Fact Checked

What is Prednisone?

If you think allergies and autoimmune disorders have nothing in common, think again. Recent research shows that allergies and autoimmune disorders, both of which involve errant immune responses from the body, are more alike than they are different, which could explain why both can often be effectively treated with the same medication, prednisone. Allergies affect approximately 50 million Americans who suffer from one or more allergic reactions each year, while autoimmune disorders affect approximately one in every fifteen Americans, or about 23.5 million people. 

Although our understanding of these two health conditions has improved, both disorders are becoming more and more common and impacting more people each year. Although there are 80 different types of autoimmune disorders and a nearly infinite number of allergens, causing a wide range of symptoms and different levels of severity, many types of allergic reactions and autoimmune disorders can effectively be treated with steroid medications like prednisone, which helps to reduce inflammation associated with these conditions. Prednisone is a widely-used, inexpensive oral medication that can be used to treat a range of conditions occurring on both an acute and chronic basis. Prednisone is highly accessible and affordable for the majority of the population thanks to the large number of manufacturers producing numerous forms of the drug.

What is prednisone?

Prednisone is a prescription medication that belongs to a class of drugs called corticosteroids; specifically, prednisone is a synthetic corticosteroid. Corticosteroids are used to treat the inflammation that is associated with a large number of health conditions, including allergies, skin disorders, arthritis, psoriasis, ulcerative colitis, lupus, and breathing disorders. Prednisone comes in many different forms, including oral capsules, tablets, and syrups. Prednisone has been around for decades and was first approved by the U.S. Food and Drug Administration in 1955 under the brand name Rayos.

What conditions are treated with prednisone?

Prednisone can be used to treat inflammation caused by a wide range of medical conditions, including arthritis, breathing problems, skin diseases, eye problems, blood disorders, severe allergies, cancer, and immune system disorders, such as autoimmune diseases. While the medication is used for the treatment of many different conditions off label, the most common or FDA-approved uses of the medication are listed below:

  • Several types of arthritis
  • Crohn's disease
  • Allergic reactions
  • Severe psoriasis
  • Ulcerative colitis
  • Systemic lupus
  • Asthma

It is also commonly used for the treatment of other conditions, including various types of leukemia, idiopathic thrombocytopenic purpura, bronchitis, various types of lymphoma, and autoimmune hemolytic anemia.

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What Are Autoimmune Disorders?

Although prednisone has a wide variety of applications, one of the most common uses of the medication is in the treatment of autoimmune disorders. Autoimmune disorders are conditions in which the immune system in the body unintentionally attacks the body rather than fighting infections by producing antibodies. The antibodies produced by the immune system attack the host body rather than foreign diseases and infections. 

Unbeknownst to many people, some of the most common and well-known medical conditions are autoimmune disorders, including Type 1 diabetes, rheumatoid arthritis, multiple sclerosis, and lupus. In fact, more than 80 autoimmune disorders have been identified. Autoimmune disorders are caused by a number of factors, but it is believed that approximately one-third of the risk of developing an autoimmune disorder is genetically linked. The onset of an autoimmune disorder can be triggered by environmental factors, including viruses and bacteria. Autoimmune disorders can affect just one part of the body, such as the joints or skin, or they can cause symptoms throughout the entire body. Statistically speaking, people with one autoimmune disorder are more likely to be diagnosed with another autoimmune disorder.

How does prednisone work?

Corticosteroids are naturally produced in the body by the adrenal glands, which are small glands that rest on top of the kidneys. However, in some situations, the body does not produce any corticosteroids or enough corticosteroids to keep inflammation suppressed, referred to as adrenal insufficiency, and additional supplies are needed. Synthetic corticosteroids, like prednisone, cortisone, hydrocortisone, and methylprednisolone, mimic the action of cortisol, which is the naturally-occurring corticosteroid produced by the adrenal glands. 

While cortisol is produced by the body in a form in which it can be readily used, prednisone cannot be immediately used in the body. Prednisone is inactive in the body until it is converted to prednisolone through the action of enzymes in the liver. After it is converted to prednisolone, the steroid begins to work by suppressing inflammation throughout the body.

Glucocorticoids like dexamethasone and deltasone are a class of corticosteroids, though a lot of people use the terms interchangeably. They function the same, binding to fight inflammation and support immune function. 

What side effects are associated with prednisone?

Prednisone is associated with a wide range of side effects, some of which can be serious and potentially dangerous. 

One important side effect to note is that prednisone and other steroids can cause high blood sugar, usually requiring fast-acting diabetes medications to help combat the spike. Make sure to make your healthcare provider aware if you have diabetes. 

While most people taking the medication will not experience serious side effects, many will experience some of the more common side effects of prednisone. However, it is important for patients to remember that their doctor has prescribed prednisone understanding the risks of the medication and has determined that the benefits outweigh the risks of side effects in this situation. It's also worth noting a lot of these side effects come with long-term use or long periods of taking high doses of prednisone, versus a short-term, low-dose pack of prednisone tablets, which is most common for most issues. 

