Prednisone Tapering Side Effects

Gradual discontinuation of steroid medications is known as tapering. If the steroid is given for a very short period of time, then tapering may not be required before stopping. The taper depends upon the time for which the medicine is given and overall health of the patient. Tapering under the guidance of the doctor helps manage the withdrawal symptoms. Before taking a look at the adverse effects of prednisone tapering, it is necessary to know when prednisone is prescribed, what are its side effects and what happens if it is stopped suddenly.

Uses and Side effects of Prednisone

Prednisone, the corticosteroid hormone (glucocorticoid) is available under the brand name Deltasone. It helps lower swelling and alleviates the symptoms of allergic reactions. Taking the medicine orally with water and food helps avoid stomach upset. It is used to cure arthritis, blood disorders, breathing problems, certain cancers, eye problems, immune system diseases, and skin diseases. Patients need to follow the instructions of the doctor regarding the dosage religiously. Otherwise side effects of prednisone like adrenal suppression, dependency on prednisone, high blood glucose levels in diabetics, insomnia, euphoria and even mania can be experienced. The effects may vary from person to person. Some other side effects that are noticed are Cushing's syndrome, weight gain, reduced sex drive, osteoporosis and type II diabetes. Some patients may suffer from glaucoma or cataract. Fatigue, abdominal pain, blurred vision, peptic ulcers, infections, body pain, low bone density, acne, weight gain, swelling in the face, nervousness, headache, dizziness, increased appetite and hyperactivity can be experienced as adverse effects of prednisone. Moreover the drug may interact with other routine medications and may lead to health complications.

To avoid prednisone dependency and dysfunction of the adrenal gland, its dose needs to be tapered (lowered gradually). If a patient stops taking prednisone abruptly then he/she may have to suffer from the life-threatening Addison's disease (scarcity of adrenal steroid hormones). Prolonged use of this drug leads to shrinkage (atrophy) of the adrenal glands. The body is then likely to suffer from scarcity of the natural corticosteroid, cortisol. Lowering the dose of prednisone gradually helps the adrenal glands to recover slowly. The taper itself may result in certain side effects.

Prednisone Tapering Side Effects

Prolonged use of prednisone results in weak immune system which in turn increases the frequency or severity of infections. It also decreases the effectiveness of vaccines and antibiotics. The drug is discontinued gradually so that the adverse effects are minimized. But complete prevention of prednisone withdrawal symptoms may not be always possible with prednisone tapering. It can lead to:

• Weakness, fatigue
• Loss of appetite
• Weight loss
• Nausea, vomiting
• Diarrhea resulting in abnormal fluid and electrolyte levels, abdominal pain
• Low blood pressure leading to dizziness or fainting
• Low blood sugar levels
• Menstrual changes
• Joint pain, muscle aches
• Fever
• Confusion, mental changes
• Increase in calcium levels
• Decreased gastrointestinal contractions can lead to dilation of the intestine

It is advised that the patient should inform the doctor about his/her medical condition, medical history, routine medications, side effects after taking prednisone, withdrawal symptoms of prednisone, or any other minute change noticed. This information helps determine prednisone tapering guidelines.

Prednisone tapering dose may vary from patient to patient. The initial dose depends on the condition being treated and the age of the patient. Usually, 5 to 60 mg per day is recommended as the initial dose, depending upon the age and condition. The dose is often adjusted taking into consideration the response to the therapy. The medicine does not produce instant effects. In most cases, prolonged use of this medicine is necessary.

Tapering ensures the normal levels of the adrenal hormones as the adrenal glands get enough time to return to their normal function. How quickly prednisone can be tapered depends on the success in controlling the underlying condition with decreasing doses. It also depends upon how quickly the patient's body starts producing its own hormones. If the conditions are favorable, tapering over four to six weeks is recommended. The patient who has been taking prednisone for a much longer period needs slower taper. The doses would have to be increased for a short period followed by gradual reduction in dosage. Even though patients suffer from prednisone tapering side effects, tapering is the only way which helps prevent the effects of sudden discontinuation of the medicine that can prove to be fatal.