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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Prednisone
Generic Name
Prednisone
Active Ingredient
PrednisoneCategory
Corticosteroid [EPC]
Variants
290
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 1 mg/1 | TABLET | ORAL | 63629-2254 |
| 20 mg/1 | TABLET | ORAL | 64380-785 |
| 2.5 mg/1 | TABLET | ORAL | 67046-1448 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Prednisone, you must consult a qualified healthcare professional.
| 50 mg/1 | TABLET | ORAL | 0054-0019 |
| 20 mg/1 | TABLET | ORAL | 68788-8819 |
| 20 mg/1 | TABLET | ORAL | 71205-407 |
| 10 mg/1 | TABLET | ORAL | 71205-421 |
| 20 mg/1 | TABLET | ORAL | 71205-797 |
| 2.5 mg/1 | TABLET | ORAL | 71335-2356 |
| 5 mg/1 | TABLET | ORAL | 80425-0069 |
| 1 mg/1 | TABLET | ORAL | 0603-5335 |
| 20 mg/1 | TABLET | ORAL | 0615-8441 |
+ 38 more variants
Detailed information about Prednisone
Prednisone is a potent synthetic corticosteroid used to suppress the immune system and reduce inflammation in conditions like asthma, arthritis, and autoimmune disorders.
The dosage of Prednisone is highly individualized based on the specific disease being treated, the severity of the condition, and the patient's clinical response. There is no 'standard' dose that applies to all patients. For many acute inflammatory conditions, healthcare providers may initiate therapy with a 'burst' dose, such as 40 mg to 60 mg per day for 5 to 10 days, followed by a rapid taper or sudden discontinuation.
In chronic conditions like rheumatoid arthritis or systemic lupus erythematosus, the initial dose may range from 5 mg to 60 mg per day. Once a satisfactory response is obtained, the healthcare provider will typically reduce the dose in small decrements to the lowest possible level that maintains an adequate clinical response. In some cases, 'alternate-day therapy' (taking a double dose every other morning) is utilized to minimize the suppression of the hypothalamic-pituitary-adrenal (HPA) axis and reduce long-term side effects.
Prednisone is approved for use in children for many of the same indications as adults. Pediatric dosing is usually calculated based on body weight or body surface area. A common dosage range is 0.05 mg to 2 mg per kg of body weight per day, divided into one to four doses. Because corticosteroids can suppress growth in children, healthcare providers aim for the shortest duration and lowest effective dose. Pediatric patients on long-term Prednisone therapy must have their growth and development monitored closely.
Prednisone and its metabolites are primarily excreted by the kidneys. While specific dosage adjustment guidelines for renal impairment are not always provided in the labeling, healthcare providers exercise caution in patients with severe kidney disease. Monitoring for fluid retention and electrolyte imbalances is crucial in this population.
Since Prednisone must be converted to prednisolone in the liver, patients with severe hepatic dysfunction (such as advanced cirrhosis) may have altered pharmacokinetics. While the conversion often remains functional, the decreased protein binding (due to low albumin) in liver disease can increase the levels of free, active drug, potentially increasing the risk of side effects. Healthcare providers may monitor these patients more frequently.
In geriatric patients, Prednisone should be started at the lower end of the dosing range. The elderly are more susceptible to the side effects of steroids, including osteoporosis, hypertension, diabetes, and thinning of the skin. There is also an increased risk of cognitive disturbances or 'steroid psychosis' in older adults.
Prednisone should be taken exactly as prescribed by a healthcare provider.
If a dose is missed, it should be taken as soon as the patient remembers. However, if it is almost time for the next dose, the missed dose should be skipped. Patients should never double the dose to catch up. If multiple doses are missed, the healthcare provider should be contacted immediately, as sudden cessation can lead to withdrawal symptoms.
An acute overdose of Prednisone is rarely life-threatening but can cause an exaggeration of side effects. Symptoms may include high blood pressure, fluid retention, and mood changes. Chronic overdose (taking too much over a long period) leads to Cushingoid features, such as a 'moon face,' buffalo hump, and central obesity. In the event of a significant acute ingestion, contact a poison control center or seek emergency medical care.
