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 the overall health of the affected person. Gradually lowering the dose 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 this drug 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. The affected people need to follow the instructions of the doctor regarding the dosage religiously. Otherwise the side effects 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 of the affected people may experience 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 the adverse effects of this drug. Moreover, it 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 the affected person stops taking it abruptly then he/she may get affected by 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 experience scarcity of the natural corticosteroid, cortisol. Lowering the dose of prednisone gradually helps the adrenal glands to recover slowly. However, the taper itself may result in certain side effects.
Side Effects of Prednisone Tapering
Its prolonged use results in a 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. However, the complete prevention of prednisone withdrawal symptoms may not be always possible with the tapering. It can lead to:
- Weakness and fatigue
- Loss of appetite
- Weight loss
- Nausea and 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 and muscle aches
- Confusion and mental changes
- Increase in calcium levels
- Decreased gastrointestinal contractions can lead to dilation of the intestine
The tapering dose may vary from one affected individual to another. The initial dose depends on the condition being treated and the age of the affected person. 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 affected person's body starts producing its own hormones. If the conditions are favorable, tapering over four to six weeks is recommended. The affected person who has been taking this drug 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 the affected people experience such side effects, tapering is the only way which helps prevent the effects of sudden discontinuation of the medicine that can prove to be fatal.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.