Cortisone Tablets

(Prednisone - Prednisone, Deltasone, Apo-Prednisone, Novo-Prednisone, Winpred)

In the management of rheumatoid arthritis, prednisone (cortisone tablets) can provide interim control of inflammation while waiting for one of the slower-acting disease-modifying agents (usually gold therapy, methotrexate or anti-malarials) to take effect. By contrast, prednisone works very quickly, usually within one to four days. At an adequate dose, it reduces inflammation when many joints are affected at the same time and performing daily activities is limited. Prednisone is also powerful enough to control serious complications in lupus, when the membranes lining major organs (such as the heart, lungs or kidneys) become inflamed. Prednisone is never used to treat osteoarthritis .

After about three months of prednisone therapy, the adrenal glands begin to secrete less and less cortisone of their own, because the supplemental doses remove the need for more to be produced naturally by the body. Thus, you should never stop taking the medication abruptly (that can result in fever, chills and severe discomfort, which may in some cases require hospitalization). Instead, if your doctor decides reducing or stopping is appropriate, he or she will gradually reduce the daily dose to allow your adrenal glands to start producing its own cortisone again.

Special Indications

Take exactly the amount prescribed by your doctor. Usually prednisone works best when you take the complete daily dose in the morning, although you can split the dosage if the benefits don't seem to last a full 24 hours. If you find that a half-dose at dinner gives you an unwelcome 'buzz' or causes insomnia, try taking it at lunch time.

Only your doctor can decide how long you'll need to take prednisone, since it depends on your individual condition. If you run out of prednisone, don't assume you're to stop taking it; contact your doctor to be sure. [Do NOT stop prednisone without discussing this with your doctor. The side effects of stopping prednisone suddenly can be dangerous.]

If you're on long-term prednisone therapy, you should wear a MedicAlert bracelet. The reason is, when you suffer any kind of major trauma, such as a car accident, your adrenal glands would normally step up production to meet the added challenge of healing. Because your prednisone therapy will have slowed down production, though, your adrenals won't be able to meet the challenge, and you'll need additional cortisone. If you're unconscious or can't speak up for any reason, a bracelet will alert the attending doctors to administer cortisone. And keep wearing the bracelet for a year after prednisone therapy has been stopped, because it can take that long for the adrenal glands to regain peak performance.

Side Effects

Prednisone is most often prescribed in low doses (three tablets or less per day) and is well tolerated. If side effects do occur, they're usually related to high-dose or long-term therapy (more than three months). The list of side effects is long. You should discuss these potential side effects with your doctor before starting the medication.

One possible consequence of long-term prednisone therapy is accelerated osteoporosis (weakening of bones). If you're not drinking a litre (four glasses) of milk per day, your doctor may request that you supplement your diet with 500 mg calcium supplements two or three times daily along with 800 units of vitamin D to help absorb the calcium. Estrogen replacement therapy - a known preventative of osteoporosis - is often prescribed for women after menopause.

If you are on a medium to high dose of prednisone for longer than six weeks, your doctor may recommend another medication called a bisphosphonate (Fosamax) to protect your bones.

If you haven't already, make sure you visit Cortisone:  General Indications.

This page was last reviewed/updated on : 02/23/2008