Mayo Clinic Health Manager. Prednisone and other corticosteroids: Balance the risks and benefits Weigh the benefits and risks of corticosteroids, such as. Docetaxel and Estramustine Compared with Mitoxantrone and Prednisone for Advanced Refractory Prostate Cancer. Petrylak, M.D., Catherine M.
What is, what is used for, dose, side effects, brands. PREDNISONEList of brands containing prednisone This page contains list of brands of authorized pharmaceutical specialties of the active principle prednisone in the countries listed below.
So that, in no case can take decisions based on the information contained in the page. MEDIZZINE is not responsible for any damage arising from the information provided, which may be incomplete or outdated.
Prednisone is a cortisone derivative (natural hormone from the adrenal glands), belonging to the group of glucocorticoids also termed steroids or corticosteroids. Drugs from this group have a similar action, but much more potent than cortisone. Its effects include mainly anti- inflammatory, antiallergic, and immunosuppressive therapeutical properties.
Lung cancer, also known as lung carcinoma, is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. This growth can spread beyond.
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- Some agents are more teratogenic than others. Less obvious is the axiom that an agent may be teratogenic in only certain species.
The multiple and potent actions in which are applied derive from these properties. Usually, steroid therapy is administered as an adjuvant in various diseases, although it may often be the only possible. The diseases which can be treated by administration of corticosteroids include: - Endocrine disorders: failure of the adrenal glands, where natural corticosteroids are not produced in adequate amounts, congenital adrenal hyperplasia, suppurative thyroiditis and hypercalcemia linked to cancer.
Oral solution: Besides the active ingredient, the oral solution may contain sodium edetate, fructose, citric acid, hydrochloric acid, maltol, peppermint essential oil, polysorbate 8. Warning: The composition of the various presentations may vary from one country to another. We recommend you consult the information provided by your local supplier. This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, contact him before taking this medicine. The sportsmen must know that this medicine contains an ingredient that may provide positive in doping controls.
Do not use prednisone. If you are allergic (hypersensitive) to prednisone, to other corticosteroids or any of the other ingredients of the medicinal product prescribed to you. If you think may be allergic, ask your doctor. Allergy symptoms may include: - Asthma attacks with shortness of breath, audible wheezing or rapid breathing.- More or less sudden swelling of the face, lips, tongue or elsewhere in the body. It is especially critical if it affects the vocal cords.- Hives, itching, rash- Anaphylactic shock (loss of consciousness, paleness, sweating, etc.). Nor you should take this medicine: - If you have a fungal generalized infection (systemic mycosis),- If you have osteoporosis or osteomalacia,- If you have diabetes mellitus,- If you have a symptomatic psychosis,- If you suffer from peptic ulcer- If you have active tuberculosis, unless you are under effective TB treatment,- If you have an acute bacterial infection,- If you have chickenpox or herpes zoster,- If you need to get vaccinated, do not take prednisone for the previous 8 weeks or 2 weeks after vaccination,- If you have severe high blood pressure,- If you have glaucoma.
Take special care with prednisone, especially : Adrenal insufficiency: Patients undergoing prolonged treatment with high doses of corticosteroids suffer a decreased function of the adrenal glands, which can cause poor response to situations of physical or psychological stress (trauma, burns, surgery, infections, etc.). In these situations, the needs of natural corticosteroids are increased, as happens in the case of exacerbation of the disease which motivates administration of prednisone, so it may be necessary to administer additional prednisone doses. The risk of poor response of the adrenal gland persists for months after stopping treatment with prednisone, forcing to closely monitor patients in situations of physical stress, as they may require replacement or supplementary doses. When the doctor deems that the drug should be discontinued, shall gradually reduce the dose, in order to avoid the appearance of a functional failure of the adrenal glands due to lack of corticosteroids, whether natural or as prednisone.
