Prednisone

The pro-drug prednisone must be converted in the body to its active form prednisolone. Prednisone, a synthetic anti-inflammatory glucocorticoid, remains among the 25 most commonly prescribed drugs in the United States and appears to be on an upward trend.

As an anti-inflammatory, prednisone combats a wide array of conditions ranging from skin rashes, allergic reactions, arthritis and COPD to gastrointestinal conditions, kidney disease, thyroiditis and even cancer.

While short term use of prednisone rarely results in significant complications, prolonged therapy produces a dramatic and lengthy list of unwanted adverse reactions. Among the side effects associated with prednisone are diabetes, susceptibility to infection, reactivation of tuberculosis, sodium retention and swelling of the legs. Other unwanted issues involve osteoporosis, avascular necrosis of the bones, cataracts, skin fragility, substantial weight gain and muscle wasting.

Prednisone also results in a number of psychiatric conditions ranging from hyperactivity, restlessness and euphoria to agitation, depression, anxiety and insomnia. Mental confusion, difficulties with memory and attention deficits occur at moderate doses. Prednisone may precipitate manic attacks.

Finding the correct dose of prednisone varies with the individual, the underlying disease and a variety of issues linked to the physician’s prescribing habits. Keeping the dose of prednisone relatively low and continuing treatment for only as long as necessary seems prudent. Prednisone must not be stopped abruptly but rather tapered over weeks to months depending on dose and duration of therapy.