Prednisone is a common prescription medication that belongs to a class of drugs known as corticosteroids. It’s widely recognized for its effectiveness in reducing inflammation and suppressing the immune system. Available in various forms, including oral tablets, prednisone is used to treat a broad spectrum of conditions. This article will delve into the specifics of prednisone 20 mg oral tablets, exploring their uses, potential side effects, warnings, and other critical information.
Highlights of Prednisone 20 mg
Prednisone is a versatile medication prescribed for numerous health issues. Here are some key highlights regarding prednisone 20 mg oral tablets:
- Generic and Brand Names: Prednisone is available as a generic drug, offering a more affordable option. It is also available under the brand name Rayos, particularly in a delayed-release formulation.
- Formulations: Prednisone comes in immediate-release tablets, delayed-release tablets (Rayos), and liquid solutions, all designed for oral administration. The 20 mg dosage is commonly available in immediate-release tablets.
- Mechanism of Action: Prednisone works by reducing inflammation and modifying the body’s immune response. This makes it effective in treating conditions characterized by inflammation, such as rheumatoid arthritis and multiple sclerosis, among others.
Important Warnings for Prednisone Use
Before starting prednisone 20 mg, it’s crucial to be aware of several important warnings associated with its use:
- Immune System Suppression: Prednisone can weaken your immune system, making you more susceptible to infections. It’s vital to be cautious about potential exposure to illnesses and to report any signs of infection to your doctor promptly.
- Live Vaccines: While taking high doses of prednisone, you should avoid receiving live vaccines. The suppressed immune system might not respond properly to the vaccine, potentially leading to infection. Consult your doctor to ensure any necessary vaccinations are safe for you.
- Bone Weakening (Osteoporosis): Long-term use of prednisone can lead to bone loss and osteoporosis, increasing the risk of fractures. This is a significant concern with prolonged prednisone therapy. Prednisone can also hinder growth in children, necessitating careful monitoring by a pediatrician.
- Adrenal Suppression: Prednisone can suppress the adrenal glands’ ability to produce essential hormones. This is more likely with long-term use or sudden discontinuation of the drug. Never stop taking prednisone abruptly without consulting your doctor, as it can lead to adrenal insufficiency.
- Risk to Fetus: Prednisone can potentially harm a developing fetus, especially during the first trimester of pregnancy. If you are pregnant, planning to become pregnant, or breastfeeding, discuss the benefits and risks of prednisone with your doctor to make an informed decision about treatment options.
What Exactly Is Prednisone?
Prednisone is a prescription steroid medication classified as a corticosteroid. It is available in various forms, including immediate-release tablets, delayed-release tablets, and liquid solutions, all taken orally. Prednisone 20 mg specifically refers to the immediate-release tablet containing 20 milligrams of the active drug.
Prednisone delayed-release tablets are sold under the brand name Rayos, while immediate-release tablets are primarily available in generic form. Generic versions are typically more cost-effective than brand-name drugs and are widely accessible. However, it’s important to note that generic versions might not always be available in the same strengths or forms as their brand-name counterparts.
Why is Prednisone 20 mg Used?
Prednisone 20 mg is prescribed to reduce inflammation and suppress the immune system. This broad action makes it useful in treating a wide range of medical conditions. Prednisone is approved to treat conditions including:
- Allergic Reactions: Prednisone can effectively manage severe allergic reactions, helping to reduce symptoms like swelling, itching, and hives.
- Anemia: Certain types of anemia, particularly autoimmune hemolytic anemia, can be treated with prednisone to suppress the immune system’s attack on red blood cells.
- Asthma: Prednisone is often used to control severe asthma exacerbations, reducing inflammation in the airways and improving breathing.
- Bursitis: Inflammation of the bursae (fluid-filled sacs cushioning joints) can be alleviated with prednisone, reducing pain and swelling.
- Colitis: Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease can be managed with prednisone to reduce inflammation in the digestive tract.
- Dermatitis: Various skin conditions characterized by inflammation, such as contact dermatitis and atopic dermatitis, can benefit from prednisone treatment to reduce itching and skin irritation.
- Endocrine Disorders: Prednisone is used to treat endocrine disorders like adrenal insufficiency and congenital adrenal hyperplasia by replacing or supplementing cortisol.
- Eye Inflammation and Ulcers: Conditions like uveitis and corneal ulcers can be treated with prednisone to reduce inflammation and prevent further damage.
- Lung Diseases: Prednisone is used for lung diseases such as sarcoidosis and aspiration pneumonia to reduce inflammation and improve lung function.
- Lupus and Nephrotic Syndrome: Autoimmune diseases like lupus and kidney conditions like nephrotic syndrome are treated with prednisone to suppress the immune system and reduce inflammation.