> Important: Follow your healthcare provider's dosing instructions precisely. Do not adjust your dose or stop taking the medication without medical guidance, as tapering is often required to prevent adrenal crisis.
Side effects of Prednisone are highly dependent on the dose and the duration of therapy. Short-term use (less than two weeks) is generally well-tolerated, while long-term use carries significant risks. Common side effects include:
Prednisone is a high-alert medication that requires careful management. One of the most critical safety points is that Prednisone should never be discontinued abruptly after long-term use. Doing so can cause an adrenal crisis, a life-threatening condition where the body cannot produce enough cortisol to maintain vital functions like blood pressure. Furthermore, Prednisone can suppress the immune system to the point where minor infections become life-threatening. Patients should avoid contact with individuals who have contagious illnesses like chickenpox or measles, as these can be much more severe in people taking steroids.
No FDA black box warnings for Prednisone. Despite the lack of a black box warning, the clinical risks associated with systemic corticosteroids are among the most well-documented in pharmacology, particularly regarding the risk of secondary infections and adrenal suppression.
There are two primary scenarios where Prednisone must never be used:
In these conditions, the risks of Prednisone may outweigh the benefits, and healthcare providers will perform a careful risk-benefit analysis:
Prednisone is generally classified as FDA Pregnancy Category C. This means that while animal studies have shown potential harm to the fetus (such as cleft palate), there are no adequate, well-controlled studies in humans. However, Prednisone is often used during pregnancy when the benefit to the mother (e.g., controlling severe asthma or an autoimmune flare) outweighs the potential risk to the fetus.
Research suggests that long-term use during the first trimester may slightly increase the risk of oral clefts. If used later in pregnancy, there is a risk of premature rupture of membranes and intrauterine growth restriction. Infants born to mothers who received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism (adrenal insufficiency).
Prednisone and its active metabolite, prednisolone, are excreted into breast milk. However, at doses of 20 mg per day or less, the amount of drug the infant receives is considered negligible. For higher doses, some experts recommend waiting 4 hours after taking the dose before breastfeeding to further minimize exposure. Overall, Prednisone is generally considered compatible with breastfeeding, but the infant should be monitored for normal growth and development.
Prednisone is a synthetic glucocorticoid receptor agonist. Its primary mechanism of action involves binding to the cytosolic glucocorticoid receptor. Once bound, the complex translocates to the nucleus where it acts as a transcription factor. It inhibits the transcription of inflammatory genes (transrepression) by interfering with the activity of NF-κB and AP-1. It also promotes the transcription of anti-inflammatory genes (transactivation). This leads to a profound reduction in the production of inflammatory mediators, including prostaglandins, leukotrienes, and various cytokines. Additionally, it reduces the capillary permeability and stabilizes lysosomal membranes, preventing the release of proteolytic enzymes that damage tissues.
The pharmacodynamic effects of Prednisone are delayed relative to its peak plasma concentration because the genomic effects (gene transcription) take time to manifest. While some non-genomic effects (such as changes in cell signaling) occur within minutes, the full anti-inflammatory effect usually takes 4 to 24 hours. The duration of action is significantly longer than its half-life, lasting 18 to 36 hours, which is why once-daily dosing is effective for most conditions.
Common questions about Prednisone
Prednisone is a versatile corticosteroid used to treat a wide variety of inflammatory and autoimmune conditions. It is commonly prescribed for asthma flares, rheumatoid arthritis, systemic lupus erythematosus, and severe allergic reactions. Additionally, it is used in the treatment of certain cancers, such as leukemia and lymphoma, and to prevent organ rejection after a transplant. Because it suppresses the immune system, it is also effective for skin conditions like psoriasis and pemphigus. Your healthcare provider will determine the specific use based on your diagnosis and the severity of your symptoms.
The most common side effects of Prednisone include increased appetite, weight gain (especially in the face and stomach), insomnia, and mood changes such as irritability or anxiety. Many patients also experience fluid retention, leading to swelling in the legs or ankles, and increased blood sugar levels. Gastrointestinal issues like nausea or heartburn are also frequent, particularly if the medication is not taken with food. While these effects are common, they are usually dose-dependent and may improve as the dose is lowered. Always report persistent or worsening side effects to your doctor.
