Prednisone

Prednisone Brand Names

Deltasone | Predone | RAYOS | Sterapred | Sterapred DS

What is Prednisone

Prednisone is the most commonly-prescribed oral corticosteroid. The drug is metabolized in the liver to its active form, prednisolone.

Relative to hydrocortisone, prednisone is roughly 4 times as potent as a glucocorticoid.

Prednisone is used in many conditions in adult and pediatric patients, including allograft rejection, asthma, chronic obstructive pulmonary disease (COPD), systemic lupus erythematosus (SLE), rheumatoid and psoriatic arthritis, and many other allergic, dermatologic, and inflammatory states.

Prednisone has very little mineralocorticoid activity, so it is not used in the management of adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly.

Systemic corticosteroids may be added to other long-term maintenance medications in the management of uncontrolled severe persistent asthma.

Once stabilization of asthma is achieved, regular attempts should be made to reduce or eliminate the use of systemic corticosteroids due to the side effects associated with chronic administration.

Short courses of treatment may be used in moderate to severe exacerbations of asthma.

Short courses of systemic corticosteroids such as prednisone have particular benefit in treating acute exacerbations of COPD.

If long-term therapy with prednisone is required for any indication, the lowest possible effective dose should be used.

Indications

1. absence seizures
2. ACE-inhibitor induced angioedema
3. acute interstitial nephritis (AIN)
4. acute lymphocytic leukemia (ALL)
5. acute respiratory distress syndrome (ARDS)
6. Addison’s disease
7. adrenocortical insufficiency
8. allergic conjunctivitis
9. allergic rhinitis
10. amyloidosis
11. anaphylaxis
12. angioedema
13. ankylosing spondylitis
14. anterior segment inflammation
15. asthma
16. atopic dermatitis
17. autoimmune hepatitis
18. Behcet’s syndrome
19. Bell’s palsy
20. berylliosis
21. bursitis
22. carpal tunnel syndrome
23. chorioretinitis
24. chronic lymphocytic leukemia (CLL)
25. chronic obstructive pulmonary disease (COPD)
26. Churg-Strauss syndrome
27. congenital adrenal hyperplasia
28. contact dermatitis
29. corneal ulcer
30. Crohn’s disease
31. dermatitis
32. dermatitis herpetiformis
33. dermatomyositis
34. Duchenne muscular dystrophy
35. eczema
36. endophthalmitis
37. eosinophilic pneumonia
38. epicondylitis
39. erythema multiforme
40. erythroblastopenia
41. exfoliative dermatitis
42. food allergy
43. gouty arthritis
44. graft-versus-host disease (GVHD)
45. heart transplant rejection
46. heart transplant rejection prophylaxis
47. hemolytic anemia
48. Hodgkin lymphoma
49. hypercalcemia
50. hypoplastic anemia
51. immune thrombocytopenic purpura (ITP)
52. infantile spasms
53. iritis
54. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
55. Kawasaki disease
56. keratitis
57. kidney transplant rejection prophylaxis
58. Lennox-Gastaut syndrome
59. Loeffler’s syndrome
60. lupus nephritis
61. mixed connective tissue disease
62. multiple myeloma
63. myasthenia gravis
64. Mycobacterium avium complex infection
65. mycosis fungoides
66. myoclonic seizures
67. nephrotic syndrome
68. optic neuritis
69. osteoarthritis
70. pemphigus
71. perennial allergies
72. pericarditis
73. peripheral T-cell lymphoma (PTCL)
74. Pneumocystis pneumonia (PCP)
75. pneumonitis
76. polyarteritis nodosa
77. polychondritis
78. polymyalgia rheumatica
79. polymyositis
80. proteinuria
81. psoriasis
82. psoriatic arthritis
83. pulmonary fibrosis
84. rheumatic carditis
85. rheumatoid arthritis
86. sarcoidosis
87. seasonal allergies
88. seborrheic dermatitis
89. serum sickness
90. spinal cord compression
91. Stevens-Johnson syndrome
92. systemic anaplastic large-cell lymphoma
93. systemic lupus erythematosus (SLE)
94. temporal arteritis
95. tenosynovitis
96. thrombocytopenia
97. thyroiditis
98. toxoplasmosis
99. tuberculosis infection
100. ulcerative colitis
101. urticaria
102. uveitis
103. vasculitis
104. Wegener’s granulomatosis

