Prednisone


Generic Medicine Info
Administration
Should be taken with food.
Contraindications
Systemic fungal infections. Concomitant administration with live or live attenuated vaccines (particularly immunosuppressive doses).
Special Precautions
Patient with systemic sclerosis; gastrointestinal disease (e.g. active or latent peptic ulcer, non-specific ulcerative colitis, diverticulitis, fresh intestinal anastomoses), hypertension, CHF, myasthenia gravis, history of seizure disorders, psychiatric disorders, diabetes mellitus, thyroid disease, osteoporosis or at risk of osteoporosis (e.g. postmenopausal women), glaucoma, acute viral infections (e.g. chickenpox, measles), history of ocular herpes simplex, Strongyloides infestation, tuberculosis (fulminating or disseminated cases), cirrhosis. Patient subjected to stressful conditions (e.g. trauma, critical illness, surgery). May mask signs of infection. Avoid abrupt withdrawal. Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. Patient Counselling Avoid exposure to chickenpox or measles; if exposed, seek immediate medical advice. Monitoring Parameters Monitor blood pressure, creatine kinase, serum glucose, Hb, electrolytes, occult blood loss, intraocular pressure (>6 weeks therapy), bone mineral density, weight; growth and development in children. Perform eye examination periodically during treatment; chest x-ray at regular intervals (prolonged use). Assess for signs and symptoms of HPA axis suppression, infection, or ocular changes.
Adverse Reactions
Significant: Adrenal suppression (e.g. hypercortisolism, hypothalamic-pituitary-adrenal [HPA] axis suppression), Cushing's syndrome, scleroderma renal crisis, transient exacerbation of myasthenia gravis; glucocorticoid-induced ocular effects (e.g. glaucoma, subcapsular posterior cataract, increased IOP), corneal perforation; CV effects (e.g. hypertension, dyslipidaemia, fluid retention, electrolyte disturbances, arrhythmias); growth suppression in children, Kaposi sarcoma, acute myopathy, immunosuppression, convulsions, psychiatric disturbances (e.g. insomnia, euphoria, mood swings, personality changes, severe depression, frank psychotic manifestations); gastrointestinal effects (e.g. peptic ulcer, dyspepsia, gastritis, abdominal distention, ulcerative oesophagitis, gastrointestinal perforation); new-onset hyperglycaemia, exacerbation of diabetes mellitus; infection (e.g. Pneumocystis jirovecii pneumonia, herpes zoster, tuberculosis, secondary ocular infection); neuromuscular and skeletal effects (e.g. osteoporosis, vertebral compression fracture, myopathy, osteonecrosis). Rarely, acute steroid myopathy. Blood and lymphatic system disorders: Leucocytosis. Ear and labyrinth disorders: Vertigo. Gastrointestinal disorders: Nausea, dyspepsia, diarrhoea, constipation, abdominal distension, gastric irritation, oesophageal ulceration, pancreatitis, peptic ulceration with perforation and haemorrhage. General disorders and administration site conditions: Fatigue. Investigations: Weight gain. Metabolism and nutrition disorders: Increased appetite, muscle atrophy. Musculoskeletal and connective tissue disorders: Myalgia, proximal, myopathy. Nervous system disorders: Headache. Reproductive system and breast disorders: Menstrual disorders. Skin and subcutaneous tissue disorders: Hirsutism, acne, pruritus, urticaria, increased sweating, rash, bruising, wound healing impairment, skin atrophy.
Drug Interactions
May result in loss of corticosteroid-induced adrenal suppression with aminoglutethimide. May increase the anticoagulant effect of vitamin K antagonist (e.g. warfarin). May decrease the plasma concentrations of isoniazid. Decreased plasma concentrations with CYP3A4 inducers (e.g. barbiturates, phenytoin, carbamazepine, rifampicin). Increased plasma concentrations with CYP3A4 inhibitors (e.g. ketoconazole, macrolide antibiotics). May increase the plasma concentration with estrogen including oral contraceptives. Concurrent use with cholestyramine may increase the clearance of prednisone. May decrease effect with mifepristone and antacids. Increased risk of gastrointestinal adverse effects with NSAIDs and aspirin. Increased risk of hypokalaemia with K-depleting agents (e.g. diuretics, amphotericin B). May increase the risk of seizures with ciclosporin.
CIMS Class
Corticosteroid Hormones
ATC Classification
A07EA03 - prednisone ; Belongs to the class of corticosteroids acting locally. Used in the treatment of intestinal inflammation.
H02AB07 - prednisone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
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