Prednisone
- Class: Systemic corticosteroid
- Used for: a bad flare of inflammation
- Say it: PRED-nih-sohn
- Forms: tablet, oral liquid
PREDNISONE PRESSES the inflammation flat — fast, hard, and everywhere at once.
It damps transcription of inflammatory genes throughout the body. Everywhere at once is also the problem: sugar up, bone down, infection masked, and never stopped abruptly after weeks of use.
Same mechanism as budesonide, different reach. Swallowed, it calms inflammation throughout the body — and gives the whole body the side effects as the price.
Side effects
Common: high blood sugar, insomnia, increased appetite, mood changes
Serious: adrenal suppression, osteoporosis
Typical dose
5–60 mg once daily in the morning
A single morning dose matches the body's own cortisol peak. Above about three weeks, come down in steps rather than stopping.
Check yourself
Why must long-term Prednisone be tapered rather than stopped?
- The adrenal glands have stopped making cortisol and need time to recover
- The drug accumulates and has to be cleared slowly
- Stopping suddenly causes only a rebound of the original inflammation
- It causes withdrawal seizures
Show answer
A. The adrenal glands have stopped making cortisol and need time to recover
Rebound of the underlying disease does happen, but the dangerous problem is adrenal insufficiency — the body is left with no cortisol at all, which can drop the blood pressure to a life-threatening level.
See it, don't memorize it
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