“Prednisone 20 mg (Generic Deltasone): Uses, Dosage, Side Effects, Warnings & Full Guide”

1. What is Prednisone?

Prednisone is a synthetic corticosteroid (glucocorticoid) used to reduce inflammation and suppress the immune system. It mimics the effects of cortisol, a natural steroid hormone produced by the adrenal glands. Prednisone is used to treat a wide variety of inflammatory, allergic, autoimmune, and cancer-related conditions.

2. Indications (Uses):

Prednisone 20 mg is prescribed for the treatment of:

Autoimmune & Inflammatory Diseases:

• Rheumatoid arthritis
• Systemic lupus erythematosus (SLE)
• Psoriatic arthritis
• Ankylosing spondylitis
• Vasculitis

Allergic Reactions & Conditions:

• Severe allergic reactions
• Asthma
• Atopic dermatitis
• Drug hypersensitivity

Respiratory Conditions:

• Chronic obstructive pulmonary disease (COPD)
• Sarcoidosis
• Interstitial lung disease

Endocrine Disorders:

• Addison’s disease (as replacement therapy)
• Adrenal insufficiency

Gastrointestinal Diseases:

• Crohn’s disease
• Ulcerative colitis

Hematologic & Oncologic Use:

• Leukemia
• Lymphoma
• Autoimmune hemolytic anemia
• Immune thrombocytopenia (ITP)

Neurological Conditions:

• Multiple sclerosis flare-ups
• Myasthenia gravis

Skin Disorders:

• Pemphigus
• Eczema
• Severe psoriasis

3. Mechanism of Action:

Prednisone is converted in the liver to its active form, prednisolone. It works by:

• Suppressing inflammation via inhibition of multiple inflammatory cytokines.
• Inhibiting immune system responses, including T-cell activation and antibody production.
• Stabilizing cell membranes, reducing capillary permeability.
• Modulating gene expression, affecting protein synthesis involved in inflammatory responses.

4. Dosage and Administration:

Typical Adult Dosage:

• Range: 5 mg to 60 mg daily (20 mg is a common moderate dose).
• Tapering: Often required if taken longer than a few days to prevent adrenal suppression.
• Route: Oral
• Timing: Best taken in the morning with food to minimize stomach upset and mimic natural cortisol rhythm.

Note: Dosage depends on the condition being treated, patient weight, severity, and treatment duration.

5. How to Take:

• Take with food or milk to reduce stomach irritation.
• Swallow whole with water.
• Follow the prescribed dosing schedule, especially if tapering is involved.
• Do not stop abruptly if taken for more than a week—must taper down under medical supervision.

6. Side Effects:

Common Short-Term Side Effects:

• Increased appetite
• Weight gain
• Insomnia
• Mood changes (anxiety, irritability)
• Elevated blood sugar
• Fluid retention and bloating

Long-Term or High-Dose Side Effects:

• Cushingoid appearance (moon face, buffalo hump)
• Osteoporosis
• Hypertension
• Glaucoma, cataracts
• Peptic ulcers
• Muscle weakness
• Skin thinning, bruising
• Increased risk of infection
• Delayed wound healing
• Adrenal suppression
• Growth suppression in children

7. Contraindications:

• Hypersensitivity to prednisone or its components
• Systemic fungal infections (unless being treated with antifungals)
• Receiving live or attenuated live vaccines during high-dose therapy

8. Warnings & Precautions:

• Infections: May mask signs of infection and increase risk.
• Diabetes: Can worsen blood glucose control.
• Osteoporosis: Increased risk with prolonged use—consider calcium and vitamin D supplements.
• Mental Health: May cause euphoria, depression, psychosis.
• Vaccinations: Avoid live vaccines.
• Tapering Required: To prevent adrenal insufficiency, especially after long-term use.

9. Drug Interactions:

• NSAIDs (e.g., ibuprofen): ↑ Risk of GI bleeding
• Diuretics: ↑ Risk of hypokalemia
• Anticoagulants (e.g., warfarin): May alter INR
• Vaccines: ↓ Immune response
• Phenytoin, rifampin, barbiturates: ↓ Prednisone effectiveness

11. Special Populations:

• Pregnancy: Category C; use only if clearly needed
• Breastfeeding: Prednisone is excreted in breast milk in small amounts—generally considered safe
• Elderly: Increased risk of osteoporosis and diabetes
• Children: Use with caution; monitor growth

12. Storage:

• Store at room temperature (20–25°C or 68–77°F)
• Protect from light and moisture
• Keep in original container and out of reach of children

13. Overdose:

Symptoms:

• Short-term: Mood changes, insomnia, high blood sugar
• Long-term: Cushing’s syndrome, muscle wasting, peptic ulcers

Management:

• Symptomatic and supportive care
• Gradual withdrawal under medical supervision