Do steroids make you thirsty: Short-term steroid treatment | Great Ormond Street Hospital
6 Side Effects of MS Steroid Treatment
When a person with relapsing-remitting multiple sclerosis (MS) has an acute symptom flare-up, they are often prescribed a short course of high-dose steroids, according to the National Multiple Sclerosis Society (NMSS). Typically, steroids are given intravenously or orally for three to five days.
“High-dose steroids are used to speed recovery” after an MS relapse, says Matthew McCoyd, MD, an associate professor and residency program director of neurology at the Loyola University Medical Center in Maywood, Illinois.
The steroids used for MS flares are known as corticosteroids, which mimic natural hormones produced in the adrenal gland and which interrupt inflammation.
“Because of long-term complications, like bruising, skin changes, and bone changes, we only use them for short periods, and it is rare to use them more than once or twice a year,” Dr. McCoyd says.
But even in the short term, steroids can have side effects — although, says McCoyd, once you start to taper the drug, most side effects will subside.
“In general, steroids are very well tolerated,” says Tamara B. Kaplan, MD, a clinician at Brigham Multiple Sclerosis Center at Brigham and Women’s Hospital in Boston. “And these side effects should never deter you from getting proper treatment.”
However, it helps to know what you may be in for, so here are six possible side effects to be aware of:
1. Sleep Problems Common From High-Dose Steroids
“One of the most common side effects from the initial high dose of steroids is sleep disturbance,” McCoyd says.
Steroids can give you an extra boost of energy, explains Dr. Kaplan. She advises her patients to schedule their infusions for early in the day so they don’t interfere with sleep.
If you do have trouble falling asleep, experience unpleasant dreams, or feel sleepy or fatigued during the day, the following tips may help:
- Take the steroids early in the morning, and avoid afternoon or evening dosing.
- Ask your doctor for prescription sleep medication.
- If you also take drugs with sedating effects, such as antidepressants, take them at bedtime.
RELATED: Getting a Good Night’s Sleep When You Have MS
2. Bad Taste, Upset Stomach a Possibility
Some people notice a funny, metallic taste in their mouth when undergoing steroid treatment. Sucking on mints or hard candies may help alleviate it.
Other common side effects of steroids include upset stomach, nausea, and vomiting. If you experience indigestion or heartburn, ask your doctor to suggest an over-the-counter antacid to help control it.
Medications called proton pump inhibitors, such as Prilosec (omeprazole) or Prevacid (lansoprazole), are also used to help with stomach symptoms, and your doctor may prescribe them to prevent stomach issues, says Barbara Giesser, MD, a multiple sclerosis specialist with Pacific Neuroscience Institute in Santa Monica, California, and professor emeritus of clinical neurology at the David Geffen UCLA School of Medicine in Los Angeles.
RELATED: Quiz: What’s Your MS Management Style?
3. Mood Disturbances: Agitation, Irritability, Mood Swings
Being on a steroid can make you feel restless, agitated, and irritable.
“Agitation is a common symptom for some people,” McCoyd says. In addition, “Patients who have a mood disorder may be treated in the hospital to make sure they do not have a serious bout of depression or anxiety.”
Mood swings with steroid treatment can range from mild to serious. Be sure to tell your doctor if you have a history of depression, anxiety disorder, or bipolar disorder.
Simply being aware that steroids can affect your moods may make this side effect easier to tolerate, but let your doctor know if it feels intolerable.
It’s also important to let loved ones know about this possible side effect so they understand what’s going on with you. “I always warn the partner: ‘She might be a little more irritable over the next few days. It’s the medicine; it’s not her,’” notes Kaplan.
4. Water Retention Annoying but Temporary
After the initial dose of steroids, you may experience swollen ankles as well as a general swollen and bloated feeling throughout your body. Since steroids cause your body to retain more water, it’s also common to experience urinary frequency, says Kaplan.
Just knowing that this can potentially happen — and that it will soon pass — can help.
“It’s not something to worry about,” she says. “It’s not a long-lasting symptom; it will improve within a few days.”
5. Infection Risk Rises With Steroid Use
One of the functions of a steroid is to suppress your body’s immune system, which places you at higher risk of infections.
If you develop any symptoms of infection while taking a steroid — such as a fever, chills, cough, or sore throat — let your doctor know, says McCoyd.
You can lower your risk of infection with frequent hand-washing and by keeping your distance from people with cold or flu symptoms.
While people with MS are generally encouraged to get an annual (non-live) flu vaccine, as well as certain other vaccines, the NMSS cautions against getting any vaccines during an MS relapse — whether or not you’re taking steroids. Also, live and live-attenuated vaccines are not recommended for people who have MS who are taking any disease-modifying therapy (DMT). There are also some restrictions on receiving some non-live vaccines if you are taking certain medications for MS.
RELATED: What You Need to Know About the COVID-19 Vaccine if You Have MS
6. Elevated Blood Sugar a Concern for Those With Diabetes
One of the most important side effects of steroids is high blood sugar levels. This is usually not a problem unless you have diabetes, but if you do have diabetes, you are likely to see higher numbers when you check your blood glucose level.
“People with diabetes should be warned that their blood sugar will go up and that they need to talk to their doctor about adjusting their insulin [or other diabetes medication] while they are on the steroid,” says Kaplan.
People without diabetes sometimes develop steroid-induced diabetes during steroid treatment. If you notice unusual thirst, dry mouth, frequent urination, blurred vision, or extreme weakness and fatigue while on steroids, let your doctor know.
Alternatives to Steroid Treatment
When someone cannot tolerate steroids or does not adequately respond to steroid treatment, the following alternatives may be considered, according to the NMSS:
Related: Understanding and Coping With MS Relapses
Additional reported by Susan Jara.
Prednisolone: steroid to treat allergies and infections
It’s important to take prednisolone as your doctor has advised.
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.
Sometimes, you may be advised to take prednisolone on alternate days only.
How much will I take?
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.
Will my dose go up or down?
Your dose may go up or down.
Once your illness starts to get better, it’s likely that your dose will go down.
Your doctor will probably reduce your dose before you stop treatment completely. This is to reduce the risk of withdrawal symptoms.
Your dose may go up if your illness gets worse.
What if I forget to take it?
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.
Do not take a double dose to make up for a forgotten one.
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.
What if I take too much?
Taking too many prednisolone tablets by accident is unlikely to harm you.
If you’re worried, talk to your doctor or pharmacist.
How steroids could give you diabetes
How steroids could give you diabetes
By Chloe Lambert for the Daily Mail
When Tony Martin was prescribed new drugs for his asthma and nasal polyps, he hoped they’d help him manage the respiratory problems he’d suffered for years.
In fact, as a result of the treatment he developed type 2 diabetes.
The drugs he’d been prescribed, glucocorticoids, are a type of steroid.
Many people will take glucocorticoids, a type of steroid, not knowing a common side-effect is type 2 diabetes (file picture)
Six million prescriptions for these powerful anti-inflammatory drugs are given out annually in the UK for conditions such as asthma, rheumatoid arthritis and irritable bowel syndrome.
And many people will take glucocorticoids not knowing a common side-effect is type 2 diabetes.
Tony had developed asthma in 2000; he was then diagnosed with bronchiectasis, a condition where some of the air passages become permanently widened, meaning extra mucus builds up and the patient is more prone to chest infections.
He was given inhalers to keep the conditions under control, but these weren’t enough.
‘I ended up in hospital four times with severe attacks,’ recalls Tony, 65, a semi-retired communications consultant from Wandsworth, South London.
In hospital he was given oral steroids in the form of prednisone, to reduce the inflammation in his airways. He then developed nasal polyps and so started taking prednisone more regularly.
Polyps are swellings in the nasal cavity which can cause a runny nose and, in Tony’s case, loss of sense of smell.
‘Doctors told me the steroids could help to shrink the polyps,’ he recalls.
‘I took them only if my chest was troubling me, or when I travelled overseas for business meetings, to spare myself the embarrassment of a dripping nose. ’
Tony’s doctors warned him not to take them too often because of serious side-effects such as a hormone disorder called Cushing’s syndrome, so he kept to no more than once every three months. But his doctors never mentioned another serious risk: that, in fact, glucocorticoids can cause diabetes.
