A synthetic steroid, C21H26O5, similar to cortisone that is used as an antiallergic and immunosuppressive drug and as an anti-inflammatory agent in the treatment of rheumatoid arthritis.
[pre(gnane), a derivative of cholesterol +
prednisone
Dictionary:
pred·ni·sone (prĕd'nĭ-sōn',-zōn')  |
| Dental Dictionary: prednisone |
(pred′ni-sōn)
n
n
trade names: Deltasone, Sterapred; drug class: intermediate acting glucocorticoid; action: decreases inflammation by suppressing macrophage and leukocyte migration, reduces capillary permeability and inhibits lysosomal enzymes and phagocytosis; uses: severe inflammation, immunosuppression, neoplasms, multiple sclerosis, collagen disorders, dermatologic disorders.
| Drug Info: Prednisone |
Brand names: Deltasone®Predone™Sterapred®Sterapred® DS
Chemical formula:
- Drug Forms:
- Prednisone Oral tablet (below)
- Prednisone Oral solution
Prednisone Oral tablet
What is this medicine?
PREDNISONE is a corticosteroid. It is commonly used to treat inflammation of the skin, joints, lungs, and other organs. Common conditions treated include asthma, allergies, and arthritis. It is also used for other conditions, such as blood disorders and diseases of the adrenal glands.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
•Cushing's syndrome
•diabetes
•glaucoma
•heart problems or disease
•high blood pressure
•infection like herpes, measles, tuberculosis, or chickenpox
•kidney disease
•liver disease
•mental problems
•myasthenia gravis
•osteoporosis
•seizures
•stomach, ulcer or intestine disease including colitis and diverticulitis
•thyroid problem
•an unusual or allergic reaction to lactose, prednisone, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
How should I use this medicine?
Take this medicine by mouth with a drink of water. Follow the directions on the prescription label. Take it with food or milk to avoid stomach upset. If you are taking this medicine once a day, take it in the morning. Do not take more medicine than you are told to take. Do not suddenly stop taking your medicine because you may develop a severe reaction. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose may be slowly lowered over time to avoid any side effects.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.What may interact with this medicine?
Do not take this medicine with any of the following medications:
•mifepristone
This medicine may also interact with the following medications:
•aspirin and aspirin-like drugs
•vaccines
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?
Visit your doctor or health care professional for regular checks on your progress. If you are taking this medicine over a prolonged period, carry an identification card with your name and address, the type and dose of your medicine, and your doctor's name and address.
This medicine may increase your risk of getting an infection. Stay away from people who are sick. Tell your doctor or health care professional if you are around anyone with measles or chickenpox.
If you are going to have surgery, tell your doctor or health care professional that you have taken this medicine within the last twelve months.
Ask your doctor or health care professional about your diet. You may need to lower the amount of salt you eat.
The medicine can increase your blood sugar. If you are a diabetic check with your doctor if you need help adjusting the dose of your diabetic medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
•eye pain, decreased or blurred vision, or bulging eyes
•fever, sore throat, sneezing, cough, or other signs of infection, wounds that will not heal
•frequent passing of urine
•increased thirst
•mental depression, mood swings, mistaken feelings of self-importance or of being mistreated
•pain in hips, back, ribs, arms, shoulders, or legs
•swelling of feet or lower legs
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•confusion, excitement, restlessness
•headache
•nausea, vomiting
•skin problems, acne, thin and shiny skin
•weight gain
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?
Keep out of the reach of children.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.
Last updated: 7/1/2002
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
| Veterinary Dictionary: prednisone |
A glucocorticoid; a synthetic analog of cortisone, used like prednisolone.
| Wikipedia: Prednisone |
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This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (November 2008) |
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Prednisone
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| Systematic (IUPAC) name | |
| (8S,9S,10R,13S,14S,17R)-
17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-7,8,9,10,12,13,14,15,16,17- decahydro-3H-cyclopenta[a]phenanthrene-3,11(6H)-dione |
|
| Identifiers | |
| CAS number | |
| ATC code | A07 H02 |
| PubChem | |
| DrugBank | |
| ChemSpider | |
| Chemical data | |
| Formula | C21H26O5 |
| Mol. mass | 358.428 g/mol |
| SMILES | & |
| Pharmacokinetic data | |
| Bioavailability | 70% |
| Metabolism | prednisolone (liver) |
| Half life | 1 hour |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. |
C |
| Legal status |
Prescription only |
| Routes | Oral, Nasal, Rectal, Injection, IV |
Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosupressant, and affects virtually all of the immune system. It may be used to treat a range of serious inflamatory diseases and tumors, but may have significant side effects. It is usually taken orally but can be delivered by intramuscular injection. It has a mainly glucocorticoid effect. Prednisone is a prodrug that is converted by the liver into prednisolone, which is the active drug and also a steroid.
