Prednisone is a corticosteroid that comes in oral or liquid form. It works by acting on the immune system to help reduce the inflammation in the airways of people with asthma.
Prednisone can also be given as long-term treatment if your asthma is severe or hard to control.
How effective is prednisone for asthma?
A review article in American Journal of Medicine evaluated six different trials for adults with acute asthma episodes. In these trials, people received corticosteroid treatment within 90 minutes of arriving at the emergency room. Researchers found that these groups had lower hospital admittance rates than people who received a placebo instead.
Additionally, a review on management of acute asthma attacks in American Family Physician found that people sent home with a 5- to 10-day prescription of 50 to 100 milligrams (mg) of oral prednisone had a decreased risk of relapse of asthma symptoms. The same review states that in children 2 to 15 years old, three days of prednisone therapy at 1 mg per kilogram of body weight can be as effective as five days of prednisone therapy.
What are the side effects?
Side effects of prednisone can include:
- fluid retention
- increased appetite
- weight gain
- upset stomach
- mood or behavioral changes
- high blood pressure
- increased susceptibility to infection
- eye changes, such as glaucoma or cataracts
- negative effect on growth or development (when prescribed to children)
It’s important to note that many of these side effects, such as osteoporosis and eye changes, typically occur after long-term use. They aren’t common with a short-term prednisone prescription. Take a look at these humorous images that feature some of the stranger side effects of prednisone.
How much will I take?
Prednisone is available as an oral tablet or oral liquid solution in the United States. While similar, prednisone isn’t the same as methylprednisolone, which is available as an injectable solution as well as an oral tablet. Typically, oral prednisone is used as a first-line therapy for acute asthma because it’s both easier to take and less expensive.
The average length of prescription for corticosteroids such as prednisone is 5 to 10 days. In adults, a typical dosage rarely exceeds 80 mg. The more common maximum dose is 60 mg. Dosages greater than 50 to 100 mg per day aren’t shown to be more beneficial for relief.
If you miss a dose of prednisone, you should take the missed dose as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take the next regularly scheduled dose.
You should never take an extra dose to make up for a dose that you’ve missed. In order to prevent an upset stomach, it’s best to take prednisone with food or milk.
Questions to ask your doctor
Prednisone isn’t safe to take while pregnant. You should immediately let your doctor know if you become pregnant while taking prednisone.
Because prednisone acts on the immune system, you may become more susceptible to infections. You should talk to your doctor if you have an ongoing infection or have recently received a vaccine.
There are a number of medications that can interact negatively with prednisone. It’s important that your doctor be informed of all of the medications you’re taking. You should talk to your doctor if you’re currently taking any of the following types of medication:
- blood thinners
- diabetes medication
- anti-tuberculosis drugs
- macrolide-type antibiotics, such as erythromycin (E.E.S.) or azithromycin (Zithromax)
- cyclosporine (Sandimmune)
- estrogen, including birth control medication
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin
- anticholinesterases, particularly in people with myasthenia gravis
There are other anti-inflammatory drugs that can be used as part of asthma treatment. These include:
Inhaled corticosteroids are very effective for limiting the amount of inflammation and mucus in the airway. They’re typically taken daily. They come in three forms: a metered dose inhaler, a dry powder inhaler, or a nebulizer solution.
These medications help prevent asthma symptoms, not treat symptoms.
When taken in low doses, inhaled corticosteroids have few side effects. If you’re taking a higher dose, in rare cases you may get a fungal infection of the mouth called thrush.
Mast cell stabilizers
These medications work by inhibiting the release of a compound called histamine by specific immune cells in your body (mast cells). They are also used to prevent asthma symptoms, particularly in children and in people who have asthma induced by exercise.
Mast cell stabilizers are typically taken two to four times per day and have few side effects. The most common side effect is dry throat.
Leukotriene modifiers are a newer type of asthma medication. They work by blocking the action of specific compounds, called leukotrienes. Leukotrienes are naturally occurring in your body and can cause constriction of the muscles of the airway.
These pills can be taken one to four times per day. The most common side effects are headache and nausea.
The bottom line
Prednisone is a corticosteroid that’s typically given for acute cases of asthma. It helps reduce the inflammation in the airways in people who are experiencing an asthma attack.
Prednisone has been found to be effective at reducing the recurrence of acute asthma symptoms following a visit to the emergency room or hospital.
Many of the adverse side effects associated with prednisone occur during long-term use.
Prednisone can interact with several other types of medications. It’s very important to tell your doctor of all other medications you’re taking before starting on prednisone.