High doses or chronic therapy with prednisone should be undertaken with great caution in patients with heart disease, hypertension, renal dysfunction, peptic ulcer, systemic fungal infection, history of psychotic disorders, diabetes mellitus, epilepsy, tuberculosis, osteoporosis, glaucoma, hypothyroidism, myasthenia gravis, hepatic failure, diverticulitis, colitis and viral diseases like herpes.
Patients who receive high dose or those on long term therapy should also be monitored for the following adverse effects: hyperglycemia, glucosuria, sodium retention with edema, hypertension, osteoporosis and fungal infection.
Treatment should not be abruptly stopped. Dosage should be reduced or slowly withdrawn or tapered off to prevent adrenal insufficiency. Treatment regimen should always be under medical supervision. Before therapy is initiated, cardiovascular function and psychologic status should be assessed.