‘During a trip to South Korea, a day after taking a dose, I found myself very thirsty and tired, and needing to go to the loo a lot,’ says Tony, who is married with two daughters and a grandson.
‘I didn’t think much of it, but when I got home my jet lag didn’t recover. I was exhausted and I started losing weight.
‘After two weeks of this, I Googled my symptoms. Straight away, diabetes came up.’
Concerned, Tony bought a home blood sugar test and found his levels were much higher than normal. He went to see his GP, who did more tests and confirmed he had type 2 diabetes.
This is where the pancreas fails to produce enough insulin, the hormone that helps glucose enter the cells where it can be used as energy. If there is not enough insulin, excess sugar builds up in the bloodstream, causing symptoms such as excessive thirst, weight loss, hunger and fatigue.
Not only was Tony showing the symptoms of diabetes, a urine test showed the presence of ketones — acids which build up in the blood when a diabetic patient’s insulin is dangerously low. Ketones can lead to ketoacidosis, a cause of diabetic coma and even death.
‘I told my doctor about my medication and he said: “You’ve got steroid-induced diabetes.” I’d never heard of it,’ says Tony.
The GP sent Tony to the diabetes clinic at the local hospital. He was given insulin and shown how to administer the injections. Within days his tiredness and thirst had faded.
Doctors told him his type 2 diabetes would be with him for life. The drugs he had taken to ease his chest problems had left him with a permanent and potentially life-threatening condition.
‘No one told me the steroids could cause diabetes,’ says Tony. ‘I felt gutted that for the rest of my life I’d have to inject myself.’
In fact, steroid-induced diabetes is ‘very common’, says Dr David Price, a diabetes expert at the Morriston Hospital, Swansea.
‘Glucocorticoids are life-saving in many situations. But the unavoidable consequence is that they raise blood sugar.’
The drugs mimic the hormone cortisol, which is produced by the adrenal gland.
Cortisol is known for its anti-inflammatory effect, which is why these medications are prescribed for inflammatory conditions such as arthritis and asthma — but it also affects the way the body metabolises sugar.
‘Cortisol is a stress hormone,’ says Dr Price. ‘When you’re stressed, it acts to free up glucose from the liver because you need this energy to get to the muscles.’
As a result, blood sugar levels go up. And while many people on glucocorticoids see their blood sugars drop back to safe levels once they stop taking steroids, some, like Tony, develop full-blown diabetes, Dr Price explains.
‘In most people, their insulin will counteract these raised sugar levels,’ says Dr Price.
‘However, in some cases there may be a slight problem with insulin production anyway — this won’t have been an issue before.
‘But the steroids cause an added strain on the pancreas, causing the patient to become permanently diabetic.
‘It can depend on the dose you’re on, and underlying risks like whether you’re overweight and whether there’s a family history of diabetes,’ adds Dr Price.
‘When older people are put on a big dose of steroids, for example, a significant minority would become diabetic.
‘And if someone is already diabetic, they may go from being on tablets to having to inject themselves. Patients should be warned of the risks.’
Tony, however, had no family history of diabetes and was not overweight. He’d also had regular blood tests for years during routine medical checks, which he says had always been normal.
Frustrated at his experience, Tony began to question whether there was anything he could do about his new condition.
‘I knew insulin is a very unstable thing. If you get your doses wrong and your blood sugar goes too low, you can get diabetic “hypos”, and if you don’t control your diabetes you can have strokes, amputations, problems with eyesight, all kinds of things.
‘On my fourth visit to the diabetic clinic I asked the nurse if I could try reducing my insulin dose slowly over time and see how it went. I did and my blood sugar went back to near normal within two to three weeks.
‘The clinic confirmed I no longer needed to inject, but said I was still mildly diabetic, so they put me onto a daily Metformin tablet. That’s been the case for four years.’
Tony now avoids glucocorticoids and his asthma has been greatly improved thanks to an inhaled steroid called Seretide.
Delia Balan, asthma nurse specialist for leading health charity Asthma UK, says oral steroids should be prescribed only when asthma cannot be controlled by other means, such as inhalers.
‘We’re trying to encourage health professionals to give clearer advice about when to take steroids, and making a patient plan to reduce the dose over time.’
She says patients should be given tips such as washing their mouth out after taking oral steroids to reduce risks of side-effects.
Meanwhile, doctors should be aware of alternatives such as montelukast, a new non-steroid medication for asthma, or Xolair, an injected medication for severe asthma, offered at a few centres across the UK.
Libby Dowling, clinical adviser at the charity Diabetes UK, says it’s vital doctors discuss the risks of diabetes with patients when prescribing high doses of steroids.
She adds: ‘If people notice any symptoms such as increased thirst, unexplained weight loss, frequent urination, tiredness and blurred vision, it is important they see their doctor.’
Tony is relieved he’s got his diabetes under control, but still wishes he’d been warned about the side-effects of gluco-corticoids.
‘So many people have blind faith in their doctors. I wonder what would have happened if I hadn’t questioned my treatment — and whether many other people are on lifelong insulin unnecessarily.’
For more information go to asthma.org.uk and diabetes.org.uk.
Side Effects Of Injectable and Oral Steroids In Cats
This article is part of our Cat Asthma series.
Download the Full Guide to Cat Asthma
Oral and injectable steroids are commonly prescribed to treat certain conditions in cats. However, the problem with these oral steroid medications is that they can have many potential side effects. As a result, using these medications long-term isn’t recommended.
What Are Oral And Injectable Steroids?
Oral corticosteroids (often called oral steroids) are medications taken by mouth in either liquid or pill form to reduce inflammation. Injectable steroids are similar but are delivered through a needle. These synthetic corticosteroid medications are meant to resemble a hormone naturally produced in the body called cortisol. 1 Cortisol’s main function is to break down sugars and reduce swelling and inflammation.
Unlike anabolic steroids that increase muscle mass (like in human bodybuilding and sports), corticosteroids are considered catabolic steroids— they help lower inflammation and, in higher doses, suppress the body’s immune system.2
What Are Steroids Used For In Cats?
Steroid medications are commonly used to treat a variety of conditions in cats, ranging from inflammatory conditions to conditions where the immune system is overactive and the body begins to attack normal, healthy cells. Depending on the severity and nature of the condition, the treatment dose will differ.
Some inflammatory conditions steroid medications are used to treat include:
- Other Respiratory Conditions
In higher doses, corticosteroid medications are used to treat overactive immune system (immune-mediated) conditions such as:
- Inflammatory Bowel Disease (IBS)
- Hyperactive immune system
- Haemolytic anaemia
- Other immune-mediated conditions3
Steroids and their anti-inflammatory properties play an important role in respiratory disease management. They help prevent asthma attacks by suppressing inflammation in the airways which otherwise causes swelling and airway blockages. Inflammation is one of the hallmarks of asthma and chronic bronchitis and requires regular steroid use for the life of the pet to keep it under control. However, oral and injectable steroids can cause health side effects when used regularly. To mitigate side effects, a preferred alternative to injectable or oral steroids is an inhaled steroid medication. (jump ahead to Oral Vs. Inhaled Steroids)
Types Of Systemic Steroid Medications For Cats
Although there are several other forms of corticosteroid medications (such as inhaled and injected), the main types of oral steroids prescribed for cats include:
Injected options include depo-medrol (Pfizer, methylprednisone) and dexamethasone.
These corticosteroids are synthetic and much more potent than steroids naturally occurring in the body and typically last much longer. This combination of strength and length of time that they are active in the body is what can cause the serious side effects when used long term.
The Difference Between Prednisone And Prednisolone
While both have similar effects, prednisolone is the metabolized form of prednisone. Prednisone must be metabolized by the liver before it can be used effectively. Cats are not able to absorb and convert prednisone into the active metabolite, prednisolone. This means there is a higher bioavailability of prednisolone—it is absorbed at a higher rate and degree than prednisone.4 Unfortunately, both forms can still cause unwanted side effects.
What Are The Side Effects Of Oral Steroids In Cats?
Oral and injectable medications need to be processed by the body. Once in the bloodstream, they spread throughout the entire body system. Only some of the medication goes to the intended target, the rest could impact other organs as well.
This is why these types of medications are often referred to as systemic steroids. As such, there are many side effects associated with oral and injected steroid use.