Side Effects

1. abdominal pain
2. acne vulgaris
3. acneiform rash
4. adrenocortical insufficiency
5. alopecia
6. amenorrhea
7. amnesia
8. anaphylactoid reactions
9. anemia
10. angina
11. angioedema
12. anorexia
13. anxiety
14. appetite stimulation
15. arrhythmia exacerbation
16. arthralgia
17. avascular necrosis
18. blurred vision
19. bone fractures
20. bradycardia
21. candidiasis
22. cardiac arrest
23. cardiomyopathy
24. cataracts
25. constipation
26. Cushing’s syndrome
27. delirium
28. depression
29. diabetes mellitus
30. diaphoresis
31. diarrhea
32. dizziness
33. dysmenorrhea
34. ecchymosis
35. edema
36. EEG changes
37. elevated hepatic enzymes
38. emotional lability
39. erythema
40. esophageal ulceration
41. euphoria
42. exfoliative dermatitis
43. exophthalmos
44. fever
45. fluid retention
46. gastritis
47. GI bleeding
48. GI perforation
49. glossitis
50. glycosuria
51. growth inhibition
52. hallucinations
53. headache
54. heart failure
55. hepatomegaly
56. hiccups
57. hirsutism
58. hypercholesterolemia
59. hyperglycemia
60. hypernatremia
61. hypertension
62. hyperthyroidism
63. hypocalcemia
64. hypokalemia
65. hypotension
66. hypothalamic-pituitary-adrenal (HPA) suppression
67. hypothyroidism
68. immunosuppression
69. impaired cognition
70. impaired wound healing
71. increased intracranial pressure
72. infection
73. insomnia
74. irritability
75. lethargy
76. leukocytosis
77. lupus-like symptoms
78. malaise
79. mania
80. memory impairment
81. menstrual irregularity
82. metabolic alkalosis
83. myalgia
84. myocardial infarction
85. myopathy
86. nausea
87. neuritis
88. neutropenia
89. ocular hypertension
90. ocular infection
91. optic neuritis
92. osteopenia
93. osteoporosis
94. palpitations
95. pancreatitis
96. papilledema
97. paresthesias
98. peptic ulcer
99. perineal pain
100. peripheral neuropathy
101. petechiae
102. phlebitis
103. physiological dependence
104. postmenopausal bleeding
105. pseudotumor cerebri
106. psychosis
107. pulmonary edema
108. purpura
109. rash
110. restlessness
111. retinopathy
112. seizures
113. sinus tachycardia
114. skin atrophy
115. skin hyperpigmentation
116. skin hypopigmentation
117. sodium retention
118. striae
119. stroke
120. syncope
121. telangiectasia
122. tendon rupture
123. thromboembolism
124. thrombosis
125. urticaria
126. vasculitis
127. vertigo
128. visual impairment
129. vomiting
130. weakness
131. weight gain
132. weight loss
133. withdrawal
134. xerosis

Monitoring Parameters

• blood glucose
• blood pressure
• growth rate
• pulmonary function tests (PFTs)
• serum potassium
• weight

Contraindications

• abrupt discontinuation
• breast-feeding
• cataracts
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• diverticulitis
• fungal infection
• geriatric
• GI perforation
• glaucoma
• growth inhibition
• heart failure
• helminth infection
• hepatic disease
• herpes infection
• hypertension
• hyperthyroidism
• hypothalamic-pituitary-adrenal (HPA) suppression
• hypothyroidism
• immunosuppression
• increased intracranial pressure
• increased intraocular pressure
• infection
• measles
• myasthenia gravis
• myocardial infarction
• neonates
• neuromuscular disease
• ocular infection
• optic neuritis
• osteopenia
• osteoporosis
• peptic ulcer disease
• pregnancy
• psychosis
• renal disease
• seizure disorder
• surgery
• thyroid disease
• tuberculosis
• ulcerative colitis
• vaccination
• varicella
• viral infection

