Warnings Precautions: Avoid alcohol. Acting together, alcohol and prednisone can be damaging to the stomach. Avoid sources of infection. Wash your hands frequently and keep them away from the mouth and eyes. Your immune system may be weakened while taking prednisone. Do not receive any immunizations during treatment with prednisone without first talking to your doctor. Prednisone may interact with estrogens and phenytoin (Dilantin). Estrogens may reduce the action of enzymes in the liver that break down (eliminate) the active form of prednisone, prednisolone. As a result, the levels of prednisolone in the body may increase and lead to more frequent side effects. Phenytoin increases the activity of enzymes in the liver that break down (eliminate) prednisone and thereby may reduce the effectiveness of prednisone. Thus, if phenytoin is being taken, an increased dose of prednisone may be required. Corticosteroids are secreted in breast milk and can cause side effects in the nursing infant. Prednisone is less likely than other corticosteroids to be secreted in breast milk, but it may still pose a risk to the infant.
Possible Side Effects: Side effects of prednisone and other corticosteroids range from mild annoyances to serious, irreversible damage, and they occur more frequently with higher doses and more prolonged treatment. Side effects include retention of sodium (salt) and fluid, weight gain, high blood pressure, loss of potassium, headache and muscle weakness. Prednisone also causes puffiness of the face (moon face), growth of facial hair, thinning and easy bruising of the skin, impaired wound-healing, glaucoma, cataracts, ulcers in the stomach and duodenum, worsening of diabetes, irregular menses, rounding of the upper back ("buffalo hump"), obesity, retardation of growth in children, convulsions, and psychiatric disturbances. The psychiatric disturbances include depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior.Prednisone suppresses the immune system and, therefore, increases the frequency or severity of infections and decreases the effectiveness of vaccines and antibiotics. Prednisone may cause osteoporosis that results in fractures of bones. Patients taking long-term prednisone often receive supplements of calcium and vitamin D to counteract the effects on bones. Calcium and vitamin D probably are not enough, however, and treatment with bisphosphonates such as alendronate (Fosamax) and risedronate (Actonel) may be necessary. Calcitonin (Miacalcin) also is effective. The development of osteoporosis and the need for treatment can be monitored, using bone density scans.
Storage: Store at room temperature 20-25 degrees C (68-77 degrees F), and keep away from moisture.