Oral steroids (prednisone) Rongoā whakakaha ā-waha

Prednisone is used to treat many health conditions that are related to inflammation, including:

• allergies
• asthma
• chronic obstructive pulmonary disease (COPD)
• rheumatoid arthritis
• gout
• inflammatory bowel disease (Crohn's disease and ulcerative colitis) .

Prednisone calms or suppresses your body's immune system. This can reduce inflammation anywhere in your body. It also helps reduce the symptoms associated with these health conditions, especially during flare‑ups. It does not cure these health conditions.

Your dose of prednisone will depend on which condition you are being treated for and how you respond. Doses of prednisone usually range from 5 mg to 60 mg daily.

You may need a short course of prednisone (such as for 5 days), or you may need to take it for longer (for weeks or months).

In Aotearoa New Zealand, prednisone tablets are available in different strengths (1 mg, 2.5 mg, 5 mg and 20 mg). Check the strength of your tablets and your prescribed dose. Often you may need to take more than one tablet. If you are unsure about your dose or the number of tablets to take, ask your pharmacist.

Always take your prednisone exactly as your healthcare provider has told you. The pharmacy label on your medicine will tell you how much prednisone to take, how often to take it and any special instructions.

• Take your prednisone tablets with food and a full glass of water.
• If you take it once a day, it is best taken at breakfast time.
• If you need to take it more than once a day, space your doses out during the day. Try not to take it too close to bedtime because it may keep you awake.
• If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.

Special instructions when taking prednisone

• Do not stop prednisone suddenly. If you have been taking it for more than 3 weeks, stopping suddenly can cause withdrawal symptoms, which can be serious or even life-threatening. Instead, you will be given a tapering dose, meaning your dose of prednisone will be gradually reduced over a few days or weeks.
• Before taking other medicines or supplements, check with your doctor or pharmacist. Do not take other anti‑inflammatory medications such as ibuprofen (Nurofen) or diclofenac (Voltaren) when using prednisone.
• Tell any healthcare providers taking care of you that you are using prednisone. Consider wearing a medical alert bracelet or pendant so medical staff know how to treat you in an emergency. Search online for 'medical bracelets NZ' to find suppliers.
• Tell your healthcare provider if you come into contact with someone who has an infectious disease such as chickenpox or measles, or if you feel unwell. Taking prednisone for a long time can increase your risk of all types of infections.
• Ask your healthcare provider for advice before you have any vaccines while you are taking prednisone. It is safe to have most vaccines, including the flu vaccine, while you are taking prednisone. Protecting yourself against infection is important because prednisone suppresses your immune system. But you should postpone any immunisations with live vaccines.
• If you go overseas, make sure you have enough tablets. Carry a summary of your medical history with you in case you need to see a healthcare provider. Do not take any risks with hygiene, as tummy bugs can be very unpleasant.

• For a mild illness when you are sick enough to stay in bed or take a day off work with something like the flu or a fever, take double your usual oral dose for 1 to 2 days. Provided you are getting better, you can then reduce the dose back down to normal.
• If you are more unwell, for example with pneumonia, or if you are not responding to the treatment described above, you should contact your healthcare provider urgently. They may give you a steroid injection or admit you to hospital.
• If you are throwing up (vomiting) or have runny poos (diarrhoea), you might not absorb the steroid medication. If you throw up within 3 hours of taking your oral steroid, take it again but take double the dose. If you throw up again or have runny poos, contact your healthcare provider urgently because you might need a steroid injection or to be admitted to hospital.
• See your healthcare provider if you are taking more than 5 mg of prednisone daily and you get sick.
• You will also need to take extra oral steroids if you have a serious accident of any kind (such as a broken bone or burn) or have surgery. You do not usually have to increase your dose because of emotional stress, a head cold or increased physical exercise.