suppress her own ability to produce steroids by her adrenal glands. This necessitates a taper if they have been used a long time (over 3 months for young people, 1-2 months for those over 65).
Abrupt Stop of Prednisone
Answer: Anything less than 3 months or so can tolerate abrupt stoppage without problems. Over three months would depend on your age and the steroid dosage, but most would have some sort of taper at that point. I wouldnt be concerned with short bursts and abrupt stoppage.
Reaction to prednisone
Answer: These are more severe and last longer than usual. However, probably are due to the steroids. If they don't go in a week, see your physician. After that amount of time they are not due to the prednisone.
Prednisone and Motrin in combination
Answer: Prednisone and any of the steroids can cause ulcers in the stomach-- referred to as Cushing Ulcers. Any non-steroidal anti-inflammatory can cause ulcers. The two together has an increased risk. I can't quote the odds. The PDR and any pharmacology text makes clear reference to this problem and physicians are taught this from the outset of their training.
Answer: Steroids can produce a wide variety of psychological changes. Clinically you see this in about 5% of patients. It seems to be dose related and high IV doses cause more problem than small oral doses. Many patients will experience euphoria and some difficulty sleeping. Anger, delusions, and paranoia are less common. An occasional patient will become psychotic on these drugs. I have seen one psychotic patient on steroids in my 20 years. He was on high IV doses and was also being treated for CNS lupus-- hard to know which caused the problem. It is an occasional problem. Minor mood problems are common.
Answer: A short course of prednisone will have no permanent or lasting side effects. It would not impair your ability to either get pregnant or remain pregnant. Women who need prednisone during pregnancy usually have no problems with their offspring-- except the pediatrician needs to observe them to ensure their adrenal glands develop appropriately.
Answer: I am not aware of food interactions with steroids.
Answer: From your description, it sounds like you presented to your physician with shoulder and neck pain or irritation. Although it is not clear what type of "x-rays" you are referring to (standard radiographs, cat scan, MRI, etc.), it appears that you have evidence on these tests of arthritis in your neck, or cervical, vertebrae. This can result in pinching of, or pushing on, one or several of the nerves that supply your neck, back, and arms. There are many medications that can be used to treat the symptoms of this condition, as well as the inflammation, or irritation of the nerves involved. A class of medications known as NSAID's, or non-steroidal anti-inflammatory medications are quite effective in reducing inflammation as well as the pain that accompanies it. An important point, however, is whether the bony changes seen on x-ray involve large nerves or the spinal cord itself. In these cases it is often important for prednisone, a corticosteroid, to be used to avoid significant inflammation and damage to these large nerve strictures. From the information you have provided it is difficult to say, but perhaps another discussion with your physician will provide you with the information necessary to determine why the prednisone is needed in your case. It is true that corticosteroids do have many side effects, but when properly used under the supervision of a physician they can be taken safely.
Answer: This is not due to the steroids that you were taking unless you had previously taken larger doses for longer periods of time. In the time frame that you have taken prednisone, withdrawal would have minor problems unless you had another problem. Why were you taking the steroids?
Answer: Dexamethasone is the generic form of decadron. Prednisone differs mainly in terms of potency. Prednisone is about 4-5 times as potent milligram for milligram as cortisol. Dexamethasone is about 20-25 times as powerful mg for mg. Prednisone also has slight sodium retaining potential that dexamethasone does not have. Prednisone lasts longer than cortisol but shorter than dexamethasone.
Prednisone causing Osteoporosis
Answer: Steroid induced osteoporosis is common and will occur with any one who takes steroids. Like most steroid side effects it depends on the dosage and the length of time. Small doses for short periods of time have negligible side effects. Larger doses or longer periods of time will thin the bones. The treatment is Vitamin D and Calcium replacement while one is taking steroids. There currently is research ongoing with Fosamax and nasal calcitonin, but it is not yet available. Some physicians are prescribing Fosamax to patients on long term system steroids assuming it will be of benefit.
Answer: I would really not recommend long term use of steroids for sinusitis. If steroids work systematically, they should work as topical spray. Use of steroids for a short period each year-- say two to three weeks might be warranted, but long term use is not.
