Prednisone

When is prednisone used?

For over 50 years, prednisone has been used to treat many different diseases, including asthma, cancer, inflammatory bowel disease and various rheumatic diseases such as lupus, dermatomyositis, and juvenile idiopathic arthritis, among others.

Prednisone often works very quickly, and has saved the lives of many people when used properly, safely and sparingly.

Prednisone is a steroid with strong anti-inflammatory effects that suppress the immune system.

How is it given?

Most important is the fact that prednisone may be given in many different forms. Prednisone comes as a tablet in many different milligram (mg) amounts (1mg or even 50mg) or as a liquid, such as Prelone (concentration of 15mg/5ml) or Pediapred (concentration of 5mg/5ml).

It is very important that you know the exact dose (milligram) of prednisone your child should receive. Many times the doctor will start with a relatively high dose of prednisone to get the disease under control rapidly.

Prednisone is best when taken with food. Prednisone can also be given intravenously (IV), topically (as a cream/ointment or eye drops), or even into a joint.

Prednisone is given with varying schedules. If you take prednisone once a day, take it first thing in the morning by 7:00 a.m. Taking it very early reduces possible side effects.

Sometimes prednisone may be given more than once a day, every other day, or even once a week. It is very important to stick with the schedule, and have your child take the prednisone at the exact same time, as instructed by your child's doctor. Never skip doses.

Marking your calendar, cell phone alarm reminders, pill boxes, or placing the prednisone next to your child's toothbrush may be helpful ways to help them remember to take the prednisone.

If your child's prednisone is switched from everyday to every other day, his or her dose may be increased by 2 ½ to three times the daily dose. 

If your child is taking the liquid form of the medication, ask your pharmacist for a syringe to help your measure the dose accurately.

The side effects from prednisone are more common when higher doses of prednisone are used for prolonged periods of time.

Possible side effects

  • Increased appetite, weight gain, cushingoid appearance (round face and stomach)
  • Diabetes, high cholesterol
  • Stretch marks, acne
  • Stomach irritation or ulcers
  • Mood swings, sleep disturbance, nervousness, restlessness
  • Delayed growth
  • Cataracts
  • High blood pressure
  • Brittle bones (osteoporosis), Avascular necrosis (dead bone), muscle weakness
  • Increased risk of serious infection

This does not include every possible side effect of prednisone.

Additional Directions

Never stop taking prednisone suddenly. Too much or too little prednisone may be dangerous and even life threatening.

This includes never “running out” of prednisone, by calling your child's doctor for a prescription refill one week in advance.

Prednisone is similar to a hormone made in the body. Your body stops making this hormone, or makes fewer hormones, while your child is taking prednisone.

The doctor or nurse will instruct you when and how to decrease this medication slowly. If Prednisone is stopped abruptly, it can result in nausea, vomiting, diarrhea or shock (life threatening illness with low blood pressure).

Your child may require extra prednisone (“stress-dose steroids”) if your child's body is stressed by surgery, a serious infection, or serious injury while taking surgery and for one year after stopping prednisone. Some patients even wear a medication bracelet indicating that they are taking prednisone.

  • If your doctor believes that your child will require prednisone for a long time, they may prescribe another medicine, which will allow the doctor to lower the dose of prednisone more easily.
  • Your child should have a PPD placed and update all of your child's vaccinations before starting prednisone if possible. Get a flu shot every Fall.
  • Your child should not receive any live immunizations (oral polio, chickenpox, MMR) while taking prednisone.
  • Call your child's doctor immediately if you develop chickenpox while on Prednisone.
  • Your child should see his or her eye doctor (ophthalmologist) yearly.
  • Your child's doctor may order a yearly bone (DEXA) densitometry scan in order to check bone health. Your child's doctor may also prescribe calcium and vitamin D to keep his or her bones strong.
  • Your child should get regular exercise and eat a healthy diet to not gain weight and strengthen his or her bones.
  • If your child is ill and has a temperature, call your child's doctor. If your child is vomiting and unable to keep down his or her prednisone, call your child's doctor immediately.

Call your child's doctor with any additional questions.