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I can remember back to when I was an adolescent and my doctor prescribed a short burst of prednisone for the first time during an asthma flare. metformin gastritis Methylprednisolone is preferred in hepatic impairment because prednisone must be converted to prednisolone in liver Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts May cause impairment of mineralocorticoid secretion; administer mineralocorticoid concomitantly Tapering the dosage over 2 months or more may be necessary for patients on prolonged treatment more than 1 year. Depending on dosage, duration of therapy and risk of systemic disease, decrease dosage by the equivalent of 2.5 to 5 mg prednisone every 3 to 7 At that time the doc said I had reactive arthritis but didn't do much of anything except prescribe celebrex. It was a humiliating experience as I felt he didn't listen to me at all, and didn't seem interested or concerned about the overwhelming fatigue and weight loss i have been experiencing, as well as the fact that more joints were involved. Well, I saw my new doc and it has been a totally different story. And he got that the fatigue and pain and stiffness were so bad I am now working only half time. He is almost 100% sure it is RA, and has referred me to the Rheumatologist on an urgent basis, and I have an appt next week. Meds: Enbrel: Once a week injection, Vitamin B-12 injection monthly, Vitamin D : Once a week. (The usual wait in Canada where I live is about 4 months)As the celebrex has done nothing - he started me on a prednisone "burst" 30mg x 2 days, 25 x 2 days, 20 x 2 days, 15 x 2days, 10 X 2 days and 5 x 10 days. I know it is just a temporary thing to control symptoms for now, but I am so grateful to have relief from the pain, and happy that I will finally see a rheumatologist to make a plan for the long term. FORUM MODERATOR: RHEUMATOID ARTHRITIS Hi glad you are getting things on track amazing how a Good Doctor can helpi have been on Prednisone for some 20years yes 20i have over that time had Bursts of higher dosesyou Will Feel So much Better right away However Depending on your RA when you start to tapper off you Might Feel Yuckdepending on your Dr he Might Leave you on a Lower Dose if you do feel Yuck But as it is with RA the Burst Might be all you Need to get over this Hump so as you Taper Down you may well simply slide along Sorry there is No Difinitive answer for you but it Seriously Depends on the Person This is a Must You Must Have Food with the Prednisone and Drink or you will end up with a bad tummyeven if you take the prednisone with a glass of milk then eat a bit latter but Do Not Take it on Empty stomach repeatedly FORUM MODERATOR Rhumatoid Arthritis. Asthma, Fibromyalgia, Osteoperosis, Cervical Spondalosos, Degenerative Disc Disese, Disc Bulges, Diabetes, Heart svt, Hypo thyroidism on Metheltrexate, Endone, Tramal 200mg, Endone, Prednisone, Metforman(Diabex), Digoxin * We are Born Crying We Die Crying Try to Laugh inbetween, None of us are Getting out of here alive Bad Day, I am thankful to hear that you have been taking prednisone for so long. I am sure there are others who have had similar "bursts" of prednisone - what can you tell me about it? I hate to know that you need it but I have been trying to get off of 2.5mg and I just cannot do it. But he knows that I have tried several times before to come off. I have the fatigue soooo bad until I have asked my dr. Just cannot do it and he always is fine with me stayng on it. it just worries me to be on it but if you have been on that for 20 years maybe I will be fine too. Peggy Rhuematoid Arthritis, degenerative joints, herniated disc's in back and neck. Day 1: 10 mg PO before breakfast, 5 mg after lunch and after dinner, and 10 mg at bedtime Day 2: 5 mg PO before breakfast, after lunch, and after dinner and 10 mg at bedtime Day 3: 5 mg PO before breakfast, after lunch, after dinner, and at bedtime Day 4: 5 mg PO before breakfast, after lunch, and at bedtime Day 5: 5 mg PO before breakfast and at bedtime Day 6: 5 mg PO before breakfast Immediate-release: ≤10 mg/day PO added to disease-modifying antirheumatic drugs (DMARDs) Delayed-release: 5 mg/day PO initially; maintenance: lowest dosage that maintains clinical response; may be taken at bedtime to decrease morning stiffness with rheumatoid arthritis Take with meal or snack High-dose glucocorticoids may cause insomnia; immediate-release formulation is typically administered in morning to coincide with circadian rhythm Delayed-release formulation takes about 4 hours to release active substances; thus, with this formulation, timing of dose should take into account delayed-release pharmacokinetics and disease or condition being treated (eg, may be taken at bedtime to decrease morning stiffness with rheumatoid arthritis) Allergic: Anaphylaxis, angioedema Cardiovascular: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture after recent myocardial infarction, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis Dermatologic: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scalp, edema, facial erythema, hyper- or hypopigmentation, impaired wound healing, increased sweating, petechiae and ecchymoses, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria Endocrine: Abnormal fat deposits, decreased carbohydrate tolerance, development of cushingoid state, hirsutism, manifestations of latent diabetes mellitus and increased requirements for insulin or oral hypoglycemic agents in diabetics, menstrual irregularities, moon facies, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in children Fluid and electrolyte disturbances: Fluid retention, potassium loss, hypertension, hypokalemic alkalosis, sodium retention Gastrointestinal: Abdominal distention, elevation of serum liver enzymes levels (usually reversible upon discontinuance), hepatomegaly, hiccups, malaise, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, ulcerative esophagitis General: Increased appetite and weight gain Metabolic: Negative nitrogen balance due to protein catabolism Musculoskeletal: Osteonecrosis of femoral and humeral heads, Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture, vertebral compression fractures Neurologic: Arachnoiditis, convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (pseudotumor cerebri; usually following discontinuance of treatment), insomnia, meningitis, mood swings, neuritis, neuropathy, paraparesis/paraplegia, paresthesia, personality changes, sensory disturbances, vertigo Ophthalmic: Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, central serous chorioretinopathy Reproductive: Alteration in motility and number of spermatozoa Untreated serious infections Documented hypersensitivity Varicella Administration of live or attenuated live vaccine (Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term ( Monitor for hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing syndrome, and hyperglycemia Prolonged use associated with increased risk of infection; monitor Use with caution in cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, renal insufficiency, pregnancy, diabetes mellitus, congestive heart failure, thromboembolic disorders, GI disorders Long-term treatment associated with increased risk of osteoporosis, myopathy, delayed wound healing Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored) Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy Methylprednisolone is preferred in hepatic impairment because prednisone must be converted to prednisolone in liver Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts May cause impairment of mineralocorticoid secretion; administer mineralocorticoid concomitantly May cause psychiatric disturbances; monitor for behavioral and mood changes; may exacerbate pre-existing psychiatric conditions Monitor for Kaposi sarcoma Pregnancy category: C (immediate release); D (delayed release) Drug may cause fetal harm and decreased birth weight; maternal corticosteroid use during first trimester increases incidence of cleft lip with or without cleft palate Lactation: Of maternal serum metabolites, 5-25% are found in breast milk; not recommended, or, if benefit outweighs risk, use lowest dose Glucocorticosteroid; elicits mild mineralocorticoid activity and moderate anti-inflammatory effects; controls or prevents inflammation by controlling rate of protein synthesis, suppressing migration of polymorphonuclear leukocytes (PMNs) and fibroblasts, reversing capillary permeability, and stabilizing lysosomes at cellular level; in physiologic doses, corticosteroids are administered to replace deficient endogenous hormones; in larger (pharmacologic) doses, they decrease inflammation The above information is provided for general informational and educational purposes only. 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