Generic Name: Prednisone (PRED-ni-zone)
Trade Name: DeltaSone®, LiquiPred, Meticorten, Orasone
How is this Prednisone used? Prednisone is FDA approved for the treatment of leukemias and lymphomas in adults and acute leukemia of childhood. It is also indicated for hypercalcemia (high levels of calcium in the blood) associated with cancer and mycosis fungoides. Prednisone may also be used to help prevent or reduce nausea and vomiting, or to reduce the swelling surrounding cancerous tumors to relieve pressure caused by the swelling. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Prednisone belongs to a class of drugs called glucocorticoids or "steroids". Prednisone produces its anti-cancer effects by inhibiting inflammatory agents in the body, which have been implicated in the development or growth of some cancers.
How is prednisone given (administered)? Prednisone is administered orally as a tablet, and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with prednisone. Blood may be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients may also have their blood sugar and electrolyte (potassium) levels monitored.
What are the common (occur in 30% or more of patients) side effects of treatment with steroids?
(Frequency not specified in insert as percentages)
• Increase in appetite
• Impaired or delayed wound healing
• Fluid retention
• Weight gain, especially around abdomen or shoulders. Round, moon shaped face.
• Swelling of feet or ankles
• Weakness of muscles
• Increased levels of sugar in the blood
• Stomach ulcers
• Irritability, nervousness
What are the less common (occur in 10% to 29% of patients) side effects of treatment with prednisone?
• Mood swings
• Increase in blood pressure
• Potassium lossT
• Thin, fragile skin
• Cataracts, glaucoma, reduction in bone density (osteoporosis)—with long-term use
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
Understanding DNA Damage Response or DDR and Cancer Treatment
What is DNA Damage Response or DDR?
What are the possible late side effects of treatment with prednisone? Patients may be an increased risk of developing cataracts or a reduction in bone density if they are treated with prednisone for a long period of time.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Prednisone may leave patients more susceptible to infection. Therefore, patients should wash their hands often, avoid large crowds of people and avoid other people who are not feeling well, as this drug may leave some patients susceptible to infection.
• Patients may wish to take their dose with food to reduce the risk of an upset stomach.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Do not discontinue treatment with prednisone abruptly, as serious side effects may occur. Follow the instructions of your healthcare provider for the schedule of administration.
• Prednisone may cause high blood sugar levels – patients with diabetes may be required to check their blood sugar levels frequently
• If an oral dose is missed, do not double up on doses. Patients should contact their doctor in this event.
• Keep tablets out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.
When should patients notify their physician?
• Fever, chills, persistent cough, sore throat, signs of infection
• Shortness of breath
• Chest or jaw pain, difficulty breathing, a noticeable change in heart rate or rhythm
• Extreme or prolonged fatigue or weakness
• Severe heartburn, abdominal or stomach pain
• Unexplained bleeding or bruising (bloody nose, blood in the urine, black tarry stools)
• Persistent or severe nausea or vomiting
• Severe or persistent headache
• Dizziness or faintness
• Signs of high blood sugar (frequent urination or severe thirst, confusion, drowsiness, decreased or blurred vision, dry mouth)
• Changes in vision or eye abnormalitites
• Discharge from eye
• Eye pain
• Changes in pupil size
• Rash or skin abnormalities, thin skin, bruising
• Wound that will not heal
• Sudden weight gain
• Swelling of feet or ankles
• Swelling, redness, tenderness or pain in one extremity and not the other
• Severe bone pain
• Extreme mood swings or depression
• Menstrual irregularities
• Rash, hives, itching
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Important Limitations of Use
The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.
As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.
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The prescribing physician is solely responsible for making all decisions relating to appropriate patient care including, but not limited to drugs, regimens, dose, schedule, and any supportive care.