Prednisone Side Effects

Prednisone – sometimes it’s mispelled as “prednizone”-is a generic, inexpensive, and commonly used medicine in arthritis treatment.

The diseases for which corticosteroids are most often used are rheumatoid arthritis, lupus, psoriatic arthritis, ankylosing spondylitis, Reiter’s disease, polymyalgia rheumatica and temporal arteritis, polymyositis and dermatomyositis, gout and pseudogout, sarcoidosis, and the arthritis accompanying inflammatory bowel disease.

It is catabolic (meaning it breaks down tissue) and anti-inflammatory.

When taken chronically it can suppress the ability of the adrenal glands to make its own steroid, particularly if the average daily dose of prednisone is greater than 7.5 mgs.

Other factors that constrain the ability of the adrenals to perform are if therapy continues for more than a few weeks or months, if doses are given late in the day or in divided doses throughout the day, or if long-acting corticosteroid preparations are used.

Patients who require high doses of prednisone (more than 20 mgs a day) for extended periods of time always develop side-effects.

Taking steroids on an alternate day (every other day) schedule reduces the chance of adrenal insufficiency but does not eliminate it.

Other side-effects include:

“Moon face”

Elevated blood sugar and diabetes

Elevated cholesterol and triglycerides

Fluid retention

Obesity

Acne

Increased blood pressure

Electrolyte abnormalities such as low potassium serum levels

Hardening of the arteries

Hirsutism (abnormal hair distribution)

Easy bruising

Thinning of the skin

Cataracts and glaucoma

Purple striae (stretch marks)

Poor wound healing

Muscle wasting

Susceptibility to infection and masking of infection leading to sepsis and death

Psychosis

Avascular necrosis (dead bone)

Sweating

Inflammation of the pancreas

Stomach ulcers (particularly if used with non-steroidal anti-inflammatory drugs

Obviously, patients must be counseled as to the relative risks and benefits, and the lowest possible steroid dose should be used.

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