Decreased defensive reaction of the organism: Corticosteroids may mask the signs of infection and facilitate the development of concurrent infections, also decreasing the body's ability to maintain isolated the source of infection, allowing it becoming general. Corticoids suppress the defensive response of the body; by this reason, patients treated with prednisone or other corticosteroids should not be vaccinated with live virus vaccines. This is the case of chickenpox and other vaccine- preventable diseases, since may occur a generalized virus infection by the vaccine virus. Exceptions to this rule are cases of patients in which is administered a corticosteroid as replacement therapy if there is a natural hormone deficiency (Addison's disease). In the case of patients with ocular herpes simplex, can occur corneal perforation when corticosteroids are used. Cardiovascular and metabolic risks. Corticosteroids can raise blood pressure, cause salt and water retention and increase calcium and potassium excretion, so your doctor may prescribe potassium supplements and recommend reducing the consumption of sodium (salt).
In the case of severe heart failure is required a careful medical supervision. Children and adolescents. Prednisone can alter growth in children, so the development of pediatric patients should be controlled on extended treatments. Prolonged treatment in children can cause damage to the pancreas. Other cautions. When possible, the doctor will use the lowest effective dose. The effect of corticosteroids increases in patients with hypothyroidism or cirrhosis; such patients may require lower prednisone doses.
Prednisone and other corticosteroids can lead to psychiatric disorders or aggravate emotional instability situations or psychosis pre- existing. May appear sleep disorders requiring a change in treatment. Corticosteroids may alter the motility and number of spermatozoa in some patients. If you have diabetes, your doctor may increase your diabetes medicine and monitor the treatment more closely.
If you have risk factors for osteoporosis (hereditary, elderly patients, post- menopause, heavy smokers and lack of physical activity) treatment with prednisone may cause bone mass loss, so your doctor may prescribe a treatment to prevent osteoporosis. Corticosteroids should be used with great caution in: - gastroduodenal ulcers,- severe ulcerative colitis with a high risk of perforation, abscess or other pyogenic infection- Diverticulitis, - recent surgical intestinal anastomosis (joining two sections of the intestine),- renal failure,- Arterial hypertension.
Hypertensive patients should be monitored more frequently.- Myasthenia gravis,- Hepatitis B,- Tuberculosis,- Poliomyelitis, a viral infection that causes the so- called infantile paralysis,- Acute viral infections, such as chickenpox, herpes simplex, herpes zoster or measles,- Acute and chronic bacterial infections, such as acute tonsillitis- Fungal infections such as candidiasis,- Parasitic infestations, such as intestinal worms. Laboratory and allergy tests. Treatment with prednisone may alter the results of skin allergy tests and determination of thyroid hormone in the blood. In both cases, tell your doctor you are being treated with prednisone.
Taking other medicines. Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including herbal products or drugs obtained without a prescription. It is especially important you tell your doctor if you take any of these drugs: - Drugs that stimulate the elimination of prednisone (enzymatic inducers), and reduce the levels and effects of this substance. These include carbamazepine, primidone, phenobarbital, phenytoin, and rifampicin.- Enzymatic inhibitors such as ketoconazole and erythromycin, which slow the elimination of steroid and increase its effects,- Estrogens (female hormone), including contraceptives, which may increase the effects of prednisone,- Concurrent administration of prednisone with digitalis, diuretics or amphotericin B can lower potassium levels,- Coumarin anticoagulants (e. It is advisable to closely monitor the INR and adjust the dose if necessary,- Alcohol and nonsteroidal anti- inflammatory drugs (NSAIDs) increase the risk and severity of suffering from ulcers and gastrointestinal bleeding.- There may be a decrease in the concentration of salicylates, including aspirin, by effects of corticoid.- The Antidiabetic drugs may require a dose increase due to rising glucose level caused by prednisone.- Antacids (aluminum, magnesium) may decrease the absorption and effects of prednisone.- Administering corticosteroids while being taking growth hormone may reduce the effect of this,- They can increase the effects of muscle relaxants (succinylcholine) if taken in combination with prednisone.- Cyclosporine and prednisone inhibit each other, so it should not be given together.- Co- administration with praziquantel reduces the effect of antiparasitic.- Co- administration of prednisone and cyclophosphamide can alter its effects.
