The therapy should not be used in people with an active herpes infection of the eyes. Prednisone also may increase the risk of eye infections. Corticosteroids also may cause cataracts (a clouding of the eye’s lens) or glaucoma, which can damage the nerves that connect the eye to brain (optic nerves). Prolonged prednisone treatment can cause an increase in the pressure within the eyeballs, which should be monitored if patients are treated for more than six weeks. It also may interfere with normal growth in young people whose bodies are still developing these patients should be closely monitored if treated with corticosteroids. In children and adolescents, in particular, prednisone may interfere with normal bone growth. Prednisone can alter how calcium is regulated in the body, which can lead to a decrease in bone density and an increase in the risk of osteoporosis, in which bones become weak and brittle. Signs of gastrointestinal perforation, such as irritation and inflammation of the gut, may be masked in patients on corticosteroids. In individuals with certain digestive problems, such as ulcers or some kinds of intestinal infections, corticosteroids can increase the risk of gastrointestinal perforation, or a tear in the digestive tract. Many symptoms commonly associated with infections (e.g., fever) are caused by the immune system’s response and not the infection itself for this reason, symptoms of infections may not be obvious in patients on corticosteroids. Infectionsīecause they lower the activity of the immune system, corticosteroids can raise the risk of new infections, or worsen pre-existing or latent infections. Hyperglycemia (high blood sugar) also may occur. These may include hypothalamic-pituitary-adrenal (HPA) axis suppression, in which the body makes too little cortisol, or Cushing’s syndrome, which is caused by excessive cortisol levels. Prednisone mimics the activity of a naturally occurring hormone called cortisol, and it can cause several hormone-related alterations that should be monitored for with long-term treatment. Psychosis, which is characterized by hallucinations (sensing something that isn’t there) and/or delusions (fixed beliefs with no basis in reality), also can develop or worsen due to corticosteroid treatment. These therapy-induced mood changes can range from euphoria to severe depression insomnia, mood swings, and personality changes may occur. Behavioral and mood disturbancesĬorticosteroids can cause mood changes, and they may worsen existing psychological problems. Blood pressure, as well as sodium and potassium levels, should be monitored during treatment. It also can cause high blood pressure and low levels of potassium (hypokalemia). Prednisone may cause the body to retain water and salt. changes in glucose tolerance (how the body processes sugar).The most common side effects of prednisone include: Higher dosage for one week, followed by lower dosage every other day for one month Food and Drug Administration, a regimen of daily oral doses of 200 mg Prednisone Intensol for one week, followed by 80 mg doses every other day for one month, is generally effective for managing acute relapses of MS.Ģ00 mg (decreased to 80 mg after initial high-dose treatment) Prednisone is commonly used for this final phase of treatment, which may last from 10 days to six weeks. This “tapering off” is recommended to prevent withdrawal symptoms associated with suddenly stopping corticosteroids, which can include anxiety, sweating, nausea, and insomnia. This most commonly is done with corticosteroids that are given intravenously, or directly into the bloodstream (e.g., methylprednisone), though high doses of oral corticosteroids like prednisone also may be used in some circumstances.Īfter the high-dose treatment, patients are then usually given oral corticosteroids at gradually lower doses. Generally, relapse treatment first involves administering high doses of corticosteroids over three to five days. Dosing of these medications is tailored based on the situation of the patient - for example, heavier individuals generally need a higher dose - and may require some trial and error to find a dose that is high enough to manage symptoms but as low as possible to avoid safety risks. There is no standard regimen for how glucocorticoids are used in the management of MS relapses.
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