Short-term side effects are expected soon after a cat begins to take oral and injected corticosteroids. These effects will vary by dose. Long-term side effects are seen over time if a cat has been prescribed long-term treatment with oral corticosteroids. The severity of these effects depends on the dose and duration of treatment.
Side Effects Of Prednisone, Prednisolone, And Dexamethasone In Cats
As prednisone, prednisolone, and dexamethasone are all oral corticosteroids, they have similar short-term and long-term side effects in cats.
Short-term effects of oral corticosteroids:
- Loss of energy
- Increased risk of infection
- Increased thirst and appetite
- Weight gain
- Frequent urination
Long-term effects of oral corticosteroids:
- Lethargy/fatigue (no energy to play)
- Change in behaviour (such as aggression)
- Suppressed immune system function
- Increased risk of bacterial/fungal infections
- Increased risk of urinary tract infections
- Poor wound healing
- Stomach ulcers
- Weight gain / obesity
- Impaired wound healing
- Cushing’s disease
- Loss of bladder control
- Hair loss
- Increased blood pressure
- Allergic reaction
- Skin or coat changes5
These side effects may reduce the quality of life of not only the affected cat, but also the family relationship. Cats who are lethargic or have a change in behaviour may be unable or unwilling to play and may no longer seem like the cat you knew.
Can Cats Be On Oral Or Injected Steroid Medications Long-Term?
In the case of feline asthma, systemic steroids may be used by a vet during an asthma attack. However, because of the many side effects of using oral steroids, they should not be used for long-term disease control.
The goal of systemic steroids is often to get an immediate respiratory response if the cat is in distress. The cat can then be transitioned to inhaled steroids for regular management. According to Plumb’s Veterinary Medication Guides 6, the goal of oral steroid treatment is to find the lowest dose possible and use it for the shortest period of time. For chronic conditions that require ongoing treatment, this becomes problematic.
Oral Vs. Inhaled Steroids For Cats With Asthma: Why Inhaled Steroids Are Considered Safe And Effective
Because cat asthma and chronic bronchitis are life long conditions, corticosteroids are an important part of daily disease management to keep the airways clear and help cats with these conditions live a normal life.
Inhaled corticosteroids are a safer alternative to oral and injectable steroids, lacking the side effects that can be common to systemic steroids. Inhaled steroids are designed to be used on an ongoing basis for inflammation and symptom control without exposing the cat to the risks of systemic medications. There are two key differences between inhaled and systemic steroids that make them safer:
1. Inhaled Steroids Target The Lungs Directly
Inhaled corticosteroids target the lungs and airways directly. Unlike systemic steroids where only some of the drug reaches the lungs (and the rest is spread throughout the body), inhaled steroids go directly to the active site where they are needed.
2. Inhaled Steroids Require A Much Lower Dose
Because Inhaled steroids target the lungs directly, the concentration of steroid can be much less. Systemic steroids have to be given in much higher concentrations to ensure that an appropriate dose reaches the airways after first being metabolized and then indiscriminately sent throughout the body.
Using a substantially lower dose to achieve the same therapeutic effect can significantly lower the risk of harmful side effects.
Keep Your Pet Safe Long-Term
The typical goals of asthma management are risk reduction and symptom control. According to the Global Initiative for Asthma (GINA)7, the intent of management is to reduce the burden to the patient and to reduce their risk of asthma-related death, exacerbations, airway damage, and medication side-effects.
In human children with asthma, inhaled steroids are considered the gold standard treatment for long term disease management. Systemic steroids are not recommended for daily asthma control. And, just like for children, inhaled steroids are considered safe and effective for cats and are a better option for the management of respiratory conditions.8
For cat owners, being informed about the side effects of injected and oral corticosteroid use is the first step in ensuring your cat is safe and healthy. Always be on the lookout for any side effects your cat may be showing after starting these medications.
Before starting your cat on oral steroids or if you are interested in transitioning away from systemic steroids, talk with your vet about using inhaled corticosteroid medications instead, and how the AeroKat* chamber can help manage your cat’s condition.
This article is part of our Cat Asthma series.
Download the Full Guide to Cat Asthma
1 Brooks, W., DVM, Veterinary Partner, “Prednisolone/Prednisone” (https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951498)
2 Brooks, W., DVM, Veterinary Partner, “Prednisolone/Prednisone” (https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951498)
3 Willows General Practice Service, “Steroid Therapy” (https://www.willows.uk.net/general-practice-service/pet-health-informat…)
4 Canna-Pet, “Side Effects of Prednisone for Cats” (https://canna-pet. com/side-effects-prednisone-cats/)
5 Hunter, T., DVM, VCA Hospitals, “Steroid Treatment Long Term Effects in Cats” (https://vcahospitals.com/know-your-pet/steroid-treatment-long-term-effe…)
6 Plumb’s Veterinary, “Prednisolone/Prednisone Medication Guide” (https://www.plumbsveterinarydrugs.com/sites/default/files/VMG-Prednisol…)
7 Global Initiative For Asthma, “Global Strategy for Asthma Management and Prevention” (https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-…)
8 Padrid, P., DVM, “Inhaled Steroids to Treat Feline Lower Airway Disease: 300 Cases 1995-2007” (https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11262&id=38656…)
Dexamethasone Side Effects | International Myeloma Fdn.
As a multiple myeloma patient, you may be treated with steroids. It is important to know the benefits, side effects, and possible withdrawal issues associated with steroid use. Always follow your healthcare team’s advice in adhering to steroid treatment.
Steroids As a Treatment for Myeloma
For many years, steroids have been an important and effective treatment for multiple myeloma, used alone and in combination with other drugs. Dexamethasone is the most commonly prescribed corticosteroid in myeloma. Other steroids commonly used corticosteroids for myeloma include prednisone, prednisolone, and solumedrol.
Steroids cause a wide range of side effects, affecting nearly every system of the body. Identifying the side effects early and managing them quickly will contribute to successful treatment. Ultimately, it will improve overall quality of life. Do not stop or adjust your medications before consulting your physician. Abrupt discontinuation of steroids can lead to withdrawal symptoms.
Potential Side Effects of Dexamethasone and Other Steroids
Steroids can affect the immune, musculoskeletal, and endocrine systems, the skin, the heart and blood pressure, the gastrointestinal tract, and the eyes. In addition, they can cause psychological and neurological problems, affecting cognition, mood, and behavior. Common steroid-related side effects include:
- “let down” or withdrawal effect
- flushing and sweating
- difficulty sleeping (insomnia)
- sexual dysfunction
- personality changes or mood alterations
- hyperactivity and jitters
- dizziness and headaches
- difficulty concentrating
- increased number of white blood cells
- muscle weakness (myopathy)
- death of bone tissue (avascular necrosis)
- muscle cramps
- weight gain in body or face
- changes affecting hair
- blurred vision
- cataract formation
- ulcers and heartburn (dyspepsia)
- gas (flatulence)
- increased appetite
- changes in taste
- higher blood sugar levels
- temporary diabetes or thyroid issues
- temporary decrease in testicular size
- swelling of hands, legs, or feet
- acne or rashes
- thinning of skin
Strategies for Continuing Steroid Treatment
- Take steroids with food.
- Steroids can cause sleeplessness. If they affect you in a short period of time, take your dose early in the morning or, if it takes a while to affect you, take your dose before going to bed at night. If you’re having difficulty sleeping, avoid alcohol, caffeine, and electronic screens before bedtime.
- Discuss stopping or reducing the dose with your doctor if you are having cognitive or behavioral problems.
- Take medication to prevent gastrointestinal issues.
- Medications may be prescribed to prevent infection, especially shingles (herpes zoster), and thrush (white coating on tongue, bad taste, and painful swallowing).
- Know the signs and symptoms of high and low blood sugar: aggressiveness, confusion, difficulty walking, increased thirst, and frequent urination. If you have known diabetes, consult with your endocrinologist prior to starting treatment with steroids.
- Avoid taking clarithromycin (Biaxin®), which can increase circulating levels and side effects of steroids.
- Always report symptoms to your healthcare provider.
Steroids and Interactions with Other Drugs
Drugs of many types can interact with steroids.
It is very important to tell your healthcare team about all prescription and over-the-counter medications you’re taking. Also share what the vitamins, supplements, and herbal preparations you take.
