Corticosteroid abrupt discontinuation

Prednisone is a drug that belongs to the corticosteroid drug class, and is an anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's disease and ulcerative colitis), lupus, asthma, cancers, and several types of arthritis.

Common side effects are weight gain, headache, fluid retention, and muscle weakness. Other effects and adverse events include glaucoma, cataracts, obesity, facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression, insomnia, mood swings, personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs, infections, and necrosis of the hips and joints.

Corticosteroids like prednisone, have many drug interactions; examples include: estrogens, phenytoin (Dilantin), diuretics, warfarin (Coumadin, Jantoven), and diabetes drugs. Prednisone is available as tablets of 1, , 10, 20, and 50 mg; extended release tablets of 1, 2, and 5mg; and oral solution of 5mg/5ml. It's use during the first trimester of pregnancy may cause cleft palate. This medicine is secreted in breast milk and can cause side effects in infants who are nursing. You should not stop taking prednisone abruptly because it can cause withdrawal symptoms and adrenal failure. Talk with your doctor, pharmacist, or other medical professional if you have questions about beta-blockers. Talk with your doctor, pharmacist, or other medical professional if you have questions about prednisone.

If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Dose reduction
The common practice of tapering the dose of oral corticosteroid after recovery from an exacerbation is complex for the patient and may be unnecessary. Several studies have compared abrupt cessation of corticosteroid after 7-10 days' therapy with a tapering dose. 9 There was no difference in lung function or relapse rate between the steroid tapering group and the abrupt cessation group. Tapering is not necessary provided that the patient is not using oral corticosteroids chronically, and is protected by high-dose inhaled corticosteroid after the oral steroid is stopped. It takes an average of 7-10 days for symptoms and lung function to stabilise after an asthma exacerbation. 7 , 9 Because of this, immediately tapering the corticosteroid could actually lead to rebound asthma. Although biochemical evidence of partial hypothalamic-pituitary axis suppression can be detected after short courses of oral corticosteroid, this is rarely of clinical significance unless the patient has been taking steroids long term.

a) A wide range of psychiatric reactions including affective disorders (such as irritable, euphoric, depressed and labile mood and suicidal thoughts), psychotic reactions (including mania, delusions, hallucinations and aggravation of schizophrenia), behavioural disturbances, irritability, anxiety, sleep disturbances, and cognitive dysfunction including confusion and amnesia have been reported. Reactions are common and may occur in both adults and children. In adults, the frequency of severe reactions has been estimated to be 5-6%. Psychological effects have been reported on withdrawal of corticosteroids; the frequency is unknown.

Corticosteroid abrupt discontinuation

corticosteroid abrupt discontinuation

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