It is not recommended simultaneous use- Bupropion, an antidepressant also indicated for smoking cessation, can reduce the prednisone effects.- Licorice may increase the effects of prednisone.- ACE inhibitors (enalapril, lisinopril, captopril, etc), medicines for high blood pressure and heart failure, may increase the risk of alteration of blood cells,- The joint use with anticholinergics increases the risk of glaucoma (ocular hypertension)- antimalarial drugs (chloroquine, hydroxychloroquine, mefloquine) increase the risk of muscle weakness, including heart muscle. Use with food and beverages.
The extended- release tablets should be taken with food or after it, as they have a better absorption, preferably in the evening.
Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis. Description. Osteoporosis is a serious public health problem. Some 4. 4 million people in the United States are at risk for this potentially debilitating disease, which is responsible for 1. These fractures, which are often the first sign of the disease, can affect any bone, but the most common locations are the hip, spine, and wrist.
Breaks in the hip and spine are of special concern because they almost always require hospitalization and major surgery, and may lead to other serious consequences, including permanent disability and even death. To understand osteoporosis, it is helpful to understand the basics of bone formation. Bone is living tissue that is constantly being renewed in a two- stage process (resorption and formation) that occurs throughout life. In the resorption stage, old bone is broken down and removed by cells called osteoclasts. In the formation stage, cells called osteoblasts build new bone to replace the old.
During childhood and early adulthood, more bone is produced than removed, reaching its maximum mass and strength by the mid- 3. After that, bone is lost at a faster pace than it is formed, so the amount of bone in the skeleton begins to slowly decline. Most cases of osteoporosis occur as an acceleration of this normal aging process, which is referred to as primary osteoporosis.
The condition also can be caused by other disease processes or prolonged use of certain medications that result in bone loss. If so, this is called secondary osteoporosis. Osteoporosis occurs most often in older people and in women after menopause.
It affects nearly half of men and women over the age of 7. Women are about five times more likely than men to develop the disease. They have smaller, thinner bones than men to begin with, and they lose bone mass more rapidly after menopause (usually around age 5. In the five to seven years following menopause, women can lose about 2. By age 6. 5 or 7.
As an increasing number of men reach an older age, there is more awareness that osteoporosis is an important health issue for them as well. In fact, a 2. 00. Causes and symptoms. A number of factors increase the risk of developing osteoporosis. Osteoporosis is more likely as people grow older and their bones lose tissue. Gender. Women are smaller and start out with less bone. They also lose bone tissue more rapidly as they age.
While women commonly lose 3. Race. Caucasian and Asian women are most at risk for the disease, but African American and Hispanic women can get it too. Figure type. Women with small bones and those who are thin are more liable to have osteoporosis. Early menopause. Women who stop menstruating early because of heredity, surgery or lots of physical exercise may lose large amounts of bone tissue early in life. Conditions such as anorexia and bulimia also may lead to early menopause and osteoporosis.
Lifestyle. People who smoke or drink too much, or do not get enough exercise have an increased chance of osteoporosis. Diet. Those who do not get enough calcium or protein may be more likely to have osteoporosis. That is why people who constantly diet are more prone to the disease. Genetics. Research in Europe reported in 2. Studies were continuing on how to identify the gene and use information from the research to prevent osteoporosis in carriers. Osteoporosis is often called the .
People often do not know they have the disease until a bone breaks, frequently in a minor fall that would not normally cause a fracture. A common occurrence is compression fractures of the spine. These can happen even after a seemingly normal activity, such as bending or twisting to pick up a light object. The fractures can cause severe back pain, but sometimes go unnoticed—either way, the vertebrae collapse down on themselves, and the person actually loses height.
The hunchback appearance of many elderly women, sometimes called . These include a geriatrician, who specializes in treating the aged; an endocrinologist, who specializes in treating diseases of the body's endocrine system (glands and hormones); and an orthopedic surgeon, who treats fractures such as those caused by osteoporosis. Before making a diagnosis of osteoporosis, the doctor usually takes a complete medical history, conducts a physical exam, and orders x rays, as well as blood and urine tests, to rule out other diseases that cause loss of bone mass. The doctor also may recommend a bone density test. This is the only way to know for certain if osteoporosis is present. It also can show how far the disease has progressed.
