Deltasone (prednisone) is a cornerstone systemic corticosteroid medication prescribed for its potent anti-inflammatory and immunosuppressive properties. It is a synthetic glucocorticoid that mimics the effects of hormones your body naturally produces in the adrenal glands. This medication is instrumental in managing a wide spectrum of conditions characterized by hyperactive immune responses and severe inflammation, providing critical symptomatic relief and modifying disease progression. Its efficacy is well-established across numerous medical specialties, from rheumatology to pulmonology and dermatology.

Features

• Active Pharmaceutical Ingredient: Prednisone.
• Drug Class: Synthetic glucocorticoid corticosteroid.
• Administration: Oral tablet available in multiple strengths (e.g., 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg).
• Mechanism of Action: Enters cells and binds to glucocorticoid receptors, modulating gene transcription to inhibit the synthesis of pro-inflammatory mediators.
• Bioavailability: Requires hepatic conversion to its active metabolite, prednisolone, to exert its therapeutic effect.
• Onset of Action: Systemic anti-inflammatory effects are typically not immediate, often taking several hours to manifest after administration.

Benefits

• Rapid and potent suppression of widespread inflammatory processes, reducing tissue swelling, pain, heat, and redness.
• Effective immunosuppression for managing autoimmune disorders by dampening the erroneous attack of the body’s own tissues.
• Provides critical symptomatic relief for acute exacerbations of chronic conditions, such as asthma attacks or rheumatoid arthritis flares.
• Can be life-saving in severe allergic reactions and certain types of shock by stabilizing blood pressure and reducing airway inflammation.
• Helps to induce and maintain remission in various autoimmune and inflammatory diseases, improving long-term quality of life.
• Offers a predictable and dose-responsive therapeutic effect, allowing clinicians to tailor treatment to disease severity.

Common use

Deltasone is indicated for a vast array of conditions where controlling inflammation or the immune system is paramount. Its use spans nearly every field of medicine. Common applications include, but are not limited to:

• Rheumatologic Diseases: Rheumatoid arthritis, systemic lupus erythematosus (SLE), polymyalgia rheumatica, giant cell arteritis, vasculitis, and polymyositis.
• Allergic Conditions: Severe, treatment-resistant allergic reactions (e.g., contact dermatitis, atopic dermatitis), and anaphylaxis (as adjunctive therapy).
• Respiratory Disorders: Severe asthma exacerbations, chronic obstructive pulmonary disease (COPD) exacerbations, and sarcoidosis.
• Dermatologic Conditions: Severe psoriasis, pemphigus vulgaris, and other blistering skin diseases.
• Ophthalmic Diseases: Uveitis and optic neuritis.
• Gastrointestinal Diseases: Inflammatory bowel disease (IBD) flares, including ulcerative colitis and Crohn’s disease.
• Hematologic/Oncologic Conditions: Autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and as part of chemotherapy regimens for certain leukemias and lymphomas.
• Organ Transplantation: Used as an immunosuppressive agent to prevent and treat organ rejection.
• Other: Adrenocortical insufficiency (as replacement therapy), certain infectious diseases with significant inflammatory components (e.g., Pneumocystis jirovecii pneumonia in HIV patients), and nephrotic syndrome.

Dosage and direction

Crucial Note: Dosing is highly individualized and MUST be determined by a qualified healthcare professional based on the specific condition being treated, its severity, and the patient’s response. The following is general information.

• Administration: Tablets are taken orally, typically with food or milk to minimize gastrointestinal upset.
• Dosing Schedules:
  • Single Daily Dose: Often administered as a single dose in the morning to coincide with the body’s natural cortisol rhythm, minimizing suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
  • Divided Doses: For more severe conditions, the total daily dose may be divided and given 2-4 times per day to maintain consistent drug levels.
  • Alternate-Day Therapy: For long-term management, a regimen where a double dose is taken every other morning may be used to further reduce adrenal suppression and side effects.
• Dosing Principles:
  • Initial Dose (Therapy Initiation): A higher “loading” dose is often used to gain rapid control of the disease.
  • Tapering (Therapy Discontinuation): It is absolutely critical that therapy not be stopped abruptly after more than a few weeks of use. The dose must be gradually tapered down under medical supervision to allow the adrenal glands to resume natural cortisol production and to avoid withdrawal symptoms or a severe flare of the underlying disease. The tapering schedule is patient-specific and can last from days to many months.
• Example Dosing Ranges (for context only):
  • Physiologic Replacement: 5 to 7.5 mg daily.
  • Inflammatory/Autoimmune Diseases: 5 to 60 mg daily, with severe cases sometimes requiring higher doses.
  • Pulse Dosing (for acute crises): Very high doses (e.g., 1000 mg IV methylprednisolone, a related drug) may be used in a hospital setting.

Precautions

Patients taking Deltasone require careful monitoring and must observe several key precautions:

• Adrenal Suppression: Prolonged use can suppress the body’s ability to produce natural cortisol, especially during physical stress (e.g., surgery, infection, major injury). Patients may need supplemental steroids during these times and must carry steroid warning identification.
• Infections: Corticosteroids mask signs of infection (like fever and inflammation) and increase susceptibility to new infections or can cause latent infections (e.g., tuberculosis) to reactivate. Report any potential signs of infection promptly.
• Vaccinations: Live virus vaccines (e.g., MMR, varicella) should be avoided during therapy due to the risk of developing the disease. Response to killed/inactivated vaccines may be diminished.
• Monitoring: Regular monitoring of blood pressure, blood glucose, weight, electrolytes, bone density (for long-term use), and ocular pressure is essential.
• Diet: A diet rich in calcium, Vitamin D, and potassium, and low in sodium and concentrated sugars is often recommended to counteract potential side effects.
• Pregnancy/Lactation: Use during pregnancy, especially in the first trimester, should only be if the potential benefit justifies the potential risk to the fetus. It may be present in breast milk; caution is advised.

