Prednisolone

What is Prednisolone?

Prednisolone is a steroid. It prevents the release of substances in the body that cause inflammation.

Prednisolone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders such as asthma.

Precautions when taking Prednisolone

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Do not receive a “live” vaccine while using prednisolone. The vaccine may not work as well during this time, and may not fully protect you from disease.

Do not stop using prednisolone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using prednisolone.

Wear a medical alert tag or carry an ID card stating that you take prednisolone. Any medical care provider who treats you should know that you take steroid medication.

What should I discuss with my healthcare provider before taking prednisolone?

You should not use this medication if you are allergic to prednisolone, or if you have a fungal infection anywhere in your body.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before taking this medication, tell your doctor about any illness or infection you have had within the past several weeks.

To make sure prednisolone is safe for you, tell your doctor about your other medical conditions, especially:

  • liver disease (such as cirrhosis);
  • kidney disease;
  • a thyroid disorder;
  • diabetes;
  • a history of malaria;
  • tuberculosis;
  • osteoporosis;
  • a muscle disorder such as myasthenia gravis;
  • glaucoma or cataracts;
  • herpes infection of the eyes;
  • stomach ulcers, ulcerative colitis, or diverticulitis;
  • depression or mental illness;
  • congestive heart failure; or
  • high blood pressure

FDA pregnancy category C. It is not known whether prednisolone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Prednisolone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication. (Drugs, 2013)

How should prednisolone be taken?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Your steroid medication needs may change if you have unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you.

Measure the liquid form of prednisolone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

You may need to shake the oral suspension (liquid) well just before you measure a dose. Follow the directions on your medicine label.

Keep the disintegrating tablet in its blister pack until you are ready to take the medicine. Open the package using dry hands, and peel back the foil from the tablet blister (do not push the tablet through the foil). Remove the tablet and place it in your mouth.

Allow the disintegrating tablet to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

Steroids can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using prednisolone.

Do not stop using prednisolone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using prednisolone.

Wear a medical alert tag or carry an ID card stating that you take prednisolone. Any medical care provider who treats you should know that you take steroid medication.

Store at room temperature away from moisture and heat.

(Drugs, 2013)

What exactly does Prednisolone do for asthma?

Short courses of steroid tablets (called prednisolone) are prescribed to treat acute asthma attacks and help reduce inflammation in the airways when a preventer inhaler is no longer effective. If you’re getting asthma symptoms whilst taking your preventer inhaler as prescribed, a course of steroid tablets may be what you need to get your asthma back under control.

Lots of people with asthma need to take short courses of steroids – known as oral corticosteroids by healthcare professionals  – when their asthma symptoms get worse. But a small number of people with severe asthma need to take higher doses of steroids for longer periods. This may mean months or years. Usually, these will be given as tablets.

Corticosteroids are copies of hormones your body produces naturally. They help to calm inflamed airways and stop inflammation by blocking the effects of some chemicals your immune system produces. This helps ease asthma symptoms such as breathlessness and coughing, and will also help prevent your lungs reacting to triggers. You’re already taking these steroids at very low doses through your preventer inhaler but some people with severe asthma need the higher dose you can get from tablets to manage their symptoms properly.

(asthma UK, 2016)

Long term use

So if you’re taking long term steroid tablets for your severe asthma, what does this mean for you?

Not everyone with severe asthma needs to take them. But if your asthma isn’t controlled with the maximum doses of a preventer inhaler and other add-on treatments, you may need to take steroids in tablet form in the long term. You might take them either continuously or simply have more frequent courses for flare-ups than other people with asthma.

The most commonly prescribed steroid tablet is prednisolone. Your healthcare professional should check your inhaler technique and make sure you’re taking your medicine properly before prescribing steroid tablets. Sometimes, a simple tweak to the way you’re taking your medicine is enough to manage your symptoms without needing steroid tablets.

Even if you have to take steroid tablets for a few weeks or months, this doesn’t necessarily mean you’ll always need them – the aim is to stop the tablets altogether, if possible. Your healthcare professional will consider assessing you for other treatments such as bronchial thermoplasty, Xolair and other medicines in the new class of ‘mab’ drugs with you – these treatments can stop you needing to take steroid tablets so often, and at such high doses. If your asthma’s controlled, you’ll be gradually taken off the tablets. You should never stop taking them suddenly as your asthma symptoms may get worse.

But not everyone who takes long term steroid tablets experiences side effects. Everyone’s different, so just because you’ve read about people having side effects, it doesn’t mean you will too. And you’re unlikely to experience all of the potential side effects. It’s also important to know that most of the common ones will stop when you finish taking the tablets. Even if you do get some side effects, there are often ways to reduce them.

Major Side Effects

It can be worrying to think about taking medicine that causes side effects but remember your healthcare professional will only prescribe steroid tablets when they’re essential to stop you having life-threatening asthma attacks and serious symptoms. They will aim to take you off them again if possible, although some people do need to take them indefinitely.