Among the drugs that can interact with steroids are:
- diuretics that affect potassium levels
- antibiotics such as erythromycin, clarithromycin, rifampicin, and azithromycin
- anticoagulants such as warfarin and aspirin
- diabetes medications
- ephedrine (found in weight-loss products)
- estrogen-containing medications (oral contraceptives and hormone replacement therapy)
- NSAIDs such as aspirin, ibuprofen, and naproxen
Prednisolone and Prednisone for Dogs and Cats
General Drug Information and Indications
How to Give this Medication
More Information About This Medication
Search for Prednisolone Dosage Forms
Search for Prednisone Dosage Forms
General Drug Information and Indications
Prednisone and prednisolone belong to a group of drugs known as corticosteroids. They are used to manage inflammation in diseases or conditions where the immune system has a significant role. The body manufactures a natural corticosteroid called cortisol in the adrenal gland. The anti-inflammatory effects of prednisone and prednisolone are about four times stronger than those of the naturally occurring cortisol.
Common uses for prednisone and prednisolone include the management and treatment of immune system diseases such as lupus, hemolytic anemia or thrombocytopenia; many central nervous system disorders; some types of cancer; skin diseases; allergic reactions such as hives and itching; orthopedic diseases; hormonal disorders including Addison’s disease; respiratory disease such as asthma; inflammatory bowel diseases; and many other conditions. Check with your veterinarian about the specific reason your pet is taking this medication.
Cats may require higher doses than dogs in order to achieve clinical response, but they are less likely to develop adverse side effects.
Like many other drugs in veterinary medicine, this drug is not FDA approved for use in animals and is not available from a veterinary pharmaceutical manufacturer. Instead, it is compounded by a specialty pharmacy.
Prednisone and prednisolone are commonly used within veterinary medicine, and are considered accepted practice.
How to Give this Medication
Give this medication to your pet exactly as your veterinarian prescribes. If you miss giving your pet a dose of prednisone or prednisolone, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not double dose to catch up.
Give oral prednisone or prednisolone with food to reduce the chance of stomach irritation. When given once daily for dogs, it’s best given in the morning. When given once daily to cats, it’s best given in the evening, as this is closest to the animals’ natural hormone cycle.
The doses of prednisone or prednisolone that are used in an emergency and in the treatment of autoimmune diseases are higher than the doses used under other circumstances.
Wash your hands after giving your pet this medication.
Be sure to discuss any side effects with your veterinarian immediately. Short-term administration of prednisone or prednisolone is unlikely to cause serious side effects.
Because these drugs affect almost all the systems in the body, they may cause a number of different side effects. The higher the dose and the longer the medication is given, the greater the chance of side effects. Short-term use of prednisone or prednisolone is unlikely to cause adverse effects.
The most common side effects in dogs include increased thirst, urination, and appetite. Because drugs like prednisone and prednisolone suppress the immune system, your pet may be more susceptible to infections. Contact your veterinarian if your pet shows signs of fever or infection.
Other side effects that may occur, especially with long-term dosing may include Cushing’s disease, which may appear as dry hair coat, hair loss, or development of a pot belly. Some animals may become aggressive while on prednisone or prednisolone.
Although cats are less likely to develop side effects than dogs, increased thirst, increased urination, increased appetite, weight gain, GI problems, and behavioral changes occur occasionally. If your cat is diabetic and on insulin, it’s insulin dose may require a change.
Keep this and all drugs out of reach of children. Prednisone and prednisolone are prescription drugs and should be used according to your veterinarian’s directions, and only given to the animal for which it was prescribed. Do not give this medication to a person.
Do not stop giving your pet prednisone or prednisolone abruptly; particularly if it has been receiving high doses or has been on the drug for a long period of time. This can cause serious, even life-threatening consequences. The dose must be tapered. Your veterinarian will advise you on how to slowly stop the medication.
Prednisone and prednisolone suppress immune response. Animals receiving prednisone or prednisolone may be more susceptible to bacterial or viral infections. Prednisone and prednisolone can also mask signs of infection, such as an elevated temperature.
The immune response to vaccination may be reduced in animals that are receiving prednisone or prednisolone.
Prednisone and prednisolone is not generally used in patients with systemic fungal infections. The treatment of Addison’s disease may be considered an exception.
Prednisone must be converted to prednisolone in the liver. Animals in liver failure should receive prednisolone rather than prednisone.
Prednisone and prednisolone should be avoided or used very carefully in young animals both because of immune suppression and the risk of GI ulcers. It should be avoided during pregnancy and lactation unless the benefits outweigh the risks.
Be sure to review with your veterinarian any medications or supplements your pet may be receiving.
Drugs that may cause drug interactions with prednisone and prednisolone include aspirin and other salicylates, phenytoin, phenobarbital, rifampin, cyclosporine, erythromycin, mitotane, anticholinesterase drugs such as neostigmine and pyridostigmine, amphotericin B, or diuretics, such as furosemide.
The risk of stomach ulcers may be increased if prednisone or prednisolone is used at the same time with other drugs prone to causing ulcers, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Digitalis and potassium levels should be closely monitored in animals taking prednisone and prednisolone.
Prednisone and prednisolone may increase insulin requirements in diabetic animals.
If you suspect your pet or another animal was overdosed accidentally or has eaten this medication inadvertently, contact your veterinarian or the A.S.P.C.A.’s Animal Poison Control Center at 888.426.4435. Always bring the prescription container with you when you take your pet for treatment.
If you or someone else has accidentally ingested this medication call the National Capital Poison Center at 800.222.1222.
Different strengths or dosage forms of prednisolone and prednisone may have different storage requirements. Read the labeling or ask your pharmacist for the storage requirements of the prescription you receive.
More Information About This Medication
Corticosteroids are hormones produced by the adrenal gland. Cortisol is the naturally occurring corticosteroid hormone. Corticosteroids are essential for life and affect the animal’s metabolism and the function of all cells and organ systems. Their anti-inflammatory effects are due to multiple actions at the cellular levels.
There are two major types of hormones produced by the adrenal gland, the mineralocorticoids and the glucocorticoids. This monograph discusses prednisone which is a synthetic glucocorticoid or corticosteroid. There are many different corticosteroid drugs available and different medical conditions are treated with different corticosteroid drugs based on the individual drug’s pharmacology (potency, speed of onset, duration of action). The other types of hormones produced by the adrenal gland are called mineralocorticoids. They primarily control salt and water balance in the body.
Chronic or inappropriate use of corticosteroids can cause life threatening hormonal and metabolic changes.
Cushing’s disease (hyperadrenocorticism) is caused by excess corticosteroid. Addison’s disease (hypoadrenocorticism) is caused by insufficient mineralocorticoids and sometimes glucocorticoids.
Both Cushing’s disease and Addison’s disease are potentially fatal and can accidentally occur due to overuse or abrupt withdrawal after a prolonged treatment with corticosteroids.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master’s degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.The information contained on this site is general in nature and is intended for use as an informational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of the products shown, nor is the information intended as medical advice or diagnosis for individual health problems or for making an evaluation as to the risks and benefits of using a particular product. You should consult your doctor about diagnosis and treatment of any health problems. Information and statements have not been evaluated by the Food and Drug Administration (“FDA”), nor has the FDA approved the products to diagnose, cure or prevent disease. Wedgewood Pharmacy compounded veterinary preparations are not intended for use in food and food-producing animals.
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90,000 Anabolic steroids and male reproductive health
As amended from 11. 10.2019
Anabolic androgenic steroids are commonly used drugs to improve muscle strength and mass, as well as athletic performance. Most people who use anabolic steroids are non-professional athletes, and many of them are teenagers. This phenomenon has spread among ordinary amateur athletes, including those who go to the gym “for themselves.”
When using steroids, people try to get the maximum anabolic effect (muscle building effect) and minimize the androgenic effect responsible for the development of male sexual characteristics. The ratio of the anabolic to androgenic effect of testosterone is 1: 1. For other anabolic steroids used, this ratio varies and may even exceed 30. Steroids can be modified in different ways to achieve a certain effect, and not all drugs are aimed at gaining bulk muscle mass.
The side effect of androgenic effects of the drug depends on the dosage and duration of use . Other hormonal medications are commonly used to maximize the desired effects and prevent side effects. The androgenic-estrogenic balance in tissues is unstable, and therefore side effects are tried to be prevented by other drugs. Websites selling anabolic steroids usually offer kits that include drugs in addition to androgenic steroids to treat the side effects of these steroids.These drugs, for their part, also partly negatively affect health.