Interactions

• Abatacept
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetazolamide
• Acetohexamide
• Adalimumab
• Albiglutide
• Aldesleukin, IL-2
• Alefacept
• Alemtuzumab
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Altretamine
• Ambenonium Chloride
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Aminosalicylate sodium, Aminosalicylic acid
• Amiodarone
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Antithymocyte Globulin
• Antitumor antibiotics
• Aprepitant, Fosaprepitant
• Argatroban
• Arsenic Trioxide
• Asparaginase Erwinia chrysanthemi
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
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• Atenolol; Chlorthalidone
• Atracurium
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• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azathioprine
• Azilsartan; Chlorthalidone
• Basiliximab
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bepridil
• Bexarotene
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bivalirudin
• Boceprevir
• Bortezomib
• Bosentan
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Bupropion
• Bupropion; Naltrexone
• Butabarbital
• Cabozantinib
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Carmustine, BCNU
• Carvedilol
• Ceritinib
• Certolizumab pegol
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorambucil
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• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cholestyramine
• Choline Salicylate; Magnesium Salicylate
• Cimetidine
• Cisatracurium
• Citalopram
• Clindamycin
• Clofarabine
• Cobicistat
• Codeine; Phenylephrine; Promethazine
• Conivaptan
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• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Darunavir
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• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
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• Dextromethorphan; Guaifenesin; Phenylephrine
• Digoxin
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• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dofetilide
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• Echinacea
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• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Hydrochlorothiazide, HCTZ
• Ephedrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erlotinib
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Estramustine
• Estrogens
• Etravirine
• Exenatide
• Fluconazole
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• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
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• Glycerol Phenylbutyrate
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• Guaifenesin; Phenylephrine
• Halofantrine
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• Hemin
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• Hydrochlorothiazide, HCTZ
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• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Hydroxyurea
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibritumomab Tiuxetan
• Idelalisib
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• Indapamide
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• Interferon Alfa-2a
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• Interferon Alfa-2b; Ribavirin
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isoproterenol
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• Itraconazole
• Ixabepilone
• Ketoconazole
• L-Asparaginase Escherichia coli
• Ledipasvir; Sofosbuvir
• Letermovir
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• Levomethadyl
• Linagliptin; Metformin
• Liraglutide
• Live Vaccines
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• Lomustine, CCNU
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• Lumateperone
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• Magnesium Salicylate
• Mannitol
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• Mecasermin, Recombinant, rh-IGF-1
• Meglitinides
• Melphalan
• Mepenzolate
• Mephobarbital
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methacholine
• Methazolamide
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methoxsalen
• Methyclothiazide
• Metolazone
• Metyrapone
• Micafungin
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• Mitotane
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• Penicillamine
• Phenobarbital
• Phenylephrine
• Phenylephrine; Promethazine
• Photosensitizing agents (topical)
• Physostigmine
• Pimozide
• Posaconazole
• Potassium
• Potassium Chloride
• Potassium Phosphate; Sodium Phosphate
• Potassium-sparing diuretics
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Primidone
• Propranolol
• Propylthiouracil, PTU
• Purine analogs
• Pyridostigmine
• Quetiapine
• Quinolones
• Rapacuronium
• Regular Insulin
• Repaglinide
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• Sodium Benzoate; Sodium Phenylacetate
• Sodium Chloride
• Sodium Iodide
• Sodium Phenylbutyrate
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Somatropin, rh-GH
• Succinylcholine
• Sulfonylureas
• Telaprevir
• Telbivudine
• Telithromycin
• Telotristat Ethyl
• Tesamorelin
• Testosterone
• Theophylline, Aminophylline
• Thiazide diuretics
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• Thyroid hormones
• Tobramycin
• Tolazamide
• Tolbutamide
• Tositumomab
• Trandolapril; Verapamil
• Tranexamic Acid
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• Tuberculin Purified Protein Derivative, PPD
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• Vancomycin
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• Verapamil
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• Vincristine Liposomal
• Voriconazole
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• Warfarin
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• Zileuton