Prednisone
DELTASONE
Pronunciation: PRED-ni-soen
“Predator”
What it isOral prodrug converted to prednisolone; systemic anti-inflammatory and immunosuppressive glucocorticoid.
Why this oneIts broad effectiveness, low cost and familiar tapers make it the default oral systemic steroid across specialties.
What limits itProlonged use suppresses the adrenal axis and raises infection, glucose and bone risks; taper when suppression is plausible.
FDA-approved for
- inflammation/immunosuppression (~1955)
Off-label
- many inflammatory conditions
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Corticosteroid-responsive disorders | Adult | 5 mg QD | individualized to lowest effective dose | 60 mg/day |
| Acute exacerbation of multiple sclerosis | Adult | 200 mg QD x1 week | then 80 mg every other day x1 month | 200 mg/day |
Renal Undefined
Hepatic Undefined
Instructions
- Individualize dose to disease and response
- After long-term therapy, withdraw gradually — do not stop abruptly
- Alternate-day therapy: twice the usual daily dose every other morning to reduce adrenal suppression
Available strengths
- tab 1, 2.5, 5, 10, 20, 50 mg
- DR tab 1, 2, 5 mg
- sol 5 mg/5 mL
Contraindications
- Systemic fungal infections
Cautions
- Adrenal suppression; taper on withdrawal
- Increased infection susceptibility and masking
- Avoid live vaccines during therapy
- Growth suppression in children
Adverse reactions
- Fluid/sodium retention, hypertension, hypokalemia
- Muscle weakness, myopathy, osteoporosis, fractures
- Peptic ulcer with perforation/hemorrhage
- Impaired wound healing, thin fragile skin
- Cushingoid state, hyperglycemia, latent diabetes
- Cataracts, glaucoma
- Hypersensitivity/anaphylactic reactions
Pregnancy Undefined
Lactation Undefined
Cost
Generic entry1982
NO BOXED WARNINGS
Principal riskAdrenal suppression with prolonged use
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHyperglycemia, infection, osteoporosis and potentially severe mood, sleep or psychotic effects.
Active metabolites
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