Anabolic androgenic steroids also significantly affect the activity of the gonads, disabling the production of androgens and sperm in the testicles. These effects appear differently in different people and cannot be predicted.
Testicular function and its disorders
The function of the testicles is the production of sperm and sex hormones, mainly testosterone. Normal testosterone production ensures the development of male sexual characteristics, and also contributes to maintaining a high level of testosterone in the testes (the concentration of testosterone in the testes is several tens of times higher than in the blood), which is necessary for normal sperm production.
The functioning of the testicles is controlled by the pituitary gland. Anabolic androgenic steroids, which are injected from the outside, disrupt the regulation of the normal functioning of the pituitary gland. With insufficient regulation of the pituitary gland, the own production of testosterone in the testes decreases, which leads to a decrease in sperm production, up to a complete cessation. Anabolic steroids cause a dose-dependent dysfunction of the pituitary-testicular axis by inhibiting the secretion of testicular gonadotropins produced in the pituitary gland, which stimulate testosterone production.This leads to a decrease in your own testosterone production, a decrease in the size of the testicles and a violation of sperm production. This can lead to infertility. Externally administered testosterone is unable to produce high levels of testosterone in the testes and actually decreases it, as the levels of gonadotropins secreted by the pituitary gland, which stimulate testicular function, are lowered.
Physicians who treat infertility are familiar with the effects of anabolic androgenic steroids on sperm production.According to some studies, about one in four people who use anabolic steroids do not have sperm production; about every second has a decrease in sperm production, compared with normal values; only a quarter of people who use anabolic steroids have normal sperm production. Anabolic steroids also affect the structure of the sperm. Especially during adolescence, anabolic steroids can cause irreparable damage to sperm production.
The effect of anabolic steroids (androgens) on sexual desire
Sex drive (or libido) is mainly controlled by testosterone. Anabolic steroids can lead to increased libido. Increasing libido can be problematic, as high-dose androgen use can also increase the likelihood of violent behavior.
A common problem is a situation that occurs after the use of steroids, when the body stops producing testosterone for a long time. This is familiar to anyone who uses steroids. At the same time, the concentration of testosterone in the bloodstream is insufficient to maintain normal libido, therefore, such hormonal disturbances can lead to a loss of libido. In addition, testosterone deficiency is associated with a myriad of other symptoms and health hazards.
A very pronounced decrease in testosterone concentration can also lead to erectile dysfunction and mental disorders. For example, a significant deterioration in the performance of a weightlifter may be accompanied by an increased risk of a new androgenic cycle.
Other Side Effects of Anabolic Steroids
Other major side effects of anabolic steroid doping have recently been identified, at least indirectly affecting reproductive health as well. Some had symptoms of a psychiatric nature and severe mood disorders: hyperactivity, irritability, aggressiveness, hyperexcitability, impaired concentration, reckless behavior, and other symptoms of a psychotic nature. Suicidal thoughts and actions were also noted. Only a few people experienced such symptoms, and there is no exact data on what the mental state of these people was before they started using anabolic steroids. There is compelling evidence of a negative effect on the heart: those who used anabolic steroids were diagnosed with a pathology of the heart muscle, which is associated with a weakening of cardiac function. Some pathological changes in the heart can be reversible if the person stops taking steroids.However, if the use of anabolic steroids has led to the destruction of heart muscle cells, then the changes are irreversible. Pathological changes in the liver can be fatal or require a liver transplant.
Study of effects and therapy
People who use anabolic steroids are somewhat aware of the problems that arise, but, for example, at the doctor’s office, they do not mention that they are using steroids. Thus, the side effects of steroid use may go unnoticed and treatment may not be optimal. On the other hand, general practitioners may have a rather superficial knowledge of the effects of steroids on the body.
A medical examination may reveal signs of long-term androgen use such as acne, stretch marks on the skin, breast enlargement and possible injection marks. Laboratory tests can show high hemoglobin levels and low HDL cholesterol (called good cholesterol), as well as abnormal liver function. As a result of long-term use of androgens, a significant decrease in the size of the testicles can be observed.
The effect of anabolic androgenic steroids on reproductive function largely depends on the drugs used, doses and timing of use. According to hormonal studies that reflect testicular function, typical abnormalities may be observed. Semen studies have shown that a significant proportion of steroid users may have no sperm at all. It should also be remembered that the use of anabolic steroids does not rule out
other causes of male infertility.Previously, it was believed that the changes caused by the use of anabolic androgenic steroids are reversible. However, for some side effects, this is obviously not the case. Severe side effects, such as effects on the heart and liver, can lead to chronic effects such as heart failure, sudden death and, in the case of liver, liver transplantation due to severe hepatic impairment. Testosterone: It can take a long time to restore normal sperm production, and even patient waiting does not always pay off.These functions are not restored for everyone. Generally, the most effective effective method is simple: completely stop using anabolic androgenic steroids. Therapy will be successful if the person understands the connection between androgen use and the development of disorders, and also realizes that it will take time to recover.
Maintenance of physiological testosterone concentrations (i.e. testosterone replacement therapy) may be required during the recovery phase if severe and prolonged hypofunction is noted.However, the risk of abuse cannot be ruled out. Substitution therapy should be confidential. It should be borne in mind that physiological replacement therapy slows down the recovery of sperm production. Therefore, in the course of treatment, you have to balance between subjectively unpleasant symptoms of testosterone deficiency and a positive effect on health in the future.
Dr., Associate Professor
Department of Reproductive Medicine and Andrology
Specialist in Gynecological Diseases, Department of Obstetrics and Gynecology, Turku University Hospital
Department of Biomedicine / Physiology, University of Turku
Changes made by:
Doctor of Medical Sciences, Associate Professor
endocrinologist, specialist in internal medicine
Dexamethasone (Systemic) | Memorial Sloan Kettering Cancer Center
This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects, and when you should contact your healthcare provider.
Trade names: USA
Active Injection D [DSC]; Decadron; Dexabliss; Dexamethasone Intensol; DexPak 10 Day [DSC]; DexPak 13 Day [DSC]; DexPak 6 Day [DSC]; DoubleDex; Dxevo 11-Day; Hemady; HiDex 6-Day; LoCort 11-Day [DSC]; LoCort 7-Day [DSC]; MAS Care-Pak; ReadySharp Dexamethasone; TaperDex 12-Day; TaperDex 6-Day; TaperDex 7-Day; TopiDex; ZCORT 7-Day; Zodex 12-Day [DSC]; Zodex 6-Day [DSC]; ZonaCort 11 Day [DSC]; ZonaCort 7 Day [DSC]
Trade names: Canada
APO-Dexamethasone; Dexamethasone Omega Unidose; Dexamethasone-Omega; DOM-Dexamethasone; PMS-Dexamethasone; PMS-Dexamethasone Sod Phosphat; PRO-Dexamethasone-4 [DSC]; RATIO-Dexamethasone [DSC]
What is this drug used for?
- Used to treat a variety of health problems including allergy symptoms, bronchial asthma, adrenal gland disorders, blood disorders, skin rashes and edema.This is not a complete list of health problems this drug is used to treat. Consult your doctor.
What do I need to tell my doctor BEFORE taking this drug?
- If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
- If you have any of the following health problems: fungal or malarial infection that affects the brain.
- For herpes eye infections.
- In case of damage to the optic nerve.
This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.
Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking.Do not start or stop taking any drug or change the dosage without your doctor’s approval.
What do I need to know or do while taking this drug?
For all purposes of this product:
- This drug may interfere with some laboratory tests. Tell all healthcare providers and laboratory staff that you are taking this drug.
- You may be at increased risk of developing an infection. Wash your hands often. Try not to come into contact with carriers of the infection, incl. with people with colds or flu.
- If any signs of infection appear, such as fever, chills, flu-like symptoms, very severe sore throat, ear or sinus pain, cough, increased or discolored sputum secretion, pain when urinating, ulceration in the mouth or non-healing wounds, see a doctor immediately.
- People who take steroid drugs like this drug can get very bad and sometimes fatal chickenpox or rubella. If you have never had chickenpox or rubella, avoid contact with people who have these diseases. If you come into contact with someone with chickenpox or rubella, consult your doctor.
