6. How to cope with s >
What to do about:
7. Pregnancy and breastfeeding
Predlone isn't usually recommended in pregnancy unless the potential benefits outweigh the risks.
Predlone has occasionally been linked to problems in the first 12 weeks of pregnancy. High doses or long-term use can also affect the unborn baby's growth.
If you take Predlone in pregnancy, the baby's growth will be checked often.
For more information about how Predlone can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.
Which drugs or supplements interact with prednisone?
Prednisone interacts with many drugs, examples include:
- Prednisone may interact with estrogens and phenytoin (Dilantin). Estrogens may reduce the action of enzymes in the liver that break down (eliminate) the active form of prednisone, Predlone. As a result, the levels of Predlone in the body may increase and lead to more frequent side effects.
- Phenytoin increases the activity of enzymes in the liver that break down (eliminate) prednisone and thereby may reduce the effectiveness of prednisone. Thus, if phenytoin is being taken, an increased dose of prednisone may be required.
- The risk of hypokalemia (high potassium levels in the blood) increases when corticosteroids are combined with drugs that reduce potassium levels (for example, amphotericin B, diuretics), leading to serious side effects such as heart enlargement, heart arrhythmias and congestive heart failure.
- Corticosteroids may increase or decrease the response warfarin (Coumadin, Jantoven). Therefore, warfarin therapy should be monitored closely.
- The response to diabetes drugs may be reduced because prednisone increases blood glucose.
- Prednisone may increase the risk of tendon rupture in patients treated with fluoroquinolone type antibiotics. Examples of fluoroquinolones include ciprofloxacin (Cipro) and levofloxacin (Levaquin).
- The elderly are especially at risk and tendon rupture may occur during or after treatment with fluoroquinolones.
- Combining aspirin, ibuprofen (Motrin) or other nonsteroidal anti-inflammatory agents (NSAIDS) with corticosteroids increases the risk of stomach related side effects like ulcers.
- Barbiturates, carbamazepine, rifampin and other drugs that increase the activity of liver enzymes that breakdown prednisone may reduce blood levels of prednisone. Conversely, ketoconazole, itraconazole (Sporanox), ritonavir (Norvir), indinavir (Crixivan), macrolide antibiotics such as erythromycin, and other drugs that reduce the activity of liver enzymes that breakdown prednisone may increase blood levels of prednisone.
Predlone comes in various formulations, including a tablet, a solution, a syrup, a liquid, a suspension, and a disintegrating tablet.
Your dose will depend on your condition and response to treatment.
Follow your doctor's instructions carefully. Don't take more or less Predlone than is recommended.
Your doctor may change your dose of Predlone if you experience unusual stress, surgery, or a serious illness.
Be sure to measure the liquid form of Predlone with a special dose-measuring cup (not a regular spoon). Ask your pharmacist about this if you don't have a dose-measuring device.
You may need to shake the liquid well before measuring a dose.
Don't remove a disintegrating tablet from its blister pack until you're ready to take the medicine. Use dry hands when opening the package, and peel back the foil — don't push the tablet through the foil.
Let the disintegrating tablet dissolve in your mouth without chewing it. You can drink some liquid if needed.
3. Who can and can't take Predlone
Predlone can be taken by adults and children.
Predlone isn't suitable for some people.
Tell your doctor before starting the medicine if you:
- have had an allergic reaction to Predlone or any other medicine
- have an infection (including eye infections)
- are trying to get pregnant, are already pregnant or you are breastfeeding
- have recently been in contact with someone with shingles, chickenpox or measles
- have recently had, or are about to have, any vaccinations
Make sure your doctor is aware if you have:
How to use Predlone
Take this medication by mouth, with food or milk to prevent stomach upset, exactly as directed by your doctor. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
There are many brands, strengths, and forms of liquid Predlone available. Read the dosing instructions carefully for each product because the amount of Predlone may be different between products. See also Precautions and Storage sections.
Follow the dosing schedule carefully. The dosage and length of treatment are based on your medical condition and response to treatment. Your doctor may direct you to take Predlone 1 to 4 times a day or take a single dose every other day. It may help to mark your calendar with reminders.
Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used Predlone for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.
Tell your doctor if your condition persists or worsens.
Missed Dose of Predlone
Ask your doctor what to do if you miss a dose of Predlone.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of Predlone. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
*Do not stop taking this drug without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as weakness, fatigue, loss of appetite, weight loss, nausea, vomiting, and diarrhea.
