Prednisone (Sterapred®, Prednisone Intensol)

Prednisone is a corticosteroid/glucocorticoid that is similar to a hormone made naturally in your body. Corticosteroids (sometimes called "steroids") are used to lessen inflammation (swelling and/or redness). Steroids may be used for a few diseases, such as asthma, autoimmune disorders, reactions to medications, and gastrointestinal (GI) disorders (colitis). Prednisone may be given to prevent a reaction to a medication, to prevent or decrease nausea, or it can be used in high doses to treat some types of cancers.

How to Take Prednisone

Prednisone comes as a tablet to take by mouth. The tablet should be swallowed whole. You should not break or chew the tablet. Prednisone is best taken with food or milk, as it can irritate your stomach. Your provider will probably tell you to take your dose(s) of prednisone at the same time(s) each day. Your dosing schedule depends on what the medication is being used for. If you miss a dose, take it as soon as possible. If it is too close to your next dose, skip the missed dose and go back to your normal schedule.

Do not stop taking this medication without first speaking to your care provider as this could cause side effects such as weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, and abdominal (belly) pain.

This medication can affect the levels of many other medications including warfarin, cyclosporine, oral birth control pills, phenytoin, bupropion, thalidomide, erythromycin, ketoconazole, and ritonavir, among others. Be sure to tell your healthcare provider about all medications and supplements you take.

You, or anyone you live with, should avoid having live or live-attenuated vaccines while receiving this medication. These include herpes zoster (Zostavax) for shingles prevention, oral polio, measles, nasal flu vaccine (FluMist®), rotavirus, and yellow fever vaccines.

Storage and Handling

Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist). Keep containers out of reach of children and pets.

Where do I get this medication?

Prednisone is available through most pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network pharmacy for the distribution of this medication.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Your care team can help you find these resources if they are available.

Possible Side Effects of Prednisone

There are a number of things you can do to manage the side effects of prednisone. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Swelling

Patients may notice swelling in their hands and/or feet. Elevating (raising) the feet may help to lessen swelling in the feet and ankles. Avoid restrictive or tight clothing that may make it harder for the fluid to drain from the hands, feet, and ankles.

Increased Risk of Infection

This medication can lower your ability to fight new and current infections. Contact your provider if you have any signs of infection, such as fever, chills, sore throat or cold, cough or burning with urination.

Tips to preventing infection:

• Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
• Avoid large crowds and people who are sick (i.e.: those who have a cold, fever, or cough or live with someone with these symptoms).
• When working in your yard, wear protective clothing including long pants and gloves.
• Do not handle pet waste.
• Keep all cuts or scratches clean.
• Shower or bathe daily and perform frequent mouth care.
• Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
• Ask your doctor or nurse before scheduling dental appointments or procedures.
• Ask your doctor or nurse before you, or someone you live with has any vaccinations.

Weakening of the Bones (Osteoporosis)

Long-term use can lead to early osteoporosis. Your provider may have you get a bone density scan (DEXA scan) to check your bone health if you are on long-term therapy.

Eye Problems

Long-term use of this medication can increase the pressure in your eyes. Report any changes in vision, blurry or double vision, and eye pain or redness.

Increase in Appetite

Prednisone can cause you to be hungrier or thirstier than usual. Drink plenty of fluids and try to make your snacks healthy ones.

Increase in Energy

Prednisone can cause an increase in energy. You may also have insomnia, or difficulty sleeping. Taking the medication in the morning may help prevent this.

Irritability or Change in Mood

Some patients report feeling irritable or might notice a change in their mood while taking prednisone. If this becomes difficult to handle or if you feel like you may harm yourself or others, call your healthcare provider right away.

Nausea and Heartburn

Taking prednisone with food or milk is usually enough to prevent nausea and heartburn. If possible, take the medication when you can be upright (not lying down) for a few hours after the dose. Avoid things that worsen the symptoms and try antacids (milk of magnesia and calcium tablets, like Tums), saltines, or ginger ale to lessen symptoms.

Increased Blood Sugar

Prednisone can raise your blood sugar. Diabetics should watch their blood sugar closely and may need higher doses of insulin while taking prednisone. Patients who are not diabetic but have increased blood sugar levels may be told to check their blood sugar and take insulin while on prednisone. Your provider will tell you if this is necessary.

GI Bleed & Tear

This medication can cause bleeding or a tear in your intestinal wall (GI tract). Signs of these problems may be: unexpected bleeding, blood in the stool or black stools, coughing up blood, vomiting blood, vomit that looks like coffee grounds, fever, severe pain in the abdomen, or new abdominal swelling. If you have any of these, contact your oncology care team right away or go to the emergency room.

Other Side Effects

Prednisone can cause delayed wound healing, headaches, muscle weakness, and cataracts (after long-term use).

Reproductive Concerns

Exposure of an unborn child to this medication could cause birth defects in rare cases, so you should not become pregnant or father a child while on this medication. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should check with your healthcare team before breastfeeding while receiving this medication.