- The use of this kind of drugs has been associated with high blood pressure.Monitor your blood pressure as directed by your doctor.
- Prolonged use increases the likelihood of developing cataracts or glaucoma. Consult your doctor.
- This drug may cause brittle bones (osteoporosis) with long-term use. If you have an increased risk of increased bone fragility or have questions, talk to your doctor.
- Consult a physician prior to any vaccination. Using some vaccines with this drug may increase the chance of infection or make the vaccine less effective.
- If you have high blood sugar (diabetes), your blood sugar should be checked regularly. Talk to your doctor if you develop signs of high blood sugar, such as confusion, drowsiness, increased thirst and hunger, increased urination, facial flushing, rapid breathing, and fruity breath.
- Consult a physician before drinking alcohol.
- A special type of cancer (Kaposi’s sarcoma) has been reported in patients who have been taking similar drugs for a long period of time.Consult your doctor.
- If you are 65 years of age or older, use this drug with caution. You may have more side effects.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. The benefits and risks for you and your child will need to be discussed.
- If you used this drug while pregnant, tell your child’s doctor.
Treatment of malignant neoplasms:
- People with cancer who take this drug may be at an increased risk of developing a serious medical condition called tumor lysis syndrome (TLS).This can lead to death. Call your doctor right away if you experience any of the following symptoms: tachycardia or irregular heartbeat; fainting; obstruction of the urinary tract; muscle weakness or muscle spasms; nausea, vomiting, diarrhea or loss of ability to eat, feeling lethargic.
- In case of an individual allergic reaction to sulfites, consult a doctor. Some foods contain sulfites.
- Very serious health problems have been reported with similar drugs in the spinal column (epidural). These included paralysis, loss of vision, stroke, and sometimes death. It is not known if drugs like this drug are safe and effective when injected into the spinal column. These drugs are not approved for this use. Consult your doctor.
What side effects should I report to my doctor immediately?
WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:
All forms of issue:
- Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
- Signs of low potassium, such as muscle pain or weakness, muscle cramps, or a feeling of an irregular heartbeat.
- Signs of a problem with the pancreas (pancreatitis) such as severe abdominal pain, severe back pain, severe stomach upset, and vomiting.
- Signs of high blood pressure, such as very severe headache, or dizziness, or loss of consciousness, or blurred vision.
- Signs of adrenal dysfunction such as severe nausea and vomiting, severe dizziness or loss of consciousness, muscle weakness, feeling very tired, mood changes, lack of appetite, or weight loss.
- Signs of Cushing’s disease such as weight gain in the upper back or abdomen, moon face, severe headache, or slow healing.
- Feeling extremely tired or weak, irritable, trembling, heart palpitations, darkening, sweating, or dizziness if you missed a drug or recently stopped taking it.
- Shortness of breath, sudden weight gain, or swelling of the arms or legs.
- Changes in the skin (acne, stretch marks, slow healing, hair growth).
- Rapid, slow heartbeat, or irregular heartbeat.
- Pain or pressure in the chest.
- Inflammation, warmth, numbness, discoloration, or pain in a leg or arm.
- Menstrual irregularities.
- Pain in bones or joints.
- Muscle pain or weakness.
- Change in vision.
- Changes in behavior.
- Depression and other mood disorders.
- Unusual burning, numbness, or tingling sensations.
- Any unexplained bruising or bleeding.
- Severe abdominal pain.
- Black, tarry, or bloody stools.
- Vomiting of blood or vomit in the form of coffee grounds.
- Injection site irritation.
What are some other side effects of this drug?
Any medicine can have side effects. However, many people have little or no side effects.Call your doctor or get medical help if these or any other side effects bother you or do not go away:
- Nausea or vomiting.
- Sleep disorders.
- Excessive sweating.
- Hair thinning.
- Feeling dizzy, tired, or weak.
- Weight gain.
- Increased appetite.
This list of potential side effects is not exhaustive.If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.
You can report side effects to the National Health Office.
You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.
What is the best way to take this drug?
Use this drug as directed by your healthcare practitioner.Read all the information provided to you. Follow all instructions strictly.
All oral preparations:
- Take in the morning if you are taking this drug once a day.
- Take with food to prevent nausea.
- Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.
- If you are taking cholestyramine, you may need to take it at a different time from the time you took this drug.Check with your pharmacist.
All liquid preparations:
- Make sure you have the correct type of liquid; there are different concentrations.
- Care should be taken to measure the doses of the liquid preparation. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.
- Use only the measuring container supplied with the liquid preparation.
- Mix liquid with water, fruit juice, apple juice or pudding before use.
- Take the dose immediately after mixing. Do not store for future use.
All forms of issue:
- Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
- Perform blood tests as directed by your healthcare practitioner.Please consult your doctor.
- Check eye pressure regularly if taking this medicine for a long time. Consult your doctor.
- Get a bone density test as directed by your doctor. Consult your doctor.
- Do not stop taking this drug suddenly without talking to your doctor. This can increase the risk of side effects. If necessary, this drug should be stopped gradually as directed by your doctor.
- You may need to reduce your salt intake and take additional potassium. Consult your doctor.
- This drug suppresses the body’s production of steroid hormones. Tell your doctor if you have a fever, infection, surgery, or injury. The body’s normal response to such stressful situations can change. You may need to increase your steroid dose.
- This drug may affect the results of allergic skin tests.Your doctor or laboratory worker should be told that you are taking this drug.
- In some cases, the drug may affect the growth rate in children and adolescents. They may need to check their growth rate regularly. Consult your doctor.
What should I do if a dose of a drug is missed?
All oral preparations:
- Take the missed dose as soon as you can.
- If it is time for your next dose, do not take the missed dose and then return to your normal dose schedule.
- Do not take 2 doses at the same time or an additional dose.
- Call your doctor for further instructions.
How do I store and / or discard this drug?
All oral preparations:
- Store at room temperature in a dry place. Do not store in the bathroom.
- Throw away all unused portions of the drug 90 days after opening the package.
- If you need to store this drug at home, ask your doctor, nurse, or pharmacist for information about how to store it.
All forms of issue:
- Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
- Dispose of unused or expired drugs.Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.
General information on medicinal products
- If your health does not improve or even worsens, see your doctor.
- Do not give your medicine to anyone or take other people’s medicines.
- Some medicines may come with other patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
- Some medicines may come with other patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
- If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.
Use of information by consumer and limitation of liability
This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient.This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional.Check with your doctor for complete information on the possible risks and benefits of taking this drug. Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.
© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.
90,000 Prednisolone – what you need to know while taking this drug
Most often in non-medical circles it is called a steroid or glucocorticoid, many think that this is a very dangerous drug and are very reluctant to agree to treatment with this drug.
But for certain diseases, it is prednisolone that is considered a mandatory and necessary drug of the first choice in the treatment of a disease (for example, nephrotic syndrome about which you can read here).
It’s not about the drug itself and what diseases it should be prescribed for, but our information block about what doctors usually forget when prescribing prednisolone. Usually, children come for a consultation while taking prednisone in combination with asparkam. Believe me, hypokalemia (a decrease in the level of potassium in the blood) and therefore prescribe asparks is not the most frequent complication when prescribing prednisolone.
In our practice, almost 90% of patients receiving this drug are observed with a diagnosis of nephrotic syndrome.
Prednisolone is prescribed for a long time (the full course of therapy until the drug is discontinued can last 6-12 months), additional drugs must be prescribed to prevent the side effects of prednisolone. It is:
- In order to protect the mucous membrane of the upper gastrointestinal tract (esophagus, stomach, duodenum), against the background of prednisolone there may be indigestion, nausea, vomiting and more serious complications such as a steroid ulcer.However, all this can be avoided by taking the so-called – gastroprotective drugs (i.e. stomach protection in literal translation). These are antacids (eg Maalox, fosfalugel, etc.), H + pump blockers (eg Omeprazole), drugs that improve the motility of the gastrointestinal tract. All doses of drugs are selected individually according to age and body weight.
- Bone protection. Long-term use of steroids can cause a decrease in bone mass, so-called steroid osteoporosis (bone loss) can develop, which ultimately leads to bone fractures.But this condition can also be prevented, it is necessary to take calcium and Vitamin D preparations. The dose of drugs is also selected individually.
