Prednisone is a corticosteroid drug with anti-inflammatory and immunosuppressive effects. It is used to address inflammations, swelling, and conditions connected to immune functions.
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Prednisone: a broad-spectrum drug but not a one-fits-all solution
Prednisone is a synthetic corticosteroid. In the liver, it metabolizes and turns into prednisolone. Glucocorticoids have immunosuppressive and anti-inflammatory effects on the organism.
Prednisone is available in various forms:
- Solutions, creams, and ointments for topical application;
- Parenteral preparations for IV and IM injections;
- Oral medications—pills, tablets, suspensions, etc.—to be taken by mouth;
- Nasal sprays;
- Suppositories (vaginal and rectal).
Some examples of prednisone trade names:
- Liquid Pred;
The mechanism of action
Prednisone inhibits inflammation: suppresses leukocyte migration, reverses increased permeability of blood vessels, etc. This results in reduced swelling, fever, and pain.
The drug also alters immune reactions which helps alleviate related conditions, such as allergic reactions and even certain types of cancer.
FDA indication and off-label use
The FDA approved prednisone in 1955 with indications connected to various body systems and functions.
Allergies and related health issues
- acute drug hypersensitivities;
- allergic rhinitis;
- atopic dermatitis, etc.
Issues related to skin and skin structures
- Stevens-Johnson syndrome (a severe skin reaction with a painful rash);
- mycosis fungoides (type of cancer that causes skin lesions);
- dermatitis, etc.
- nonsuppurative thyroiditis;
- adrenocortical insufficiency;
- congenital adrenal hyperplasia, etc.
- Crohn's Disease;
- ulcerative colitis.
Hematologic (blood-related) conditions
- (autoimmune) hemolytic anemia;
- secondary thrombocytopenia in adults;
- pure red cell aplasia, etc.
- acute leukemia;
- aggressive lymphomas.
In such cases, prednisone is used as a palliative drug.
Conditions of the nervous system
- cerebral edema;
- acute exacerbations of multiple sclerosis.
Ophtalmic (related to eyes and vision) pathologies
- uveitis (inflammation involving the middle layer of the eye tissues);
- sympathetic ophthalmia (bilateral uveitis following an eye injury);
- ocular inflammations that do not respond to topical steroids.
- chronic obstructive pulmonary disease.
- vasculitis, etc.
Additionally, prednisone is indicated for the treatment of certain renal and infectious diseases, as well as for organ rejection after transplantation.
There is also off-label use when the drug does not have an FDA indication for that specific case but was found to be effective and is used nonetheless.
For example, prednisone may be prescribed to lessen inflammation and aid breathing in a patient with severe obstructive bronchitis.
It is also part of standard care for patients who suffer from Duchenne muscular dystrophy — a severe condition characterized by skeletal and heart muscle weakness that progresses over time.
Dosage and administration
Recommended forms and dosages for prednisone therapy depend on many factors, including the patient’s age, condition, comorbidities, response to treatment, etc.
For example, the initial dose of prednisone for oral intake varies from 5 mg to 60 mg. The treatment process is to be carefully designed, watched, and managed by a healthcare professional; abrupt discontinuation is not suggested.
The most common side effects of corticosteroids include:
- increased blood pressure;
- changes in tolerance to glucose;
- altered behavior and mood;
- increased appetite and weight.
Who should not take prednisone
Medication containing prednisone is contraindicated if the patient has a history of recognized hypersensitivity to the drug's active ingredient or any other component.
Prednisone is a prescription-only medication, and there are certain warnings and precautions doctors take into account when considering the drug as a treatment option.
While the anti-inflammatory and immunosuppressive effects of prednisone are used to treat and alleviate a wide range of conditions, it can cause unwanted side effects, drug interactions, etc.
Healthcare providers are to prescribe corticosteroids thoughtfully and carefully monitor the treatment process.