Several diagnostic tools are available to measure bone density. The ordinary x ray is one, though it is the least accurate for early detection of osteoporosis, because it does not reveal bone loss until the disease is advanced and most of the damage has already been done.
Two other tools that are more likely to catch osteoporosis at an early stage are computed tomography scans (CT scans) and machines called densitometers, which are designed specifically to measure bone density. The CT scan, which takes a large number of x rays of the same spot from different angles, is an accurate test, but uses higher levels of radiation than other methods. The most accurate and advanced of the densitometers uses a technique called DEXA (dual energy x- ray absorptiometry).
With the DEXA scan, a double x- ray beam takes pictures of the spine, hip, or entire body. It takes about 2.
Doctors do not routinely recommend the test, partly because access to densitometers is still not widely available. People should talk to their doctors about their risk factors for osteoporosis and if, and when, they should get the test. Ideally, women should have bone density measured at menopause, and periodically afterward, depending on the condition of their bones. Men should be tested around age 6.
Men and women with additional risk factors, such as those who take certain medications, may need to be tested earlier. Treatment. There are a number of good treatments for primary osteoporosis, most of them medications.
Two medications, alendronate and calcitonin (in nose spray form), have been approved by the Food and Drug Administration (FDA). They provide people who have osteoporosis with a variety of choices for treatment.
For people with secondary osteoporosis, treatment may focus on curing the underlying disease. Drugs. For many women who have gone through menopause, the treatment of choice for osteoporosis has been hormone replacement therapy (HRT), also called estrogen replacement therapy. Many women choose HRT when they undergo menopause to alleviate symptoms such as hot flashes, but hormones increase a woman's supply of estrogen, which helps build new bone, while preventing further bone loss. A 2. 00. 2 report from a large clinical trial called the Women's Health Initiative helped verify HRT's positive effects in preventing osteoporosis in postmenopausal women. However, the WHI also revealed several risks with taking combined HRT (estrogen and progesterone).
In fact, the trial was stopped early because the incidence of invasive breast cancer in women on HRT passed a threshold that was considered too risky for the benefits they were receiving. The study also found that the women on combined hormone therapy were at increased risk for coronary heart disease and stroke. Whether or not a woman takes hormones and for how long is a decision she should make carefully with her doctor. Women should talk to their doctors about personal risks for osteoporosis, as well as their risks for heart disease and breast cancer. Since estrogen may no longer be recommended for prevention of osteoporosis, selective use of alendronate and calcitonin are possible alternatives.
Alendronate and calcitonin both stop bone loss, help build bone, and decrease fracture risk by as much as 5. Alendronate (sold under the name Fosamax) is the first nonhormonal medication for osteoporosis ever approved by the FDA. It attaches itself to bone that has been targeted by bone- eating osteoclasts, protecting the bone from these cells. Osteoclasts help the body break down old bone tissue.
Calcitonin is a hormone that has been used as an injection for many years. A new version is on the market as a nasal spray. It too slows down bone- eating osteoclasts. Side effects of these drugs are minimal, but calcitonin builds bone by only 1. Fosamax has proven safe in large, multi- year studies, but not much is known about the effects of its long- term use. Several medications under study include other bisphosphonates that slow bone breakdown (like alendronate), sodium fluoride, vitamin D metabolites, and selective estrogen receptor modulators.
Some of these treatments are already being used in other countries, but have not yet been approved by the FDA for use in the United States. In early 2. 00. 3, a report announced that the FDA had recently approved the first drug that could form bone in osteoporosis patients. The drug is a form of the human parathyroid hormone called teriparatide. It shows promise for those patients at highest risk for fracture from the disease. There are some patients who cannot use the drug, so all considering the new treatment must check with their physician and may need to undergo bone densitometry scans or other testing. Surgery. Unfortunately, much of the treatment for osteoporosis is for fractures that result from advanced stages of the disease.
For complicated fractures, such as broken hips, hospitalization and a surgical procedure are required. In hip replacement surgery, the broken hip is removed and replaced with a new hip made of plastic, or metal and plastic. Though the surgery itself is usually successful, complications of the hip fracture can be serious. Those individuals have a 5- 2.