- Multiple Sclerosis (MS) Exacerbations: Prednisone is a common treatment for MS flare-ups, helping to reduce inflammation in the nervous system and manage symptoms.
- Optic Neuritis: Inflammation of the optic nerve can be treated with prednisone to reduce swelling and prevent vision loss.
- Osteoarthritis: While not a primary treatment, prednisone may be used for short-term relief of severe inflammation and pain in osteoarthritis.
- Psoriasis: Severe cases of psoriasis, a chronic skin condition, can be managed with prednisone to reduce inflammation and skin cell overproduction.
- Rheumatoid Arthritis: Prednisone is frequently used to reduce inflammation, pain, and stiffness in rheumatoid arthritis, an autoimmune joint disease.
- Thrombocytopenia: Low platelet count due to autoimmune destruction (thrombocytopenia) can be treated with prednisone to suppress the immune system and increase platelet levels.
- Symptoms of Lymphoma and Leukemia: Prednisone is part of chemotherapy regimens for certain cancers like lymphoma and leukemia, helping to kill cancer cells and manage symptoms.
How Does Prednisone 20 mg Work?
Prednisone exerts its effects by weakening the immune system. It interferes with the body’s inflammatory processes by blocking the production of chemicals that trigger inflammation as part of the immune response. By reducing the activity of these inflammatory pathways, prednisone helps to decrease swelling, redness, pain, and heat in various parts of the body. This mechanism of action is crucial for managing conditions where inflammation plays a central role in the disease process.
Prednisone 20 mg Side Effects
While prednisone 20 mg is effective in treating various conditions, it can also cause a range of side effects. It’s important to be aware of these potential effects and discuss any concerns with your healthcare provider.
Common Side Effects
The more common side effects associated with prednisone use include:
- Confusion
- Excitement or Agitation
- Restlessness
- Headache
- Nausea
- Vomiting
- Thinning Skin
- Acne
- Trouble Sleeping (Insomnia)
- Weight Gain
These side effects are often mild and may resolve on their own within a few days to weeks as your body adjusts to the medication. However, if these effects become severe or persistent, it’s important to consult your doctor or pharmacist for advice and management strategies.
Serious Side Effects
In some cases, prednisone can lead to more serious side effects that require immediate medical attention. Call your doctor right away or seek emergency medical help (call 911) if you experience any of the following serious side effects:
- Severe Allergic Reactions: Symptoms may include rash, hives, itching, swelling of the face, tongue, or throat, severe dizziness, and trouble breathing.
- Changes in Emotions or Moods: Prednisone can cause significant mood changes, including depression, anxiety, irritability, and even psychosis.
- Changes in Vision: Blurred vision, decreased vision, or other visual disturbances should be reported immediately.
- Eye Pain: Sudden or severe eye pain can be a sign of serious eye problems.
- Infection: Due to immune system suppression, prednisone increases the risk of infections. Symptoms of infection can include:
- Fever or Chills
- Cough
- Sore Throat
- Pain or Difficulty Urinating
- High Blood Sugar (Hyperglycemia): Prednisone can elevate blood sugar levels, especially in individuals with diabetes. Symptoms of high blood sugar include:
- Increased Thirst
- Frequent Urination
- Sleepiness or Fatigue
- Confusion
- Swelling of Ankles or Feet
Disclaimer: This is not an exhaustive list of all possible side effects. Individual responses to prednisone can vary. Always discuss potential side effects with your healthcare provider who is familiar with your medical history.
Prednisone 20 mg Interactions with Other Medications
Prednisone 20 mg oral tablets can interact with various other medications, vitamins, and herbal supplements. These interactions can alter how prednisone or the other medications work, potentially leading to harmful effects or reduced effectiveness. To manage potential interactions, it’s crucial to inform your doctor about all medications, vitamins, and herbs you are currently taking.
Examples of drugs that can interact with prednisone include:
Mifepristone
Taking mifepristone with prednisone might interfere with prednisone’s effectiveness. It is advisable to avoid mifepristone if you are taking prednisone regularly, especially for long-term treatment.
Bupropion
Combining bupropion with prednisone may increase the risk of seizures. Caution is advised when using these medications together.
Haloperidol
Taking haloperidol with prednisone may increase the risk of heart rhythm problems. This combination should be used with caution, and patients may need cardiac monitoring.
Live Vaccines
As prednisone weakens the immune system, receiving live vaccines while on prednisone can lead to infection. It’s generally recommended to avoid live vaccines during prednisone treatment.