While there is no direct contraindication, healthcare providers generally recommend limiting or avoiding alcohol while taking Prednisone. Both substances can irritate the stomach lining, and combining them significantly increases the risk of developing peptic ulcers or gastrointestinal bleeding. Alcohol can also interfere with blood sugar regulation, which is already affected by Prednisone, potentially leading to dangerous spikes or drops. Furthermore, alcohol may worsen the mood swings and sleep disturbances often caused by the medication. It is best to discuss your alcohol consumption habits with your doctor before starting therapy.
Prednisone is used during pregnancy only when the potential benefits to the mother outweigh the risks to the fetus. It is classified as Category C, meaning animal studies have shown some risks, such as cleft palate, but human data is limited. Use during the first trimester is generally avoided unless necessary, while later use may be associated with premature birth or low birth weight. If a mother takes high doses of Prednisone during pregnancy, the newborn must be monitored for adrenal insufficiency. Always consult with an obstetrician or specialist if you are pregnant or planning to become pregnant while taking this medication.
The time it takes for Prednisone to work depends on the condition being treated and the dose administered. For acute allergic reactions or asthma, some patients may feel improvement within 4 to 6 hours as the drug begins to suppress inflammatory pathways. However, for chronic conditions like rheumatoid arthritis or skin disorders, it may take several days of consistent dosing to reach the full therapeutic effect. Because Prednisone works by changing gene expression within cells, its action is not instantaneous. If you do not see improvement within a few days, contact your healthcare provider for further guidance.
No, you should never stop taking Prednisone suddenly if you have been taking it for more than a few weeks. Prolonged use causes your adrenal glands to stop producing natural cortisol, a process known as HPA axis suppression. If you stop the drug abruptly, your body will not have enough cortisol to function, leading to a life-threatening adrenal crisis. Symptoms of an adrenal crisis include severe weakness, confusion, and dangerously low blood pressure. Your doctor will provide a tapering schedule to slowly reduce your dose, allowing your body to resume its own hormone production safely.
If you miss a dose of Prednisone, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular timing. Do not take two doses at once to make up for the one you missed, as this increases the risk of side effects. If you are taking Prednisone on an alternate-day schedule and miss a dose, contact your healthcare provider for specific instructions. Consistently missing doses can lead to a flare-up of your condition or withdrawal symptoms, so using a pill organizer or alarm is recommended.
Yes, weight gain is one of the most well-known and frequent side effects of Prednisone, especially with long-term use. The medication increases appetite and alters how the body stores fat, often leading to deposits in the abdomen, the back of the neck (buffalo hump), and the face (moon face). It also causes the body to retain sodium and water, which contributes to 'water weight' and bloating. To manage this, healthcare providers often suggest a low-sodium, low-calorie diet and regular exercise. Fortunately, much of the weight gained due to fluid retention and increased appetite usually subsides once the medication is discontinued.
Prednisone interacts with many other medications, so it is vital to provide your doctor with a complete list of everything you take. It can interact dangerously with NSAIDs like ibuprofen, increasing the risk of stomach ulcers, and can reduce the effectiveness of diabetes medications and vaccines. It also interacts with blood thinners like warfarin and certain anti-seizure drugs. Some supplements, like St. John's Wort, can make Prednisone less effective. Your pharmacist can check for specific drug-drug interactions to ensure your treatment plan is safe and effective.
Yes, Prednisone is widely available as a generic medication and is typically very affordable. Generic versions are bioequivalent to brand-name versions, meaning they contain the same active ingredient and work the same way in the body. It is available in various strengths and forms, including tablets and oral solutions. Because it has been off-patent for decades, it is one of the most commonly prescribed and accessible medications in the world. Always ensure you are receiving the correct strength as prescribed, as generic tablets from different manufacturers may look different in color or shape.
Other drugs with the same active ingredient (Prednisone)
> Warning: Stop taking Prednisone and call your doctor immediately or seek emergency care if you experience any of the following:
Prolonged use of Prednisone (typically defined as more than 3 months) can lead to several chronic health issues:
No FDA black box warnings are currently issued for Prednisone. However, the FDA requires extensive 'Precautions' and 'Warnings' sections in the labeling regarding HPA axis suppression and the risk of infections.