Answer: Overdose can be for either one day or several days. A high dose for one day should have minimal effects. Occasional people get confused and there is an occasional person who actually can become psychotic, although this is rare. Huge doses of steroids are usually tolerated without any special problem other than difficulty sleeping. Long term use of high doses is another matter.
Answer: Why were you taking Prednisone in the first place? Muscle weakness can occur with prednisone, as can swelling of the face, and also sleeping difficult. However, swelling of the tongue and headaches would be unusual. The sleeping difficulty will clear fairly rapidly after cessation of prednisone. The swelling of the face and muscle weakness will last for several weeks to months (depending on dosage and the length of time you were taking prednisone). The longer that you take Prednisone and the larger the dosage, the more side effects and the more time it takes to clear. Some side effects like cataracts, hardening of the arteries, and osteoporosis do not seem to correct.
Answer: Multiple doses of steroids are more effective, but also will suppress your adrenal gland more effectively. We try to space out steroid dosing to avoid adrenal suppression (so that your own adrenal will "kick in" after you stop the steroids). Other side effects and toxicities of multiple dosing have not been well studied.
Answer: The major effects of steroids is to accelerate the aging process. So, hardening of the arteries accelerated, diabetes develops, cataracts, osteoporosis, degeneration of the cartilage surfaces of the body. We try to minimize the length and dose due to this problem. Unfortunately, there is no other drug which will accomplish their anti-inflammatory effect. Methylprednisone is a similar drug in terms of effects and side effects.
Answer: You have a different problem than many people. An inherited enzyme deficiency that wont allow proper steroid development. This is treated with prednisone (or equivalent). Side effects at this dose should be fairly minimal, especially with your specialized problem.
Answer: Prednisone mainly acts to speed up the aging process of the body. Hence, hardening of the arteries will accelerate, cholesterol is higher, osteoporosis is faster and more severe, the blood sugar is higher, cataracts form, muscles atrophy and lose strength, fat forms around the abdomen, the legs thin, and the skin thins. In general, think of any aging effect that you see on any organ and prednisone will accelerate this effect.
Answer:Prednisone is a glucocorticoid(steroid). It is used to treat many
different conditions which require either a strong anti-inflammatory or to decrease the
immune system. Once absorbed prednisone is metabolized in the liver to the active drug
prednisolone. There are some people who have difficulty with this metabolic step and
should be given prednisolone. Prednisone should he given in the smallest dose for the
shortest time necessary. This is because prednisone accelerates the aging process of the
body. Consequently, it increases the rate of hardening of the arteries, increases
osteoporosis, can cause diabetes mellitus, increases the cholesterol, causes cataracts.
For all the bad things that prednisone(and similar drugs) cause it is often the only drug
available to treat certain conditions.
Answer: Prednisone has many deleterious side effects, but rarely affects sperm production or viability.
Answer: Prednisone is a glucocorticoid which is generally used as an anti-inflammatory. It has numerous effects on the body in addition to its anti-inflammatory effects. In general, these act to accelerate the aging process. In addition, there is a suppressive effect on the immune system. Prednisone is often used in organ transplant patients for this very effect. Consequently, one could argue that steroids will increase the rate of cancers by decreasing the ability of one's body to find and kill cancers. While this is probably true, certain patients cannot exist without the effects of prednisone. Prednisone is rarely used without consideration for its potential side effects. It should never be used for long periods without good cause.
Prednisone and osteoporosis
Answer: Prednisone as any steroid certainly increases the rate of bone loss leading to osteoporosis. In the last few years, we have started adding calcium and vitamin D while patients are on prednisone to avoid this problem. It may be that drugs like Fosamax used during treatment with Prednisone will also help. Research is in progress. I would ensure that your physician has checked other causes for compression fractures-namely, hyperparathyroidism, Vitamin D deficiency, hypo or hyperthyroidism-all are common and you will continue to have bone fractures if these are not corrected.
Answer:The personality effects sometimes seen with steroids are usually dose related and will disappear after 4-5 days(maximum) after stopping the drug. In general, I see few effects on personality and they are less common after the dosage is decreased below 20 mg. They are not the source of the problem if he is off the drugs in excess of 3-4 days.
Answer: Almost always.
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