What else you need to pay attention to:
- Compulsorily monitor blood pressure
- Observation by an ophthalmologist: control of vision, the state of intraocular pressure and the lens of the eye.
- Check blood glucose levels when taking prednisone for very long periods of time.
- Mental health status. Children very often become capricious, sometimes even aggressive. This condition goes away on its own after discontinuation of the drug.
- Monitor your weight and diet. On the background of taking prednisolone, appetite is greatly increased. However, as a parent, you can control your child’s nutrition by limiting the intake of easily digestible carbohydrates.
- In order to control and evaluate the effectiveness of gastroprotective therapy, the mucous membrane of the upper gastrointestinal tract is assessed by means of EGDS (gastroscopy).
This information has been prepared by an employee of the department (pediatrician) for informational purposes. It is imperative to consult with your doctor.
If you have any questions on this topic or have any suggestions, we are happy to answer questions and accept your suggestions.
Veterinary Oncology / Veterinary Clinic ASVET Odintsovo
For owners about animal oncology
The main condition for the effectiveness of the treatment of any disease is early diagnosis, but especially the importance of this provision in oncology should be emphasized.In the late stage, the cure of a malignant tumor is a rare exception.
Among the causes of general mortality in dogs and cats, tumor diseases confidently hold the second place. The 1st and 2nd are occupied by tumors of the skin and mammary glands, respectively. Given the high frequency of detection of cancer in domestic animals, cancer alertness should be shown to both doctors and animal owners.
When a pet owner asks the doctor what caused his pet’s cancer, the question is often abstract.He has no intention of knowing what histones, DNA methylation and stage 3 carcinogenesis are. In fact, the owner implies: why did my animal get sick; you can cure him; what is the prognosis for each treatment method?
Our task is to make this secret understandable.
Why did my animal get sick?
Normal (healthy) cells are self-regulating. Abnormal (diseased cells) activate the p53 suppressor gene, which delays cell division until the abnormalities are corrected.If no correction occurs, p53 induces programmed cell death – apoptosis.
Cancer cells carry mutations and errors in genes, including the p53 gene. They avoid apoptosis and thus acquire “immortality”. After degeneration, unregulated, rapidly dividing cancer cells are characterized by a gradual change in genotype.
Genetic failures can be spontaneous or can be caused by viruses, chemicals, parasites, radioactive radiation, caused by light rays, as a result of disruption of endocrine / metabolic processes, etc.mechanisms.
So, a tumor is a group of cells characterized by continuous growth and reproduction, not controlled by the organism. “Immortality”, constant division and dysregulation of genes provide cancer cells with advantages that benign cells do not.
Benign tumors, unlike malignant ones, do not penetrate beyond the tissues in which they began to develop, or into other parts of the body. In most cases, the prognosis for benign tumors is favorable.However, they can have serious consequences if, for example, they compress vital structures such as blood vessels and nerves.
Malignant tumors are characterized by local invasion into the surrounding tissues, a high growth rate, so they reappear (recur) after surgical removal. Cancer cells are able to metastasize. Metastasis is the process of spreading tumor cells through the intercellular spaces into the bloodstream and lymph, which makes it possible for new foci of tumor growth to appear in various parts of the body.
Depending on the time of appearance and place of development, there are early and late, regional and distant metastases. The earlier metastases appear, the more malignant the tumor. Distant metastases (not regional lymph nodes, organs) are a factor of poor prognosis.
It is important to note that tumors that develop as benign can become malignant over time. Also, a certain group of diseases is distinguished that have a high risk of transition to a malignant tumor: chronic gastritis, long-term non-healing ulcers of the mucous membranes and skin, glandular degeneration of the endometrium of the uterus, adenofibrous mastopathy, accompanied by a sharp proliferation of the epithelium, etc.
Oncological alertness of the owner
Unfortunately, often animals with oncological diseases come to oncologists at rather advanced stages of the process. This affects the choice of treatment for the animal, the prognosis, as well as the patient’s quality of life. For early diagnosis and complete cure, it is important that the owners themselves have an attentive and responsible attitude to the animal, knowledge of the main signs of possible malignancy of a number of diseases. The overwhelming majority of owners are of the opinion that cancer occurs only in older older animals.This stereotype reduces oncological alertness, leads to late visits to a doctor with an already incurable stage of the disease.
For example, tumors of the mammary gland of dogs account for 25% of all neoplastic diseases in dogs and are the second most common after skin tumors in females. The peak of the disease occurs in the age group 7-10 years. In almost 50% of cases in dogs, the disease is malignant and in 25% of cases it has a poor prognosis. Factors in the development of this pathology are hormonal disorders (absence of childbirth, frequent falsehoods, drug suppression of lactation, cystic degeneration in the ovaries).One of the important criteria for predicting life in breast cancer is the size of the tumor. If the size of the mammary gland tumor is more than 3 cm in cats and more than 5 cm in dogs, the third (out of possible four) stage of the process is set and the animal is recommended not only for surgery, but also chemotherapy. At the fourth stage of the disease, even with ongoing therapy, the average life expectancy is from 1 to 2 months.
In cats, breast cancer is characterized by an extremely aggressive course, a high degree of malignancy and a poor prognosis.Benign processes can be found in the mammary gland of cats only in 10 – 14% of cases, while malignant tumors are diagnosed in 86 – 90%. The disease affects mainly animals aged 10 – 12 years, however, there are observations of the disease in cats at a young age. Breast tumors are easily diagnosed by the owners themselves. But, unfortunately, often a visit to the clinic occurs even when the tumor grows to a significant size, and this began to bother the cat or dog.
Symptoms in patients with oncology are varied, they depend, first of all, on the localization of the neoplasm.
Skin cancer is the most common cancer in dogs and cats. You can find formations while bathing and stroking your pet. Tumors of the skin and soft tissue appear as thickening on or under the skin. Very often they do not bother animals, and the owners discover them by accident. Some skin tumors look like ordinary dermatitis, and sometimes only the absence of the effect of treatment can lead to thoughts of research on oncology.If the tumor has fuzzy boundaries, is motionless relative to the underlying tissues, is characterized by rapid growth, the skin grows (the presence of ulcerations) – this indicates a malignant process and the animal needs a doctor’s consultation.
The presence of a tumor in the animal’s oral cavity is indicated by increased salivation, bad breath, impaired swallowing, weight loss or impaired appetite, as well as enlargement and induration of the mandibular and periopharyngeal lymph nodes, detected by palpation, loss of interest in chewing toys, scratching the mouth with paws …
Signs of the presence of a tumor in the nasal cavity – exophthalmos (bulging of the eyeball), asymmetry of the muzzle, sneezing, chronic, refractory, discharge from the nose and eye slits, bleeding, wheezing.
Musculoskeletal tumors account for 3.5 – 5% of all tumors in dogs and cats. Most of them are bone neoplasms, which are subdivided into: primary (osteosarcoma, chondrosarcoma, fibrosarcoma) and metastatic.
Primary bone tumors are predominantly malignant (98% of the total) and are 5 times more common than metastatic tumors.
Osteosarcoma or osteosarcoma is the most common primary malignant bone tumor in dogs and cats. With osteosarcoma, the limbs are mainly affected. The pain is localized at the site of the tumor, swelling, diffuse edema may appear. In this case, the mobility of the joint may be impaired, a pathological limb fracture may occur in the area of the neoplasm. Bone tumors occur in dogs between the ages of 6 and 7, although they are thought to occur earlier. Developing slowly, sometimes for many years, they do not show themselves in any way.The first clinical signs of a tumor, if it develops in the bones of the limb, is lameness, a clear reluctance of the dog to get up from its place, especially after lying. The impetus for the development of osteosarcoma in animals of large breeds can be the trauma suffered, although today it is not clear whether this is actually so. But there are suggestions that damage can provoke disease. It is believed that malignant bone tumors are diseases of giant and large breeds. Among the patients, St. Bernards, Doberman Pinschers, Irish Setters, Danish Great Danes, German Shepherds, and Golden Retrievers are registered.Nevertheless, according to experts, the size of the animal is a more significant factor in the appearance of osteosarcoma than belonging to a particular breed.
Tumors of the testes account for 15% of all tumors arising in males. The average age of the animals is 7 years. Formations are easy to detect when examining and palpating the scrotum. In most cases, tumors arise in one testis, and about a third of them affect the non-descended testis. In this case, the tumor is located in the inguinal canal or in the abdominal cavity.