Predlone and prednisone cost about the same. Both drugs come in generic and brand-name versions. Like all drugs, the generic versions usually cost less. GoodRx.com can give you an idea of the current cost of the drug your doctor prescribes.
However, not all generics are available in the same forms or strengths as the brand-name versions. Ask your healthcare provider if it’s necessary for you to take the brand-name strength or form.
Most pharmacies stock the generic versions of both prednisone and Predlone. The brand-name versions aren’t always stocked, so call ahead before you fill your prescription if you take a brand-name version.
Most insurance plans also cover both prednisone and Predlone. However, your insurance company may require a prior authorization from your doctor before they approve the prescription and cover the payment.
These drugs are from the same drug class and work in a similar way. Because of this, the side effects of prednisone and Predlone are also similar. However, they do differ in a couple of ways. Prednisone may cause your mood to change and may make you feel depressed. Predlone may cause convulsions.
What Is Predlone (Orapred)?
Predlone is a prescription medicine sold under the brand name Orapred, among other names.
It's used to treat a variety of conditions, including:
- Asthma and other breathing disorders
- Skin problems
- Ulcerative colitis (a chronic, inflammatory bowel disease)
- Kidney problems
- Lupus (an autoimmune disease characterized by inflammation and a variety of symptoms)
- Psoriasis (a skin condition)
- Multiple sclerosis (a disease that causes weakness, numbness, loss of coordination, and other problems because nerves in the body don't function properly)
- Adrenal problems
- Eye conditions
- Blood or bone marrow problems
Predlone is a corticosteroid. It works by stopping the release of substances in the body that cause inflammation.
The Food and Drug Administration (FDA) first approved Predlone in 1955. It's marketed by various pharmaceutical companies.
What is Predlone, and how does it work (mechanism of action)?
Predlone is a synthetic adrenal corticosteroid (cortisone). Corticosteroids are natural substances produced by the adrenal glands located adjacent to the kidneys. Corticosteroids have potent anti-inflammatory properties, and are used in a wide variety of inflammatory conditions such as arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes. There are numerous preparations of corticosteroids including tablets, capsules, liquids, topical creams and gels, inhalers, eye drops, as well as injectable and intravenous solutions. The FDA approved Predlone in June 1955.
What are the side effects of Predlone?
Predlone side effects depend on the dose, the duration and the frequency of administration. Short courses of Predlone - days to a week or two - are usually well tolerated with few and mild side effects. Long-term, high doses of Predlone will usually produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of Predlone should be used for the shortest length of time to minimize side effects. Alternate day dosing can also help reduce side effects.
Side effects of Predlone and other corticosteroids range from mild annoyances to serious irreversible damage. Side effects include
- fluid retention,
- weight gain,
- high blood pressure,
- potassium loss,
- muscle weakness,
- puffiness of and hair growth on the face,
- thinning and easy bruising of the skin,
- peptic ulceration,
- worsening of diabetes,
- irregular menses,
- growth retardation in children,
- convulsions, and
- psychic disturbances. (Psychic disturbances can include depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior.)
Predlone and other corticosteroids can mask signs of infection and impair the body's natural immune response to infection. Patients on corticosteroids are more susceptible to infections and can develop more serious infections than healthy individuals. For instance, chickenpox and measles viruses can produce serious and even fatal illnesses in patients on high doses of Predlone. Live virus vaccines, such as smallpox vaccine, should be avoided in patients taking high doses of Predlone, since even vaccine viruses may cause disease in patients taking Predlone. Some infectious organisms, such as tuberculosis (TB) and malaria, can remain dormant in a patient for years. Predlone and other corticosteroids can reactivate dormant infections in these patients and cause serious illnesses. Patients with dormant TB may require anti-TB medications while undergoing prolonged corticosteroid treatment.
By interfering with the patient's immune response, Predlone can impede the effectiveness of vaccinations. Predlone can also interfere with the tuberculin skin test and cause false negative results in patients with tuberculosis infection.
Predlone impairs calcium absorption and new bone formation. Patients on prolonged treatment with Predlone and other corticosteroids can develop thinning of bone (osteoporosis) and an increased risk of bone fractures. Supplemental calcium and vitamin D are encouraged to slow this process of bone thinning. In some patients, medications used to treat osteoporosis may be prescribed. In rare individuals, destruction of large joints (osteonecrosis) can occur while undergoing treatment with Predlone or other corticosteroids. These patients experience severe pain in the involved joints, and can require replacement of joints. The reason behind such destruction is not clear.