If any of the following side effects occur while taking prednisolone, check with your doctor immediately:

More common:

  • Aggression
  • agitation
  • anxiety
  • blurred vision
  • decrease in the amount of urine
  • dizziness
  • fast, slow, pounding, or irregular heartbeat or pulse
  • headache
  • irritability
  • mental depression
  • mood changes
  • nervousness
  • noisy, rattling breathing
  • numbness or tingling in the arms or legs
  • pounding in the ears
  • shortness of breath
  • swelling of the fingers, hands, feet, or lower legs
  • trouble thinking, speaking, or walking
  • troubled breathing at rest
  • weight gain

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Incidence not known:

  • Abdominal cramping and/or burning (severe)
  • abdominal pain
  • backache
  • bloody, black, or tarry stools
  • cough or hoarseness
  • darkening of skin
  • decrease in height
  • decreased vision
  • diarrhea
  • dry mouth
  • eye pain
  • eye tearing
  • facial hair growth in females
  • fainting
  • fatigue
  • fever or chills
  • flushed, dry skin
  • fractures
  • fruit-like breath odor
  • full or round face, neck, or trunk
  • heartburn and/or indigestion (severe and continuous)
  • increased hunger
  • increased thirst
  • increased urination
  • loss of appetite
  • loss of sexual desire or ability
  • lower back or side pain
  • menstrual irregularities
  • muscle pain or tenderness
  • muscle wasting or weakness
  • nausea
  • pain in back, ribs, arms, or legs
  • painful or difficult urination
  • skin rash
  • sleeplessness
  • sweating
  • trouble healing
  • trouble sleeping
  • unexplained weight loss
  • unusual tiredness or weakness
  • vision changes
  • vomiting
  • vomiting of material that looks like coffee grounds

Minor Side Effects

Some prednisolone side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

  • Increased appetite

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Incidence not known:

  • Abnormal fat deposits on the face, neck, and trunk
  • acne
  • dry scalp
  • lightening of normal skin color
  • red face
  • reddish purple lines on the arms, face, legs, trunk, or groin
  • swelling of the stomach area
  • thinning of the scalp hair

(Drugs, 2013)

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About steroid cards

Anyone taking oral steroids or a high dose of inhaled steroids for more than three weeks should be given a steroid treatment card. Small enough to keep in your purse or wallet, this card has room to record the details of your dose and your condition(s).

This is so that if you ever need any medical treatment and you’re not able to communicate (you’re having an asthma attack, for example), the people treating you know you’re taking prednisolone and can plan your treatment accordingly.

If you are taking oral steroids, or high-dose inhaled steroids, for more than three weeks then you should never suddenly stop them.

 

My Prednisolone story:

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For me prednisolone is a life saver, it’s a miracle drug. It opens my airways better then most and when i’m too low on steroids or i cut down too quick my breathing deteriorates very badly. Yes, it gives me horrible amount of side affects but it helps me breathe. I can’t breathe without it, or can’t breathe well. So for me when i weigh up the huge list of cons and on the pro’s list i’ve got ‘being able to breathe’… for me that makes it an easy decision.

My hope is that I can get my health better and reduce my steroids. So that is why i’m focusing hard on getting better, managing my asthma so that it doesn’t get worse and being aware of my asthma. Doing this gives me the best chance of cutting my steroids down so that i get less side affects, and who knows maybe one day I can come off them.

I am a long term steroid user – been on them 12 months now. Mostly 30mg and higher although i’d say 80% of the time was at 40mg. (which is a high dose). I have medically induced Cushings Syndrome caused by the steroids. I’m dependant on the prednisolone because i’ve been on them so long my body no longer produces it’s own natural steroids. So when and if I do reduce my dose of prednisolone i have to do it very slowly and carefully.

I also have ostoperosis (yes thats right i’m 24 years old with brittle bones) because of the steroids, so now if i cough too hard i break ribs and fracture my sternum. Which then when i continue to cough means the stress fractures never really heal so it leaves me with a lot of pain and discomfort. I also have to be very aware that i’m quite clumsy and one wrong fall can have me with broken bones.

I’ve put on large amounts of weight, i’m not in the ‘obese’ catagory according to my BMI. Mentally this has changed how I see myself, I’m better than I was as I know that it’s the steroids and that if I can get my steroids down then the weight will go. However, the strain it’s put on me putting on that amount of weight hasn’t done my mental health much good. Not to mention the mood swings from steroids, that doesn’t help. Sometimes i’m not sure if i want to kill everyone or find a hole to just crawl into. I know it’s the steroids doing it, I can feel them messing with my head. It’s not all the time, just every know and then I get a bad ‘pred-rage’ day.

The biggest side affect that I find affects my daily living is the muscle weakness and the muscle pains. I’m barely able to do much anymore and when I try to do more, it doesn’t just ache but I get severe pains in my muscles. Just standing still for more than 30 seconds, first my back hurts, then my legs hurt, then my legs start to shake from the weakness, then the back pain starts to get eye watering, then i get my body telling me that if i don’t sit down asap then i’m going to be on the floor when my legs will just give way.

The other thing that is also caused from the prednisolone is the stretch marks I now have covering my body. They are huge and ugly and sometimes even painful. Just because my skin is now ‘less stretchy’ and part of the Cushings Syndrome. I know stretchmarks will go eventually, so i’m just putting cream on regularly and just hoping that will help.

The BEST thing that steroids do for me… helps me to:

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For me that’s the greatest part of all.

 

Remember:

I’m just one person, this is just how they affect me and they affect everyone differently. Yes all medications have side affects, but how important is the medication… is it worth it? To me it is. Even with all the bad that comes with it.

 

References:

Asthma UK, Steroids. Available from : https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/steroids-long-term-use [accessed 08/02/2017]

Drugs, prednisolone. Available from: https://www.drugs.com/mtm/prednisolone.html [Accessed 08/02/2017]

 

 

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