May 29, 2023


Is prednisone 20 milligrams a high dose or is it a low dose what about 40 milligrams we’re going to talk about the answers to many of these questions today first of all i’m dr. megan your prednisone pharmacist and i’m here to provide expert help to support people suffering from prednisone side effects so let’s find out what those might be if you are on high doses

For today we will go and continue our prednisone side-effect series we’ve covered common side effects in the past we’ve covered psychiatric side effects we’ve covered all sorts of different deep dives into prednisone side effects today our deep dive is into high-dose prednisone side effects so we’ll start by an overview of a visual representation of what i look

Like when i was on prednisone then we’ll jump into what changes when you go up to 20 milligrams and above and finally will conclude with where you can find more help so this is me there’s a round cartoon with the crazy curly hair you can see all of these different side effects i personally experienced and what it did to my body i felt like a stranger in my own skin

It made me feel like i wasn’t i couldn’t trust my own brain and it was a tricky time i’ve covered this in a lot of depth in a previous video called adverse effects of prednisone so check that one out if you want to hear more about this but it’s just an overview really quick so you can see what it looks like to be on prednisone what kind of a caricature you really

Become when you suffer from moonface from prednisone so as i did my research while i was on prednisone i wanted to know what was going to happen to me what was actually likely to happen and so i looked in micromedex and clinical pharmacology and lexicomp and up-to-date and daily med and i looked in all of these online drug references to find out what i should expect

As a patient on prednisone but what was crazy is they all had different lists so even though one pharmacy might be looking at one list and another pharmacy might be looking at a different list they might give you different advice what i’m going to show you today is what i compiled based on all of these different lists and you’ll see on the left how many sources

So we’re gonna start with the things that have five sources first and then we’ll go down and to four sources three down to one source which side effects were only reported in one database and it doesn’t mean that it’s more likely to happen just because it’s been reported in more than one database it just means that that’s the information that they have to share

So we’ll start with five so five sources the number one thing that happens when you’re on high doses of prednisone is it starts to affect your water balance it becomes more of a mineralocorticoid before it was it leaned heavier on the glucocorticoid side which means it didn’t affect your water quite as much but when you are in high doses it causes all of these

Things and so you’ll see on each of these slides the top header it says retain water so that’s kind of a simpler term for what is below and then in the navy the fluid retention increased plasma volume and leg edema is what it actually sets in those databases so i tried to simplify it on the top term and use the actual medical term at the bottom so each database

Might have used a different term for each basically of the same thing so i lumped them together and so retain water just means swelling with fluid retention fluid volume changes so i’m trying to keep it simple so the number one thing to remember is you retain water then the the retaining of water leads to high blood pressure another word for high blood pressure

Is hypertension and having high blood pressure is pretty common on high doses that are used long term all right the next thing is the higher the dose the more likely it is going to affect your emotional state you might feel crazy and you just have to remember it’s not me it’s the drug that doesn’t mean it’s not a real thing you do need real help with these issues

But it’s not you and so you can feel peace knowing that you are seeking help because you’re dealing with a side effect not because you personally are crazy and have some issue otherwise it’s just a drug side effect and then that was five sources now we’re dropping down to four sources so those ones are all about just serious seriously feeling crazy now this one is

More of depression so feeling sad so at high doses it’s more likely to feel depression and at low doses it’s more likely to feel anxiety if you want to know more about psychiatric side effects i have a video series all about that first is about how prednisone causes it and then the next one is coping with those side effects all right now three sources back to the

Original problem of fluid retention that makes it really hard for your heart when there’s extra blood to pump because there’s more water in your blood harder on your heart to do its job and so normally it could pump and get a certain amount of fluid moved now it has to pump harder and so the consequence is a cascade of heart problems i’m not going to read all of

These but you can see it’s everything from strokes to death all cause mortality and i personally have a friend who died of this so i know it’s real and the research shows that it’s one of the main ways that prednisone can kill people it’s not that likely but it is more likely at higher doses than at lower doses so now that was three sources now we’re down to two

Sources that are referring to other heart disease issues especially relating to the rhythm now so this is the way the heart beats so i personally had the palpitations where it’s like my heart’s beating weird like it’s not just duh don’t it’s like duh duh duh duh duh duh duh it was just a weird beat and that’s called palpitations and then arrhythmia is the fancy

Term for that and then it can be beating really fast or being really slow it can just really do anything alright still from two sources we’re gonna talk about fat no i personally think this should have been mentioned in all five sources there’s no reason that the three that didn’t mention this didn’t do it aside from they just didn’t and so fat redistribution i

Personally think is one of the most common side effects it’s everything from belly fat to moonface your face getting round and swollen like the moon to the buffalo hump on the back of your neck and moon face is incredibly common and when you are on doses over 80 milligrams it’s really unlikely to not have moon face it pretty much happens to everyone when you’re

On very high doses of prednisone so moon face and other fat redistribution is very common at high doses and so the higher the dose the rounder the face the bigger the belly the lower the dose the more likely those things go away all right now on to sugar so sugar changes so prednisone is a glucocorticoid that’s a fancy term that basically means it’s a steroid that

Messes up the way you use sugar normally you could eat a cake and maybe tolerate it but while you’re on prednisone it’s a lot harder to tolerate the sugars so especially refined sugars and that leads to high blood sugar which is also known as hyperglycemia and it affects the fasting glucose levels and the postprandial levels and that little code there at the bottom

Stands for a relative risk of 10.3 basically you have a 10 times greater risk of having high blood sugar while you’re on prednisone at a dose greater than 30 milligrams then somebody who’s not on prednisone all right now your brain so your brain on prednisone this is your brain this is your brain on drugs yeah prednisone is one of those drugs and it makes you

Feel forgetful or have brain fog or amnesia dementia and there’s a one percent risk of memory impairment that doesn’t ever go away so most of the time you stop taking the prednisone and the brain fog goes away but in 1% of cases it never does alright now we’re down to one source the immune system and prednisone is often used for this purpose it is designed by the

Doctors prescribing it to be used to suppress the immune system that’s why people who have lung transplants kidney transplants heart transplants use it is so that their own body doesn’t attack that brand-new organ that is saving their lives i personally used it for this reason too because my immune system was attacking my own blood little cells called platelets

And so it’s the reason people use it but it’s also a side effect so it’s an indication and an adverse effect at the same time and that means you might be more likely to get infections and so you just need to take the proper precautions as far as supporting your immune system and because i wanted to support my body in as many ways possible i created the ultimate

Prednisone checklist it has the top 25 things to do to support your health while on prednisone in addition to which questions to ask your doctor about making sure you get checked so that even though you have to take prednisone to survive at least maybe you can thrive while you’re on it you can find that at my website and if you already have it i’d love for you to

Share what you’ve personally done because of that checklist and if you haven’t gotten it i’d encourage you to go check it out signing off as dr. megan your prednisone pharmacist you

Transcribed from video
Prednisone 20 mg Side Effects & What You Can Do About It By Dr. Megan – Prednisone PharmacistliveBroadcastDetails{isLiveNowfalsestartTimestamp2020-06-02T195357+0000endTimestamp2020-06-02T200850+0000}