Allergic Reaction To Prednisone

An overdose of prednisone is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

Hypersensitivity reactions to corticosteroids

Hypersensitivity reactions to corticosteroids (CS) are rare in the general population, but they are not uncommon in high-risk groups such as patients who receive repeated doses of CS. Hypersensitivity reactions to steroids are broadly divided into two categories: immediate reactions, typically occurring within 1 h of drug administration, and non-immediate reactions, which manifest more than an hour after drug administration. The latter group is more common. We reviewed the literature using the search terms “hypersensitivity to steroids, adverse effects of steroids, steroid allergy, allergic contact dermatitis, corticosteroid side effects, and type I hypersensitivity” to identify studies or clinical reports of steroid hypersensitivity. We discuss the prevalence, mechanism, presentation, evaluation, and therapeutic options in corticosteroid hypersensitivity reactions. There is a paucity of literature on corticosteroid allergy, with most reports being case reports. Most reports involve non-systemic application of corticosteroids. Steroid hypersensitivity has been associated with type I IgE-mediated allergy including anaphylaxis. The overall prevalence of type I steroid hypersensitivity is estimated to be 0.3-0.5%. Allergic contact dermatitis (ACD) is the most commonly reported non-immediate hypersensitivity reaction and usually follows topical CS application. Atopic dermatitis and stasis dermatitis of the lower extremities are risk factors for the development of ACD from topical CS. Patients can also develop hypersensitivity reactions to nasal, inhaled, oral, and parenteral CS. A close and detailed evaluation is required for the clinician to confirm the presence of a true hypersensitivity reaction to the suspected drug and choose the safest alternative. Choosing an alternative CS is not only paramount to the patient’s safety but also ameliorates the worry of developing an allergic, and potentially fatal, steroid hypersensitivity reaction. This evaluation becomes especially important in high-risk groups where steroids are a life-saving treatment. The assessment should be done when the patient’s underlying condition is in a quiescent state.

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    Prednisone

    Medically reviewed by Melisa Puckey, BPharm. Last updated on May 23, 2022.

    What is prednisone?

    Prednisone is a corticosteroid medicine used to decrease inflammation and keep your immune system in check, if it is overactive. Prednisone is used to treat allergic disorders, skin conditions, ulcerative colitis, Crohn’s disease, arthritis, lupus, psoriasis, asthma, chronic obstructive pulmonary disease (COPD) and many more conditions.

    Warnings

    Prednisone treats many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

    You should avoid taking prednisone if you have a fungal infection that requires oral antifungals. Topical antifungals may not be an issue, but always let your doctor know what medicines you’re taking before starting this medicine.

    Steroid medication can weaken your immune system, making it easier for you to get an infection. Avoid being near people who are sick or have infections. Do not receive a “live” vaccine while using prednisone.

    Call your doctor at once if you have shortness of breath, severe pain in your upper stomach, bloody or tarry stools, severe depression, changes in personality or behavior, vision problems, or eye pain.

    You should not stop using prednisone suddenly. Follow your doctor’s instructions about tapering your dose.

    Before taking this medicine

    You should not use this medication if you are allergic to prednisone, or if you have a fungal infection that requires oral antifungal treatment.

    Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

    To make sure prednisone is safe for you, tell your doctor if you have:

    • any illness that causes diarrhea;
    • liver disease (such as cirrhosis);
    • kidney disease;
    • heart disease, high blood pressure, low levels of potassium in your blood;
    • a thyroid disorder;
    • diabetes;
    • a history of malaria;
    • tuberculosis;
    • osteoporosis;
    • glaucoma, cataracts, or herpes infection of the eyes;
    • stomach ulcers, ulcerative colitis, or a history of stomach bleeding;
    • a muscle disorder such as myasthenia gravis; or
    • depression or mental illness.

    Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis.

    Prednisone can cause low birth weight or birth defects if you take the medicine during your first trimester. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Use effective birth control.

    Prednisone can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

    Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine.

    How should I take prednisone?

    Take prednisone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

    Take prednisone with food.

    Your dosage needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Do not change your medication dose or schedule without your doctor’s advice.

    Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

    Do not crush, chew, or break a delayed-release tablet. Swallow it whole.

    While using this medicine, you may need frequent blood tests at your doctor’s office. Your blood pressure may also need to be checked.

    This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.