Contraindications

Deltasone is contraindicated in patients with:

• Known hypersensitivity (allergy) to prednisone or any component of the formulation.
• Systemic fungal infections, unless being used for life-saving treatment in conjunction with antifungal therapy.
• Live virus vaccinations are contraindicated in patients receiving immunosuppressive doses of corticosteroids.
• Caution is Extreme: It is used with extreme caution, if at all, in patients with active peptic ulcer disease, uncontrolled hypertension, congestive heart failure, psychosis, and ocular herpes simplex due to the risk of exacerbation.

Possible side effect

The side effect profile of Deltasone is extensive and is often related to the dose and duration of therapy.

• Common: Fluid retention, weight gain, increased appetite, facial mooning, acne, thinning skin, easy bruising, insomnia, mood swings (euphoria, irritability), nervousness, indigestion, nausea.
• Serious (require medical attention):
  • Endocrine: HPA axis suppression, Cushing’s syndrome, growth suppression in children, menstrual irregularities, hyperglycemia (may trigger steroid-induced diabetes).
  • Cardiovascular: Hypertension, congestive heart failure.
  • Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, tendon rupture.
  • Ophthalmic: Glaucoma, cataracts.
  • Gastrointestinal: Peptic ulcer disease with potential for perforation and hemorrhage, pancreatitis.
  • Dermatologic: Impaired wound healing.
  • Neurologic/Psychiatric: Seizures, increased intracranial pressure (pseudotumor cerebri), vertigo, severe depression to frank psychosis.
  • Metabolic: Hypokalemia, hyperlipidemia.

Drug interaction

Deltasone interacts with numerous medications. A complete list of all medications (prescription, OTC, and herbal) must be provided to the prescribing physician.

• Anticoagulants (e.g., Warfarin): Corticosteroids may alter the response to anticoagulants, requiring more frequent INR monitoring.
• Antidiabetic Agents (Insulin, Oral Hypoglycemics): Prednisone increases blood glucose, necessitating dosage adjustments of diabetes medications.
• Diuretics (e.g., Furosemide, Hydrochlorothiazide): Concomitant use increases the risk of severe hypokalemia (low potassium).
• NSAIDs (e.g., Ibuprofen, Naproxen): Significantly increases the risk of gastrointestinal ulceration and bleeding.
• CYP3A4 Inducers/Inhibitors: Drugs like phenobarbital, phenytoin, rifampin (inducers) can increase the metabolism of prednisone, reducing its efficacy. Ketoconazole and other inhibitors can decrease its metabolism, increasing the risk of toxicity.
• Live Vaccines: As noted in Contraindications.
• Potassium-Depleting Agents: Enhanced risk of hypokalemia.

Missed dose

• If you miss a dose, take it as soon as you remember.
• However, if it is almost time for your next dose, skip the missed dose and resume your usual dosing schedule.
• Do not take a double dose to make up for a missed one.
• If you are on a tapered schedule and miss a dose, contact your healthcare provider for specific instructions, as this can disrupt the carefully planned taper.

Overdose

• Symptoms: An acute single overdose is unlikely to be life-threatening. Symptoms would be an exaggeration of known side effects, including severe hypertension, hyperglycemia, fluid retention, psychosis, and electrolyte imbalances.
• Action: Seek immediate medical attention or contact a Poison Control Center. Treatment is supportive and symptomatic. There is no specific antidote. Hemodialysis is not effective.

Storage

• Store at room temperature (68°F to 77°F / 20°C to 25°C).
• Keep the container tightly closed.
• Protect from light and moisture.
• Keep out of reach of children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.

Disclaimer

This information is for educational purposes only and is not a substitute for the professional medical advice, diagnosis, or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The author and publisher are not responsible for any errors or omissions or for any consequences from application of the information in this document.

Reviews

• “As a rheumatologist, Deltasone is an indispensable tool in my arsenal for managing acute flares of autoimmune arthritis. Its rapid onset provides patients with much-needed relief, allowing us to bridge to slower-acting DMARDs. The key, of course, is meticulous management of the taper and side effects.” – Dr. A. Vance, MD, Rheumatology
• “Prescribing prednisone is always a risk-benefit analysis. For a patient experiencing a severe asthma exacerbation, its benefits in reducing airway inflammation are undeniable and can prevent hospitalization. My focus is on using the smallest effective dose for the shortest possible duration.” – Dr. L. Torres, MD, Pulmonology
• “After being diagnosed with giant cell arteritis, starting on Deltasone was like a switch being flipped—the debilitating headaches and muscle pain vanished within days. While the side effects of weight gain and moon face have been challenging, the trade-off for preventing blindness was unquestionably worth it. My doctor’s careful tapering plan has been crucial.” – Patient M.S.
• “The psychological side effects were significant for me—severe insomnia and mood swings. It was effective for my skin condition, but the experience highlighted the importance of close communication with my doctor about all side effects, not just the physical ones.” – Patient J.K.