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If My Allergy is Gone Why Do I Need to Continue Prednisone

Prednisolone is a corticosteroid or steroid. It's only available on prescription.

It usually comes as tablets and soluble tablets, but you can get it as an injection, eye drops, rectal foam or suppositories. Adults usually get it as tablets.

Brands available in Ireland are Deltacortril and Prednesol.

COVID-19 and prednisolone

Do not stop taking prednisolone suddenly if you develop COVID-19 symptoms. Ask your GP if you need to stop taking it.

Take prednisolone as usual if you have no symptoms of COVID-19.

Uses for prednisolone

Prednisolone:

  • reduces inflammation
  • helps to control autoimmune illnesses, including rheumatoid arthritis

It's also used to treat a wide range of health problems including:

  • allergies
  • blood disorders
  • skin diseases
  • infections
  • certain cancers
  • preventing organ rejection after a transplant

Get emergency help

You might need emergency help if you have serious side effects, take too much or get a serious allergic reaction (anaphylaxis).

Serious side effects

Taking prednisolone for a long time at a high dose or repeatedly in short courses can lead to serious side effects.

Urgent advice: Call your GP immediately if you get:

  • breathless
  • weakness in your arms or legs
  • changes in your eyesight
  • any bruising or bleeding that is not normal
  • black or dark brown vomit
  • feelings of harming yourself or depression
  • signs of infection, such as fever, chills, sore throat, a cough, or pain peeing
  • signs of high blood sugar, such as feeling sleepy, confused, very thirsty or hungry, peeing more often, breath that smells like fruit
  • weight gain in the upper back or belly, a puffy face, very bad headaches and slow wound healing
  • a very upset stomach, vomiting, dizziness or passing out, very tired, mood changes, loss of appetite and weight loss
  • muscle pain, weakness or cramps, a heartbeat that does not feel normal
  • severe stomach pain, severe back pain, severe upset stomach, being sick

Serious allergic reaction

Warning signs of a serious allergic reaction (anaphylaxis) might mean you need to go to an emergency department (ED).

If you take too much prednisolone

Urgent advice: Phone your GP or go to your nearest ED if you:

  • take too much prednisolone

When you start taking prednisolone

You might feel better after a couple of days of taking prednisolone. But it depends on your illness.

For some illnesses, you may not notice any difference in how you feel after you start taking prednisolone. This does not mean the medicine is not working. Ask your GP what to expect for your illness.

Tell your GP about risks of infections

You are more likely to get infections when you're taking any steroid medication, such as prednisolone.

Tell your doctor if you're exposed to infectious illnesses like chickenpox or shingles.

Prednisolone makes you more likely to catch infections such as:

  • flu
  • the common cold
  • chest infections

Tuberculosis (TB) may also recur.

Keep away from people with an infectious disease, especially chickenpox or shingles. If you have never had these illnesses, they could make you very ill.

How long you'll need to take prednisolone

You may only need a short course of prednisolone for up to a week.

But some people need to take it many years or the rest of their life.

Ask your GP what to expect for your illness. Follow their advice.

Changes to your dose

Your dose may go up or down. When your illness starts to get better, it's likely that your dose will go down.

Your GP may reduce your dose before you stop treatment. This is to reduce the risk of withdrawal symptoms.

Your dose may go up if your illness gets worse.

Liquorice

Do not eat liquorice while taking prednisolone.

Liquorice plant extract may increase the amount of prednisolone in the body and also increases the risk of low potassium.

Check if you can take prednisolone

Prednisolone can be taken by adults and children.

Prednisolone is not suitable for some people.

Non-urgent advice: Check with a GP or pharmacist before starting to take prednisolone if you:

  • already have a medical problem - includes mental health problems as well as any unhealed wounds
  • have had an allergic reaction to medicine in the past
  • are trying to get pregnant, already pregnant or breastfeeding
  • have an infection - including eye infections
  • have been around someone with shingles, chickenpox or measles in the last few months
  • have recently had any vaccinations or are about to have a vaccine

Ask about the risks for your child

Check with your GP about the risks of giving prednisolone to your child. Your child's growth can be slowed if they take it for a long time.

