Prednisone (Deltasone) is part of a potent class of anti-inflammatory agents, known as corticosteroids, which are used to control inflammation of the joints and organs. It is often used to treat a variety of inflammatory conditions, including redness, swelling, and pain. Prednisone is used to treat rheumatoid arthritis, lupus, vasculitis, and many other inflammatory diseases.
Dosing of prednisone varies widely depending on the state of the disease being treated. Doses used in rheumatoid arthritis are commonly 5-10mg daily, while doses needed in lupus and vasculitis are often 60–80 mg daily, or sometimes higher. The dose is usually decided based on your weight and disease manifestations. Prednisone usually achieves its effect within one – two hours. The delayed release tablets take effect about six hours after taking the dose. Prednisone stops working soon after stopping the medication. If you have been taking prednisone regularly for longer than two weeks, do not stop it suddenly because you could develop adrenal insufficiency. Instead, you should discuss a tapering schedule with your rheumatology provider.
Most side effects are related to the dose administered and duration of treatment, so the goal is to use it at the lowest effective dose for the shortest period of time necessary. Some potential side effects include easy bruising, osteoporosis (or weakened bones), diabetes, hypertension, weight gain, cataracts, glaucoma, and a bone disorder called avascular necrosis.
Although prednisone rarely has a direct interaction with other medications, there is an increased risk of infection when combining prednisone with other medications that affect your immune system. At higher doses of prednisone, your provider may also prescribe you prophylactic medications to prevent pneumonia. Additionally, when taking prednisone with NSAIDs (such as naproxen or ibuprofen), there can be an increased risk of stomach ulcers. Make sure to review all of your medications with your physician at each visit.
Your doctor will monitor you for side effects. Be sure to discuss any new symptoms you are experiencing with your rheumatology provider.
Talk to your rheumatology provider about which vaccines are appropriate for you, as it depends on your dose of prednisone.
If you are pregnant or are considering pregnancy, discuss this with your doctor before starting medication. Although prednisone can be necessary to use during pregnancy, complications can still birth, and premature delivery. Babies born from women receiving large doses of corticosteroids during pregnancy can develop under active adrenal glands and also can be smaller than expected at birth. Babies can develop cleft lip and cleft palate as well. Although some of the drug passes into breast milk, prednisone appears to be safe while breastfeeding. After a dose >20 mg of prednisone, a 4-hour delay in breastfeeding is recommended.
Updated February 2022 by Kanika Monga, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.