Tumors of the vestibule of the vagina – the urogenital canal ending with an external opening – are predominantly sarcomas. The initial stages of their development are asymptomatic. However, many dogs at this time become restless, often urinate. Later, bloody mucus begins to stand out from the genital slit. Sometimes it is brick red or resembles meat slop. Therefore, frequent licking of the external genitalia can be a sign of tumor development in a dog. With its strong increase, the perineum protrudes.A tumor of the vaginal wall (usually benign leiomyoma) occurs mainly in females over 5 years old. Unlike sarcoma, it is a smooth, well-defined muscle knot and does not show bleeding, so that the two diseases can be distinguished. In cases where the neoplasm grows towards the tissues surrounding the vagina, it can be felt through the dog’s perineum. Clinical symptoms will be difficulty in the act of urination, less often, defecation.
Discharge from the prepuce, the skin fold covering the dog’s penis, should also alert the owner, especially if it intensifies and becomes purulent, dirty brown, with an unpleasant odor (which occurs when the tumor decays).
Tumors of internal organs in dogs are difficult to diagnose due to the absence of any specific signs and clinical manifestations that could indicate a tumor lesion of one or another organ. Even when the tumor reaches a significant size and there are changes in the activity of the body, then the symptomatology is very general in nature, which does not allow suspecting a tumor process. Among such common phenomena observed, for example, with tumors of the liver and spleen, include ascites (accumulation of fluid in the abdominal cavity), pallor of the mucous membranes (as an external manifestation of anemia), weakness, refusal to eat, thirst.Ovarian tumors clinically can manifest themselves in estrus disturbance, lengthening of the estrus phase with constant bloody discharge. With tumors of the bladder and kidneys, hematuria (blood in the urine), dysuric phenomena (urinary disorders), weakness, weakness can be noted. When tumors of the stomach develop phenomena associated primarily with obstruction (vomiting eaten, exhaustion, weakness). Tumors of the internal organs lead to a decrease in their function, which will manifest itself with its own symptoms.Yellowness of the skin and mucous membranes, weight loss, digestive problems can appear with liver cancer. A swelling in the intestine can lead to symptoms of obstruction – first of all, frequent, prolonged vomiting, stool disturbances (visible blood in the stool, discoloration, regularity, difficulty in defecating). Coughing, shortness of breath, impaired coordination of movements are also a reason for an immediate visit to a doctor. syncope (short-term fainting), exercise intolerance.
Biochemical products of tumors in advanced stages often cause malaise and anorexia (refusal to eat). At the same time, other substances can mediate chemical signals that mimic wound healing, and catabolic processes will occur in the deceived, emaciated body to provide the tumor with proteins and nutrients. Therefore, the most common cancer conditions are malnutrition and cachexia (wasting).
This is not a complete list of alarming symptoms that can appear both separately and in combination, requiring immediate examination and diagnosis.
Diagnosis is necessary for prognosis and correct treatment
Diagnosis begins with anamnesis. The doctor will ask you to evaluate the dynamics of tumor growth, the duration and sequence of symptoms. Age and breed, sex, type of animal are also taken into account.
Further, for the correct treatment, it is necessary to answer two basic questions:
1. What is it (including diagnosis and grade)?
2. Does the tumor spread (locally, regionally, systemically)?
Answers to these questions will be obtained through the diagnosis and determination of the stage of the neoplasm.
Staging is important for determining the extent of the lesion. It is based on examination of the tumor, local and regional lymph nodes, and distant areas such as the lungs. Areas for research are selected taking into account the known biological characteristics of the tumor.
To determine the type of tumor and its stage:
Minimum diagnostic spectrum:
1. Fine needle aspiration biopsy is a cytological study (at the cellular level).The procedure is fast. Used to give an initial assessment of the tumor and diagnose either inflammation or neoplasia. When the results of only one cytological study are not enough, a biopsy (examination at the tissue level) is performed.
2. Thick needle biopsy. This type of biopsy allows you to obtain a slightly larger area of tissue. For its implementation, a thick needle equipped with a cutting device is used. The advantage of this type of biopsy is that a larger tissue site for histological examination allows for a more accurate diagnosis.
3. Incisional biopsy. This biopsy technique involves cutting off a small piece of tumor tissue. It already looks more like surgery. This biopsy is done under local anesthesia. An incisional biopsy is often done when the results of an aspiration biopsy are insufficient.
Tissue biopsy confirms cytology and is the “accepted diagnostic standard” for evaluating completeness of removal and staging a tumor to help predict prognosis.
However, damage to the tumor can lead to the fact that cancer cells can be carried into the wound channel, so the puncture or incision site should be located in such a way that it is also removed during excision.
The most common form of biopsy in animals is complete removal of the tumor followed by histological examination.
4. Chest X-ray and ultrasound examination of the abdominal cavity to exclude the fact of tumor metastasis.
5. Hematological examinations (blood tests). If the location of the tumor remains unknown or additional evidence is required apply:
6. Endoscopic research methods,
7. Magnetic resonance imaging, computed tomography.
8. Laboratory methods include morphological examination of blood, bone marrow.
If there is fluid in the chest and abdominal cavities, they are also subjected to cytological examination.
If cancer is confirmed
First of all, we must try not to fall into despair and not see cancer as the “last” disease of our time, firmly associated with suffering. Veterinary oncology is developing rapidly. The accumulated knowledge of practicing doctors in this area will allow either to cure the animal completely, or to significantly prolong its life, reducing the intensity of the disease, i.e. improve the condition of the animal by reducing the rate of development of the disease and prolonging the good quality of life.
The goal of all cancer treatment options is to inhibit the division of tumor cells and their irreversible destruction, that is, to suppress the possible recurrence of the disease.
Methods of local (local) exposure: surgery, radiation therapy, cryodestruction, hyperthermia, etc.
Methods of systemic exposure: chemotherapy, immunomodulatory therapy.
Surgery is the most common treatment for cancer in pets and can be very effective if the cancer is localized and enough tissue is removed.Diagnostics combined with comprehensive staging makes it possible to decide on the need for only surgery or the simultaneous use of additional therapy
Chemotherapy is most commonly used to treat systemic rather than local cancer, and it can also be used when injected into a cavity or inside damaged tissue (interstitially). Chemotherapy is indicated when it is known that the tumor is sensitive to it, also when the risk of developing systemic cancer is unknown or increased.
Each method has its own advantages and disadvantages. Depending on the location of the tumor and its sensitivity to the chosen method of treatment, one treatment option will be more effective than the other. Sometimes, to achieve the goal, it is necessary to combine several types of treatment, the so-called combination therapy.
After the owner is informed of the diagnosis, stage, treatment options, and response to treatment, the owner and veterinarian decide on a treatment goal.
Treatment goals: cure, prolong and improve quality of life, temporary relief of symptoms and observation.
Healing therapy has the goal of completely eliminating the disease. It is a radical treatment that maximizes cancer clearance while preserving normal tissue, which involves the use of non-surgical treatments such as chemotherapy and radiation to areas that may contain viable cancer cells. Cure is always the optimal goal, but not always possible due to the diagnosis / stage of the disease, the body’s reserves and the financial capacity of the owner or the limits of risk.
Reducing the intensity of the disease is a treatment aimed at reducing the rate of cancer development, prolonging the high quality of life.
Relief is a treatment aimed at minimizing the suffering of an animal and possibly prolonging life while maintaining its good quality, but the final stage is euthanasia.
Observation is a continuous targeted examination that is necessary to change or establish a different goal of treatment. During observation, the animal may or may not receive treatment.All treated animals need regular medical supervision, taking into account changes in the course of the disease.
Oncological alertness is the key to successful cancer treatment
Having discovered a tumor in your pet, do not expect that it will disappear by itself. Do not waste such precious time for you and for doctors. In the later stages, the diagnosis of tumor malignancy does not cause difficulties, but the treatment is much more difficult. More often than not, it is for this reason that we are unable to help our patients, and they continue to die of cancer.
Remember that a complete cure is possible only with timely treatment and early diagnosis of tumors.
A specialized veterinary oncologist, Elena Nikolaevna Shvydkina, is attending our clinic.
Reception of an oncologist is conducted by appointment .