Medications for Diabetes
Prednisone can raise blood glucose levels, potentially counteracting the effects of diabetes medications. Individuals taking prednisone with diabetes medications may experience difficulties in blood sugar control. Examples of diabetes medications include:
- Sulfonylureas (e.g., glipizide, glyburide)
- Biguanides (e.g., metformin)
- Thiazolidinediones (e.g., pioglitazone, rosiglitazone)
- Acarbose
- Metiglinides (e.g., nateglinide, repaglinide)
Dosage adjustments of diabetes medications might be necessary when prednisone is started or stopped.
Warfarin
Prednisone can reduce the blood-thinning effect of warfarin, an anticoagulant. If these drugs are taken together, your doctor may need to monitor your warfarin treatment more closely and adjust the dosage as needed.
Digoxin
Combining digoxin with prednisone may increase the risk of heart rhythm problems. Careful monitoring is recommended when these medications are used concurrently.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Taking NSAIDs with prednisone can increase the risk of stomach problems such as ulcers and bleeding. Examples of NSAIDs include:
- Piroxicam
- Ibuprofen
- Flurbiprofen
- Naproxen
- Meloxicam
- Sulindac
This combination should be used cautiously, and patients should be monitored for gastrointestinal side effects.
Disclaimer: This list is not exhaustive and other drug interactions are possible. Always consult with your healthcare professional about potential interactions with all prescription medications, over-the-counter drugs, vitamins, herbs, and supplements you are taking.
Prednisone 20 mg Warnings
Prednisone 20 mg comes with several important warnings for specific populations and health conditions.
Allergic Reaction Warning
Prednisone oral tablets can cause allergic reactions in some individuals. Symptoms of an allergic reaction may include:
- Skin rash
- Hives
- Itching
- Trouble breathing
- Swelling of the face, tongue, or throat
If you develop any of these symptoms, seek immediate medical attention by calling 911 or going to the nearest emergency room. Do not take prednisone again if you have ever had an allergic reaction to it, as subsequent exposure could be fatal.
Warnings for People with Certain Health Conditions
- Infections: Prednisone weakens the immune system and can worsen existing infections or increase susceptibility to new infections. Inform your doctor if you have any current infections.
- Heart or Kidney Disease: Prednisone can cause fluid retention (salt and water), which may elevate blood pressure and worsen heart failure or kidney disease.
- Diabetes: Prednisone can increase blood sugar levels, necessitating closer monitoring of blood glucose and potential adjustments to diabetes medications.
- Eye Problems: Long-term prednisone use can increase the risk of eye infections, cataracts, and glaucoma. Prednisone should be avoided in cases of herpes infection of the eye. Report any vision changes or eye pain to your doctor.
- Stomach Problems: Prednisone can irritate the stomach lining and potentially cause ulcers or bleeding. Inform your doctor if you experience persistent stomach pain or notice dark or bloody stools.
- Mood Disorders: Prednisone can affect mood and behavior, potentially causing mood swings, depression, or insomnia. Report any changes in mood, feelings of depression, or sleep disturbances to your doctor.
Warnings for Other Groups
- Pregnancy: Prednisone can pose risks to the fetus, particularly in the first trimester. It should only be used during pregnancy if the benefits outweigh the potential risks and if it is essential to treat a serious condition in the pregnant person. Discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant.
- Breastfeeding: Prednisone can pass into breast milk and may affect a nursing infant. High doses may interfere with a child’s growth and development. Consult your doctor before taking prednisone while breastfeeding.
- Older Adults: Older adults may process prednisone more slowly due to age-related changes in kidney, liver, and heart function. They may be started on lower doses to minimize side effects.
- Children: Prednisone can slow growth in children if taken for extended periods. A pediatrician should monitor a child’s growth rate during prednisone treatment.
Prednisone 20 mg Dosage
The dosage of prednisone 20 mg oral tablet varies widely depending on the condition being treated, its severity, individual patient factors, and response to treatment. Your doctor will determine the appropriate dosage, form, and frequency of administration.
Dosage for Endocrine Disorders, Rheumatic Disorders, Skin Diseases, Allergies and Asthma, Eye Diseases, Lung Diseases, Blood Disorders, Lymphoma and Leukemia, Lupus and Nephrotic Syndrome, and Stomach Diseases
For most of the conditions prednisone 20 mg treats, including endocrine, rheumatic, skin, allergy, asthma, eye, lung, blood, lymphoma/leukemia, lupus/nephrotic syndrome, and stomach diseases, the adult dosage guidelines are similar:
Adult Dosage (ages 18–64 years)
- Typical Starting Dosage: The initial dosage can range from 5 mg to 60 mg per day, depending on the specific condition and its severity.
- Immediate-Release Tablets: For immediate-release tablets, to minimize side effects, a strategy called alternate-day therapy may be used, where twice the usual daily dose is taken every other morning. This approach should only be implemented under the direction of your doctor.