Report any unusual symptoms to your healthcare provider immediately. Regular monitoring can help catch these side effects early.
Patients on long-term Prednisone therapy require regular clinical and laboratory monitoring to ensure safety:
Prednisone generally does not interfere with the ability to drive or operate machinery. However, some patients may experience dizziness, blurred vision, or mood changes that could impair their coordination or judgment. Patients should observe how the medication affects them before engaging in these activities.
While there is no direct chemical interaction between Prednisone and alcohol, healthcare providers generally advise against significant alcohol consumption. Both alcohol and Prednisone can irritate the stomach lining, increasing the risk of peptic ulcers and gastrointestinal bleeding. Additionally, alcohol can exacerbate the blood sugar fluctuations caused by Prednisone.
If Prednisone has been taken for more than a few weeks, it must be 'tapered' off. This involves gradually reducing the dose over weeks or months. This allows the adrenal glands to slowly resume their natural production of cortisol. Symptoms of withdrawal (or 'steroid withdrawal syndrome') include joint pain, fever, malaise, and nausea.
> Important: Discuss all your medical conditions, especially any history of tuberculosis, diabetes, or heart disease, with your healthcare provider before starting Prednisone.
Prednisone can affect several laboratory results, including:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking to prevent dangerous interactions.
Patients who are allergic to other corticosteroids (such as Prednisolone or Methylprednisolone) may also be allergic to Prednisone due to the similarity in their chemical structures. While cross-sensitivity is not universal, healthcare providers exercise extreme caution when switching between different steroid medications in a sensitive patient.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of infections or mental health issues, before prescribing Prednisone.
Prednisone is approved for pediatric use across a wide range of conditions. The most significant concern in children is the suppression of linear growth. Corticosteroids inhibit bone growth and the secretion of growth hormone. To minimize this, healthcare providers use the lowest effective dose and may employ alternate-day dosing. Children on long-term therapy should have their height and weight tracked on growth charts at every visit. Additionally, children on Prednisone are at higher risk for severe complications from common childhood illnesses like chickenpox.
Elderly patients are at a significantly higher risk for the adverse effects of Prednisone. Specifically, the risk of corticosteroid-induced osteoporosis and resulting hip or spinal fractures is much higher in this population. Geriatric patients are also more prone to developing hypertension, fluid retention, and steroid-induced diabetes. Cognitive impairment and 'steroid psychosis' are also more frequently reported in older adults. Healthcare providers often prescribe bone-protective medications (like bisphosphonates) alongside Prednisone for older patients.
In patients with renal impairment, the clearance of Prednisone metabolites may be reduced. While standard dose adjustments are not always required, these patients must be monitored closely for signs of corticosteroid toxicity, particularly fluid retention and electrolyte imbalances. Prednisone is not significantly removed by hemodialysis, so supplemental doses after dialysis are usually not necessary.
Since Prednisone is a prodrug that must be converted to prednisolone by the liver, severe hepatic impairment can theoretically reduce the drug's efficacy. However, the 11β-HSD enzyme responsible for this conversion is often preserved. The bigger concern in liver disease is hypoalbuminemia (low blood protein); since prednisolone is protein-bound, low protein levels lead to higher concentrations of 'free' drug, increasing the risk of side effects. Dose adjustments should be based on clinical response and tolerance.
> Important: Special populations require individualized medical assessment and more frequent monitoring by a healthcare professional.
|---|---|
| Bioavailability | 70% to 90% |
| Protein Binding | 70% to 90% (Concentration-dependent) |
| Half-life | 3 to 4 hours (Plasma); 18-36 hours (Biological) |
| Tmax | 1 to 2 hours |
| Metabolism | Hepatic (Conversion to Prednisolone via 11β-HSD) |
| Excretion | Renal (primarily as metabolites) |
Prednisone is classified as a Corticosteroid [EPC] and a Glucocorticoid. It is closely related to other synthetic steroids like Prednisolone, Methylprednisolone, and Dexamethasone. Compared to hydrocortisone, Prednisone has about four times the anti-inflammatory potency but significantly less mineralocorticoid (salt-retaining) activity.