    You should not stop using prednisone suddenly. Follow your doctor’s instructions about tapering your dose.

    Wear a medical alert tag or carry an ID card stating that you take prednisone. Any medical care provider who treats you should know that you are using a steroid.

    Store at room temperature away from moisture and heat.

    What happens if I miss a dose?

    Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

    What happens if I overdose?

    Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

    An overdose of prednisone is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

    What should I avoid?

    Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using a steroid.

    Do not receive a “live” vaccine while using this medicine. Prednisone may increase your risk of harmful effects from a live vaccine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, yellow fever, varicella (chickenpox), one type of the typhoid vaccine and nasal flu (influenza) vaccine.

    Avoid drinking alcohol while you are taking prednisone.

    Prednisone side effects

    Get emergency medical help if you have any of these signs of an allergic reaction to prednisone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

    Call your doctor at once if you have:

    • blurred vision, eye pain, or seeing halos around lights;
    • swelling, rapid weight gain, feeling short of breath;
    • severe depression, feelings of extreme happiness or sadness, changes in personality or behavior, seizure (convulsions);
    • bloody or tarry stools, coughing up blood;
    • pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);
    • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or
    • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

    Other common prednisone side effects may include:

    • sleep problems (insomnia), mood changes;
    • increased appetite, gradual weight gain;
    • acne, increased sweating, dry skin, thinning skin, bruising or discoloration;
    • slow wound healing;
    • headache, dizziness, spinning sensation;
    • nausea, stomach pain, bloating; or
    • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

    This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    What other drugs will affect prednisone?

    Many drugs can interact with prednisone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with prednisone, especially:

    • amphotericin B;
    • cyclosporine;
    • digoxin, digitalis;
    • St. John’s wort;
    • an antibiotic such as clarithromycin or telithromycin;
    • antifungal medication such as itraconazole, ketoconazole, posaconazole, voriconazole;
    • birth control pills and other hormones;
    • a blood thinner such as warfarin, Coumadin;
    • a diuretic or “water pill”;
    • the hepatitis C medications boceprevir or telaprevir;
    • HIV or AIDS medicine such as atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir;
    • insulin or diabetes medications you take by mouth;
    • a non-steroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
    • seizure medications such as carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or
    • the tuberculosis medications isoniazid, rifabutin, rifapentine, or rifampin.

    This list is not complete and many other drugs can interact with prednisone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

    Popular FAQ

    The starting dose of prednisone may be between 5 mg to 60 mg per day. A dose above 40 mg per day may be considered a high dose. However, everybody responds differently to prednisone, so what might be a high dose depends on the person and the condition. Continue reading

    Although there is no direct drug interaction between prednisone and alcohol, mixing them together is not a good idea because some of the effects of alcohol and the side effects of prednisone are similar, so taking both at the same time can increase the risk of these side effects occurring. Continue reading

    There is no set limit on how long you can safely take prednisone. It depends on the dose of prednisone and the condition being treated. It may be prescribed short term or long term. The dosage will be adjusted or stopped based on your response or lack of response to the medication. Continue reading

    The best prednisone taper will depend upon how long you have been taking the medicine, your dose, and why you are being treated. If you’ve been treated with a high dose of prednisone, or taken it for more than a few weeks, you will need to slowly stop your medicine, usually over a period of days, weeks or months. Your healthcare provider will determine your prednisone tapering schedule. Continue reading

    It’s best to take prednisone as a single dose once a day straight after breakfast. For example if your dose is 30mg daily, it’s usual to take 6 tablets (6 x 5mg) all at the same time after breakfast. Continue reading

    More FAQ

    • How long does it take for prednisone to work?
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    More about prednisone

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Alex Koliada, PhD

Alex Koliada, PhD

Alex Koliada, PhD, is a well-known doctor. He is famous for his studies of ageing, genetics and other medical conditions. He works at the Institute of Food Biotechnology and Genomics NAS of Ukraine. His scientific researches are printed by the most reputable international magazines. Some of his works are: Differences in the gut Firmicutes to Bacteroidetes ratio across age groups in healthy Ukrainian population [BiomedCentral.com]; Mating status affects Drosophila lifespan, metabolism and antioxidant system [Science Direct]; Anise Hyssop Agastache foeniculum Increases Lifespan, Stress Resistance, and Metabolism by Affecting Free Radical Processes in Drosophila [Frontiersin].
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