Your GP will:

  • watch their growth carefully while they are taking steroids
  • change treatment if necessary

Pregnancy and prednisolone

Tell your GP immediately if you are pregnant, think you are pregnant or are trying to get pregnant.

Prednisolone usually is not recommended if you're pregnant.

High doses or long-term use can affect your baby's growth. Your baby's growth will be checked often if you take prednisolone.

In some cases, you may be advised to continue taking prednisolone during your pregnancy. Your GP will decide if the benefits outweigh the risks.

Find out more about how prednisolone can affect you and your baby during pregnancy

Breastfeeding and prednisolone

Tell your GP if you are breastfeeding or about to start breastfeeding before taking prednisolone.

Prednisolone can get into breast milk. Your GP may want to monitor your baby for side effects if you're taking it.

Contraception and prednisolone

Tell your GP if you're taking oestrogens. These are found in the contraceptive pill or hormone replacement therapy (HRT).

How and when to take prednisolone

Take prednisolone exactly as your GP has advised.

Usually, you'll take a single dose once a day in the morning so it does not:

  • upset your stomach
  • keep you awake at night

Your GP will decide on the dose. They might tell you to take it on alternate days.

In children, the dose is calculated based on their height and weight. So it may be lower than for an adult.

Taking enteric-coated or gastro-resistant tablets

If your prednisolone tablets are labelled as 'enteric coated' or 'gastro resistant', you can take these with or without food. Make sure to swallow them whole.

Do not take indigestion medicines 2 hours before or after taking enteric-coated or gastro-resistant tablets.

Avoid stopping prednisolone suddenly

Prednisolone can cause extra side effects and withdrawal symptoms if you stop taking it suddenly.

Do not stop taking prednisolone if you've:

  • been on it for more than 3 weeks
  • taken high doses (more than 40mg) for more than 1 week

If you get severe withdrawal symptoms, tell your GP immediately.

If you forget to take your prednisolone

Take your prednisolone as soon as you remember if you forget a dose.

Skip the missed dose if you do not remember until the following day.

Do not take a double dose to make up for a forgotten dose.

Use an alarm to remind you if you forget doses often.

Side effects

Not everyone who takes prednisolone gets side effects. But the higher your dose, the more chance you'll experience some.

Side effects of prednisolone include:

  • insomnia
  • weight gain
  • indigestion
  • sweating a lot

Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as a rounder 'moon' face, happen after weeks or months.

Keep taking your prednisolone but tell your GP if any side effects bother you or do not go away.

Information:

See the patient information leaflet that comes with your medicine for a full list of side effects.

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA).

Stay healthy to control long-term effects

Taking prednisolone for many months or years can have harmful effects on your body, including:

  • thinner bones (osteoporosis)
  • poorly-controlled diabetes
  • eyesight problems
  • slower growth in children and teenagers

Ask your GP to check the height of your children and teenagers regularly. This can pick up any stunting of growth quickly.

Making lifestyle changes can help you control the possible harmful effects, for example regular exercise and a calcium-rich diet.

Read advice on diet, exercise and healthy living

Taking prednisolone with other medicines

Many medicines interfere with prednisolone or increase the risk of side effects.

Ask a GP or pharmacist before you take any other medicines if you're taking prednisolone, including:

  • over the counter pain medicines like aspirin and ibuprofen
  • herbal remedies, vitamins or supplements

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine.

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the 'Find a medicine' search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select 'PIL'. A PDF of the PIL opens in a new window.

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window.

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select 'PIL'.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word 'epar'. For example: 'Zoely epar'. A list of matching medicines appears.
  2. Select the 'Human medicine European public assessment report (EPAR)' for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under 'labelling and package leaflet'

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland's Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

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Source: https://www2.hse.ie/conditions/prednisolone/