What to look out for when you use a corticosteroid
As with any prescription drug, you have a responsibility to monitor the way your body reacts to the medication. If you are worried or alarmed, you should seek the guidance of your doctor. It is dangerous to assume that the drug is working and you will just “get better”. This is particularly important with Prednisone because it modifies the way in which your immune system works. That means you can be more likely to lose resistance to new infections. Thus, as an introductory warning, you should not use Prednisone if you already have or later contract a fungal infection. More generally, the use of this drug can mask the signs of an infection or, if you do have symptoms, it can make a diagnosis more difficult — the steroid makes it more difficult to localize the source of the problem.
Because the use of this drug affects the way in which the adrenal glands work, there are difficulties if you are subjected to stress while taking it. The question of changing the dosage if you are subjected to stress is a little controversial. There seems to be some agreement that the dose should be increased following surgery or any serious or traumatic injury. But there is less agreement when you are on a long-term course of treatment. The agreement for increasing the dose is that, over time, the glands’ natural production is slowly reduced to almost zero. Thus, if you are experiencing stress for some reason, the dosage should mimic what the gland would do naturally. However, a range of recent double-blind, randomized clinical trials have produced results questioning the need to increase the dose. The results of the trials showed no statistically significant difference in outcome between those who did receive an increase and those who did not. It seems that your body may simply make do with the level of Prednisone that it is used to, no matter what the level of stress. In any event, it is difficult to calculate how well or badly your body is using the Prednisone and so judge by what amount to change the dose. Note that some doctors take a precautionary view and routinely advise an increase of dose.
| If you are taking Prednisone for a chronic condition and so will use the drug either continuously or in controlled bursts, you should monitor your eyesight. Over time, steroids may encourage the growth of cataracts or the development of glaucoma with consequent damage to the optic nerve. There is also a risk, particularly if you use contact lenses, that you may be prone to fungal infections. More generally, there can be problems if your blood pressure rises and remains high. Similarly, there can be higher levels of fluid retention. The chemical balance of the blood can also be disturbed. It is advisable to monitor your blood pressure on a regular basis and to have blood tests. If necessary, you will be advised to change the amount of salt you use in cooking, or to take potassium and calcium supplements. |
Finally, you should avoid contact with anyone who has a communicable sickness such as measles and chickenpox. Because your immune systems is compromised, you are not only more prone to catch these diseases, they can be far more severe (even life-threatening in some cases). For the same reason, you should not be vaccinated against any of these more serious diseases while on Prednisone. If this means you have to cancel a holiday abroad, that is what you must do. Never take unnecessary risks with your own health.