Child Dosage (ages 0–17 years)
- Dosage for children is typically determined based on body weight. The pediatrician will calculate the most appropriate dose for your child.
Senior Dosage (ages 65 years and older)
- Older adults may metabolize drugs more slowly. A standard adult dose might lead to higher drug levels in seniors. Lower starting doses and adjusted dosing schedules may be necessary.
Dosage for Multiple Sclerosis Exacerbations
For managing acute exacerbations of multiple sclerosis, the dosage regimen is different:
Adult Dosage (ages 18–64 years)
- Immediate-Release Tablets: In cases of MS symptom flare-ups, a high dose of 200 mg once daily for one week may be prescribed. This may be followed by a reduced dose of 80 mg once every other day for one month.
Dosage adjustments for children and seniors with MS exacerbations follow the same principles as mentioned above, with weight-based dosing for children and potentially lower doses for seniors.
Disclaimer: Dosage information provided here is for general guidance only and may not encompass all possible dosages. Always follow your doctor’s specific instructions regarding dosage and administration. Do not adjust your dose without consulting your healthcare provider.
How to Take Prednisone 20 mg
It’s essential to take prednisone 20 mg oral tablets as directed by your healthcare provider. The duration of treatment depends on your condition and how your body responds to the medication.
If you stop taking the drug or don’t take it at all: If you abruptly stop prednisone or do not take it as prescribed, your symptoms may not improve and could worsen. Never stop taking prednisone suddenly without consulting your doctor, as it can lead to withdrawal symptoms due to adrenal insufficiency.
If you miss doses or don’t take the drug on schedule: For prednisone to work effectively, it needs to be taken consistently. Missed doses or irregular dosing can reduce the medication’s effectiveness or lead to treatment failure.
If you take too much: Taking too much prednisone can lead to dangerously high levels of the drug in your body. Overdose symptoms may include:
- Burning or Itching Skin
- Seizures
- Deafness
- High Blood Pressure
- Muscle Weakness
If you suspect an overdose, seek immediate medical attention. Call your doctor or the Poison Control Center at 1-800-222-1222, or go to the nearest emergency room.
What to do if you miss a dose: If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.
How to tell if the drug is working: You should experience a reduction in pain, swelling, and other symptoms related to your condition. The specific signs of improvement depend on the condition being treated. Discuss with your doctor what specific improvements you should expect to see as prednisone starts to work.
Important Considerations for Taking Prednisone 20 mg
Keep these important considerations in mind while taking prednisone 20 mg:
General Tips:
- Take with Food: To prevent stomach upset, take prednisone with food or milk.
- Timing of Dose: If you take prednisone once a day, take it in the morning to coincide with your body’s natural cortisol production cycle. If taking multiple doses, space them evenly throughout the day.
- Tablet Handling: Do not cut or crush delayed-release tablets (Rayos). They are designed to release medication slowly. However, immediate-release tablets can be cut or crushed if needed.
Clinical Monitoring:
Your doctor will likely schedule regular check-ups to monitor your health and the effectiveness of prednisone. These may include:
- Blood Tests: To monitor blood sugar levels, electrolyte balance, and other parameters. Prednisone can increase blood sugar and affect electrolyte levels.
- Bone Density Tests: To assess bone health, as long-term prednisone use can lead to bone loss and osteoporosis.
- Eye Exams: To monitor for potential eye-related side effects like cataracts or glaucoma, especially with long-term use.
Storage:
- Store prednisone tablets at room temperature between 59°F and 86°F (15°C and 30°C).
- Keep the medication in a tightly closed container, protected from light and moisture.
- Avoid storing prednisone in damp areas like bathrooms.
Travel:
- Always carry your prednisone medication with you, especially when traveling. Keep it in your carry-on bag when flying, not in checked luggage.
- Airport X-ray machines will not harm your medication.
- It’s advisable to carry the original prescription-labeled container to show airport security if needed.
- Avoid storing prednisone in your car’s glove compartment or leaving it in a car, especially in extreme temperatures.
Dietary Considerations:
Prednisone can affect fluid and electrolyte balance in the body. High doses can cause sodium retention and potassium loss. Your doctor might recommend dietary adjustments, such as a low-sodium diet and potassium-rich foods, to manage these effects.
Alternatives:
There are alternative medications available to treat many of the conditions prednisone is used for. Discuss with your doctor if there are other treatment options that might be more suitable for you, especially for long-term management.
Disclaimer: This information is intended for educational purposes and should not replace professional medical advice. Always consult with your doctor or other qualified healthcare provider for any questions you may have regarding prednisone or your medical condition. Do not use this information to diagnose or treat a medical condition.
