It took a seasoned doctor about 10 seconds to diagnose me with hives: the often-mysterious allergic reaction that affects about one-fifth of us at some time in our lives. He prescribed an over-the-counter antihistamine, Benadryl, and a steroid, prednisone. I knew vaguely that steroids were not-to-be-taken-lightly drugs.
They carry the potential for significant side effects: 'roid rage, blood sugar spikes, long-term risk of infection and bone loss. But this was a "Make it stop! The treatment worked beautifully, ending the itch and beating down the swelling within a day or two. I never did figure out what triggered the hives. Hold The Steroids. The press release about the Annals Of Emergency Medicine study included this:. With the addition of prednisone, the relief scores were actually worse.
Levocetirizine — better known by the brand name Xyzal — is a non-sedating antihistamine that lasts 24 hours. It got federal approval earlier this year to be sold over the counter. So maybe, I wondered, I didn't need to take those slightly scary steroids after all?
The French study was small -- just patients with basic hives, no puffiness of face or feet — but high quality: patients were randomly assigned to steroids or placebo, and "blind" to which they got. On the other hand, hives can be a little scary too: They can — rarely — progress to a potentially life-threatening anaphylactic reaction. So couldn't steroids help prevent that?
What does this study mean for the next time you or I see those nasty itchy red bumps breaking out? First, as always, ask your doctor if you're in any doubt: Is this hives? Should I be seen? Editorializing here, but if you can't send a smartphone photo to your primary care office, something's wrong. Rade Vukmir. Both say the study is unlikely to shift the current standard practice of offering both an antihistamine and a steroid — and often a Pepcid or Zantac as well, which block an additional kind of histamine, Vukmir said, for a " punch.
But each found value in it nonetheless. Hsu Blatman says that for patients with relatively mild cases of hives, the study underscores the option of simply taking antihistamines at home. But if you continue to have symptoms or it doesn't seem like it's turning around, then you should be seeking medical advice. She called the study "nicely done," and further evidence that histamine is a key element in the hives allergic reaction, "so it makes sense that if you take an antihistamine, that that would help with blocking the histamine, which is what's really driving that itch.
But, I asked her, doesn't it make sense that if an allergic reaction like hives is an overreaction of the immune system, and steroids ratchet down the immune system, they should be helpful against hives? The steroid "is trying to help decrease that inflammation kind of slowly," she said.
Back to Medicines A to Z. Prednisolone is a type of medicine known as a corticosteroid or steroid. Corticosteroids are not the same as anabolic steroids. Prednisolone is used to treat a wide range of health problems including allergies, blood disorders, skin diseases, infections, certain cancers and to prevent organ rejection after a transplant.
It helps by reducing inflammation. It also damps down your immune system, which can help in autoimmune illnesses like rheumatoid arthritis , where your immune system mistakenly attacks its own tissues. Prednisolone is available only on prescription as tablets and as a liquid to drink. It can also be given by injection but this is usually only done in hospital. As long as you have no symptoms of coronavirus infection, carry on taking your prescribed steroid medicine as usual. If you develop any coronavirus symptoms, do not stop taking your steroid medicine suddenly.
Ask your doctor about whether you need to stop taking it or not. The usual dose varies between 5mg and 60mg daily - 1ml of liquid prednisolone is usually equal to 10mg. Unless your doctor or pharmacist gives you different instructions, it's best to take prednisolone as a single dose once a day, straight after breakfast. For example, if your dose is 40mg daily, your doctor may tell you to take 8 tablets 8 x 5mg all at the same time.
Take prednisolone with breakfast so it doesn't upset your stomach. Taking prednisolone in the morning also means it's less likely to affect your sleep. If your prednisolone tablets are labelled as "enteric coated" or "gastro resistant", you can take these with or without food but make sure to swallow them whole. Do not take indigestion medicines 2 hours before or after taking enteric coated or gastro resistant tablets. The dose you'll take depends on your illness and whether you are taking prednisolone as a short course or for longer.
In children, the dose may be lower than for an adult with the same illness because it is calculated according to their height and weight. Your doctor will probably reduce your dose before you stop treatment completely. This is to reduce the risk of withdrawal symptoms. If you miss a dose of prednisolone, take it as soon as you remember. If you don't remember until the following day, skip the missed dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. The higher the dose of prednisolone that you take, the greater the chance of side effects. You are less likely to get side effects if you take a relatively low dose of less than 20mg prednisolone daily.
Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months. Common side effects happen in more than 1 in people. Keep taking the medicine, but tell your doctor if they bother you or don't go away:. You are more likely to have a serious side effect if you take a higher dose more than 20mg daily of prednisolone or if you have been taking it for more than a few weeks.
In rare cases, it's possible to have a serious allergic reaction anaphylaxis to prednisolone. These are not all the side effects of prednisolone. For a full list see the leaflet inside your medicines packet. You can report any suspected side effect to the UK safety scheme.
Long periods of prednisolone treatment can slow down the normal growth of children and teenagers. Your child's doctor will watch their growth carefully while they are taking steroids. That way any slowing of growth can be picked up promptly and treatment changed if necessary.
Prednisolone isn't usually recommended in pregnancy unless the potential benefits outweigh the risks. Prednisolone has occasionally been linked to problems in the first 12 weeks of pregnancy. High doses or long-term use can also affect the unborn baby's growth. You can usually take prednisolone while you're breastfeeding. However, prednisolone can get into breast milk. If you're taking a high dose of prednisolone the baby may need to be monitored for side effects.
For safety, it's usually recommended that you wait 3 to 4 hours after taking your dose of prednisolone before feeding your baby or expressing milk. There are many medicines that interfere with the way prednisolone works, or that increase the risk of side effects. It's very important you check a medicine is safe to take with prednisolone before you start taking it. This includes some medicines that you buy over the counter like aspirin and anti-inflammatory painkillers such as ibuprofen.
There's very little information about taking herbal remedies and supplements with prednisolone. For safety, tell your doctor or pharmacist if you take any other medicines, including herbal remedies, vitamins or supplements.
Steroids mimic the effects of hormones your body naturally produces in your adrenal glands. The adrenal glands sit on top of your kidneys. When prescribed in doses higher than your body's usual levels, steroids like prednisolone dampen inflammation. This can reduce the symptoms of inflammatory conditions, such as arthritis and asthma. Steroids also damp down your immune system, which can help in autoimmune illnesses like rheumatoid arthritis , where your immune system mistakenly attacks its own tissues.
For other illnesses, you may not feel any better even though the medicine is helping you. This may be the case if you're taking prednisolone to stop your symptoms getting worse or to prevent a problem happening for example after an organ transplant. If you have to take prednisolone for more than a few weeks, the chances are that you will put on weight.
Prednisolone can make you hungrier and retain water, so it can be quite challenging to avoid weight gain. Try to eat well without increasing your portion sizes. Regular exercise will also help to keep your weight stable. Once you stop taking prednisolone, any issues around increased appetite or water retention should return to normal. It can be dangerous to stop taking prednisolone suddenly, especially if you have been on a high dose for a long time.
These side effects are most likely to happen if you have taken prednisolone for more than a few weeks or you take more than 40mg daily. Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects. Do not stop taking prednisolone without talking to your doctor - you will need to reduce the dose gradually. Taking prednisolone for many months or years can have several harmful effects on your body. It can lead to:. If you have to take prednisolone for a long time, there are steps you can take to stay as healthy as possible:.
Taking prednisolone makes you more likely to catch infections such as flu , the common cold and chest infections. 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. Tell your doctor straight away if you come into contact with someone who has an infectious disease such as chickenpox or shingles.
Your doctor may be able to prescribe a medicine to protect you. Taking prednisolone lowers your immune system. If you have a "live" vaccine, like the shingles vaccine, while you are taking prednisolone your immune system might not be able to handle it. This may lead to an infection. Inactive vaccinations, like the flu vaccine, are safe. If you are taking prednisolone for longer than 3 weeks, or you have been prescribed a high dose of more than 40mg daily, your doctor or pharmacist will give you a blue steroid treatment card.
The card is the size of a credit card and fits in your wallet or purse. It tells you how you can reduce the risks of side effects. It also gives details of your doctor, how much prednisolone you take and how long the treatment will last for.
If you need any medical or dental treatment, show your blue steroid card to the doctor or dentist so they know that you are taking prednisolone. For most health problems, these steroids are very similar to prednisolone in terms of how well they work and how safe they are.