Common side effects associated with prednisone include:

  • Sleep problems (insomnia)
  • Increased appetite
  • Acne
  • Dry skin
  • Bruising or discoloration
  • Headache
  • Spinning sensation
  • Stomach pain
  • Changes in the location or shape of body fat, particularly in the arms, face, breasts, legs, neck, and waist
  • Mood changes/mood swings
  • Gradual weight gain
  • Increased sweating
  • Thinning skin
  • Slow wound healing
  • Dizziness
  • Nausea
  • Bloating
  • Fluid retention

Other side effects associated with prednisone are considered serious and require immediate medical attention. Seek medical attention immediately if you experience any of the following side effects of prednisone:

  • Blurred vision
  • Seeing halos around lights
  • Rapid weight gain
  • Severe depression
  • Changes in personality or behavior
  • Bloody or tarry stools
  • Pancreatitis, as characterized by:
    • Severe pain that occurs in the upper stomach and spreads to your back
    • Nausea and vomiting 
    • Rapid heart rate
  • Dangerously high blood pressure, as evidenced by:
    • Severe headache
    • Buzzing in your ears
    • Confusion
    • Shortness of breath
    • Seizure
    • Blurred vision
    • Anxiety
    • Chest pain
    • Uneven heartbeats
  • Eye pain
  • Swelling
  • Feeling short of breath
  • Feelings of extreme happiness or sadness
  • Seizure (convulsions)
  • Coughing up blood
  • Low potassium, as demonstrated by:
    • Confusion
    • Extreme thirst
    • Leg discomfort
    • Limp feeling
    • Uneven heart rate
    • Increased urination
    • Muscle weakness

Are there any drug interactions associated with prednisone?

Numerous drugs interact with prednisone, so it is important to give your doctor a complete medication history prior to beginning use of prednisone to avoid serious adverse effects. Include a list of all prescription and over the counter medications you are taking, as well as nutritional supplements, herbal supplements, and vitamins and minerals. Drug interactions associated with prednisone include:

  • Aminoglutehimide
  • Anticholinesterase agents
  • Antidiabetic agents
  • CYP 3A4 inducers, including barbiturates, carbamazepine, phenytoin, and rifampin
  • CYP3A4 inhibitors, including ketoconazole and macrolide antibiotics
  • Cyclosporine
  • Estrogens, including oral contraceptives
  • Potassium-depleting medications, such as diuretics and amphotericin B
  • Toxoids
  • Live or attenuated vaccines
  • Amphotericin B injections
  • Anticoagulent agents
  • Antitubercular drugs
  • Cholestyramine
  • Digitalis
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen
  • Skin tests

Are there any risks associated with prednisone?

Prednisone is a popular and widely used medication, but its use has numerous drawbacks, particularly for people with certain medical conditions and other groups of people. By suppressing inflammation, corticosteroids like prednisone may weaken the immune system, which can increase susceptibility to infection and can also cause existing or recent infections to worsen. 

Prolonged use of corticosteroids like prednisone can lead to bone loss (osteoporosis or osteopenia) in some patients, particularly those who smoke, do not receive adequate levels of calcium or vitamin D, do not exercise, or have a family history of bone loss. Children who take prednisone regularly may have their growth inhibited, so it is important to pay attention to your child's growth rate while they take prednisone and let your child's doctor know if they are not growing at a normal rate. 

Additionally, prednisone use during the first trimester of pregnancy is associated with low birth weight and some birth defects, so women who are pregnant or planning to become pregnant while taking prednisone should tell their doctor immediately. Nursing women can pass prednisone through their breast milk to a nursing infant, creating potentially harmful effects. Make sure to tell your doctor if you plan to breastfeed while taking prednisone.

 Finally, people who are allergic to prednisone or are taking an oral antifungal medication to treat a fungal infection should not take prednisone. Patients with other medical conditions should speak to their doctors about whether or not prednisone is safe to use. 

These conditions include:

  • Any illness that causes diarrhea
  • Kidney disease
  • Thyroid disease or disorder
  • History of malaria
  • Osteoporosis
  • Stomach ulcers
  • History of stomach bleeding
  • Muscle disorders, including myasthenia gravis
  • Liver disease, such as cirrhosis, or reduced liver function
  • Heart disease
  • Low levels of potassium in the blood
  • High blood pressure
  • Diabetes
  • Tuberculosis
  • Glaucoma
  • Herpes infection of the eyes
  • Cataracts
  • Ulcerative colitis
  • Depression or mental illness

Sources:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202020s000lbl.pdf 

https://www.webmd.com/drugs/2/drug-6007-9383/prednisone-oral/prednisone-oral/details 

https://www.drugs.com/prednisone.html 

https://www.mayoclinic.org/steroids/art-20045692 

https://www.medicinenet.com/prednisone/article.htm#what_diseases_and_conditions_does_prednisone_treat_uses 

https://www.benaroyaresearch.org/blog/post/connecting-dots-between-allergies-and-autoimmune-disease

Published August 31st, 2020 by Chris Riley
Fact Checked by Chris Riley

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