Contents |
Uses
Prednisone can, therefore, be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe allergies, angioedema episodes, severe urushiol-induced contact dermatitis, systemic lupus erythematosus, ulcerative colitis, rheumatoid arthritis, Bell's palsy, Crohn's disease, pemphigus and sarcoidosis), uveitis, various kidney diseases including nephrotic syndrome, mononucleosis Epstein-Barr virus, and to prevent and treat rejection in organ transplantation. Prednisone has also been used in the treatment of migraine headaches and cluster headaches and for severe aphthous ulcer ("Cankersore") outbreaks. It can also be used to treat autoimmune pancreatitis.
Prednisone is used as an antitumor drug. Prednisone is very important in the treatment of acute lymphoblastic leukemia, Non-Hodgkin lymphomas, Hodgkin's lymphoma, multiple myeloma, and other tumors in combination with other anticancer drugs.
Furthermore, the pharmaceutical industry uses prednisone tablets for the calibration of dissolution testing equipment according to the United States Pharmacopeia (USP).
Intravenous application may be employed for cerebral inflammation, as in the periodic attacks caused by multiple sclerosis.
Prednisone is also used for the treatment of the Herxheimer reaction which is common during the treatment of syphilis, and to delay the onset of symptoms of Duchenne muscular dystrophy. The mechanism for the delay of symptoms is unknown.
Because it suppresses the adrenals, it is also sometimes used in the treatment of congenital adrenal hyperplasia.
History
The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation, by Arthur Nobile and coworkers.[1] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone.[2] Their discovery was protected by US Patents 2,837,464 (1958); 2,897,216 (1959); and 3,134,718 (1964).
The enhanced adrenocorticoid activity of these compounds over cortisone and hydrocortisone was demonstrated in mice.[3]
Prednisone and prednisolone were introduced by Schering in the mid-1960s under the brand names Meticorten and Meticortelone respectively.
These prescription medicines are now available from a number of manufacturers as generic drugs.
Dependency
Adrenal suppression will occur if prednisone is taken for longer than 7 days. This will cause the body to lose the ability to synthesize natural corticosteroids, resulting in dependence on prednisone. For this reason, prednisone should not be abruptly stopped if taken for more than seven days, and instead, the dosage should be gradually reduced. This weaning process may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects.[4]
Glucocorticoids act to feedback inhibit both the hypothalamus (decreasing Corticotropin-releasing hormone [CRH]) and corticotrophs in the anterior pituitary gland (decreasing the amount of Adrenocorticotropic hormone [ACTH]). For this reason exogenous glucocorticoid analogues down-regulate the body's ability to naturally produce glucocorticoids. This mechanism leads to dependence in a short time and can be very dangerous if medications are withdrawn too quickly. The body must have time to begin synthesis of CRH and ACTH and for the adrenal glands to begin functioning normally again.
Side-effects
Short-term side-effects, as with all glucocorticoids, include high blood glucose levels, especially in patients that already have diabetes mellitus or are on other medications that increase blood glucose (such as tacrolimus), and mineralocorticoid effects such as fluid retention (it is worth noting, however, that the mineralocorticoid effects of prednisone are very minor; this is why it is not used in the management of adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly).
Additional short-term side-effects include insomnia, euphoria, and, rarely, mania (particularly in those suffering from Bipolar I and II).
Long-term side-effects include Cushing's syndrome, truncal weight gain, osteoporosis, glaucoma, type II diabetes mellitus, and depression upon withdrawal.
Major
- increased blood sugar for diabetics
- weight gain
- facial swelling
- depression, mania, or other psychiatric symptoms
- unusual fatigue or weakness
- mental confusion / indecisiveness
- blurred vision
- abdominal pain
- peptic ulcer
- infections
- painful hips or shoulders
- Steroid-induced osteoporosis
- Long term migraines
- insomnia
- severe joint pain
- cataracts
- anxiety
- black stool
- stomach pain or bloating
- severe swelling
- mouth sores or dry mouth
- avascular necrosis
Minor
- stretch marks
- nervousness
- acne
- rash
- increased appetite
- hyperactivity
- frequent urination
- diarrhea
- removes intestinal flora
- leg pain
- sensitive teeth
References
- ^ Merck Index, 14th Edition, p.1327. Published by Merck & Co. Inc.
- ^ A.Nobile "et al." Journal of the American Chemical Society Vol 77, p.4184 (1955).
- ^ H.L. Herzog et al. Science, Vol. 121, p 176 (1955).
- ^ "Therapeutic and Adverse Effects of Glucocorticoids". U.S. Pharmacist. http://www.uspharmacist.com/NewLook/CE/glucocort/lesson.htm.
National Inventors Hall of Fame induction of Arthur Nobile [1]
External links
- Kelly, Janis (July 2000). "Prednisone-related growth impairment persists in children with CF". Respiratory Reviews 5 (7). http://www.respiratoryreviews.com/jul00/rr_jul00_prednisone.html.
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