March 24, 2023

Medications FAQ2: What are side effects associated with Prednisone?

Um the things that really are associated with side effects from prednisone are the daily prednisone dose and then the duration of therapy so the higher doses you’re on and the longer amount of time that you’re on the prednisone the more likelihood you have of developing a lot of the different side effects associated with prednisone use a lot of them luckily are

Partially partially reversible as you come off the dose of medicine and as we replace it with other medications but cataracts some of the bone effects and then the cardiac side effects can be longer-lasting overall we have significantly less side effects if you can get people on doses less than 10 milligrams a day so these are some of the side effects that you guys

Have seen or familiar with i know there was another talk on prednisone and some of the side effects so skin you can get the steroid associated acne you can get some hair loss on the top of your head more hair growth in other areas bruising right skin thinning and a lot of these features luckily do improve as the steroids are lowered but they still affect your quality

Of life and there’s still something that you might be concerned about obviously with some of the extra hair growth there’s hair removal creams there’s topic topical acne medications even though you do have some thinning of the capillaries with increased bruising on your arms and legs maybe from like a small bump that you didn’t even know happen few patients will

Come in and have sort of this just really thin easy break breakable skin it will improve as your prednisone dose is lowered but the good thing to know about it it doesn’t signify an increased risk of internal bleeding because so just because you’re having those sort of lesions on the hands and sort of superficial areas it doesn’t mean that you have an increased risk

Of bleeding into your organs or anything like that um peptic ulcer disease a lot of people will be all have some stomach upset and irritation when they’re taking prednisone so you can take it with food especially if you’re taking anti-inflammatories like and said so ibuprofen i leave something like that if you’re taking that for pain control and you’re also taking

Prednisone you actually have a significantly two times higher risk of getting peptic ulcer disease or gastritis so you want to protect your stomach so you can ask your doctor either to prescribe you like a protonix or an exome or something some sort of stomach protection and make sure you take it with food other effects include sort of mental status changes so

You can get hypomanic and 30% depression and 10% you can have some memory memory loss psychosis so these are all different side effects that can happen with variable doses of prednisone and then prednisone can affect your bones which we all know and and a lot of your doc’s will talk to you about bone protection some of the way that it does this there’s two bones

Are constantly in a state of turnover but there’s two main cells that are sort of building up and then destroying your bones and this is constantly happening in everybody but when you get outside when steroids are given to you basically the cells that are responsible for building up your bones are inhibited they’re kind of shut off a lot and the bones that are

Responsible for their the cells that are the osteoclast which is the other one up there those are the ones that are responsible for eating away and sort of eating away at the bones and like i said usually they’re in a really nice balance where they kind of are constantly eating away bone and developing new bone but because of the steroids it’s shifted and so you

Get a lot more bone loss and a lot less bone development which leads to a lot of the osteoporosis and worrisome long-term side effects with being on prednisone you have less calcium absorption you get rid of more calcium and like i said the cells shift is off so you have more bone resorption and less bone formation so things that we will try to give you to try to

Prevent some of those side effects include calcium and vitamin d if your vitamin d is really low we’ll give you the weekly dosing that high dose one but calcium and vitamin d can be supplemented when you’re on prednisone especially above 20 milligrams a day and then in terms of just long-term monitoring you want to get a bone density scan especially if you have risk

Factors for osteoporosis within six months of starting the steroids to try to see if you need to be on a medication really to prevent your bone bone health long-term other effects and i’m moving on prednisone shortly obviously cardiac effects so elevated blood pressure weight gain elevated blood sugars so even patients on less than 10 milligrams a day have almost

Two times increased risk of needing to be on a diabetic medication so while you’re on steroids obviously trying to do things like you know watch your diet you can make people more hungry so it’s hard to say watch your diet and you’re more hungry and you’re taking this medicine that’s making you feel that way and making you like hold on to more water and feel bloated

So it’s difficult but but trying to stay within those a healthier eating habits will help when you sort of decrease the dose of prednisone too to be able to get back closer to your baseline and then of course infection so there’s always higher risk of infection with prednisone and with all of the medications that we use again this doesn’t mean that you can’t go

Visit your you know go to a go to a grade school play or go on a flight or do anything like that you just have to take standard precautions so you know keep the hand sanitizer stuff with you like make those decisions just so that way you can minimize your risk but don’t you don’t have to change your entire life you can still go to visit your relatives do whatever

You need to do but just if you know that there is someone sick don’t maybe wait a couple days before you go you go see them until they start feeling better because you are at increased risk of infections and in fact the reason that a lot of vaska is patients a lot of reasons for their for issues and for death is because of infection it’s not from the vasculitis

In that first year so you really do need to protect yourself from infections

Transcribed from video
Medications FAQ2 What are side effects associated with Prednisone? By vasculitisfoundation