Short-Term & Serious Side Effects

Common short-term prednisone side effects include nausea, weight gain and headaches. More serious side effects include fetal toxicity, allergic reactions and high blood pressure. Prednisone side effects are more likely to occur with larger doses or long-term therapy.

Common Short-Term Prednisone Side Effects

Common side effects of prednisone tend to be mild, especially with lower doses and short-term use. They may last a few days to a few weeks. If side effects persist or worsen, talk to your doctor or pharmacist.

Women are more likely to experience prednisone side effects, which can vary in severity and type, depending on a person’s overall health, age and other medications they take.

Common prednisone side effects include:

• Acne
• 
  Blurred vision
• 
  Changes in behavior or mood
• 
  Dizziness
• 
  Elevated blood pressure levels
• 
  Elevated blood sugar levels
• 
  Fluid retention
• 
  Headache
• 
  Increased appetite
• 
  Insomnia or fatigue
• 
  Nausea
• 
  Restlessness and inability to stay still (akathisia)
• 
  Sleep problems
• 
  Swelling
• 
  Thinning skin
• 
  Vomiting
• 
  Weight gain

Many people take prednisone with only minor side effects — or none — but each method of taking corticosteroids can present its own unique side effects. In its liquid form, prednisone can cause a sore mouth, sore throat and stomach pain.

Other corticosteroids come as inhalers, as topical creams or as IV fluids. Fluticasone in asthma medications, such as Advair, comes in an inhaler. Hydrocortisone often comes as a cream. Methylprednisolone comes in tablet form, but medical providers can also deliver it intravenously for multiple sclerosis patients.

Serious Prednisone Side Effects

The most serious prednisone side effects usually include allergic reactions, infections, gastrointestinal issues and elevated blood sugar. These may occur when people take larger doses or take the medication for long-term treatment.

Some side effects and what to expect from them include:

Allergic Reactions:

The most prevalent reactions are hives, skin rashes, itching, difficulty breathing, and swelling of the lips, tongue or face. If you experience any of these symptoms, contact an urgent-care provider or your local emergency room.

Bone Loss:

One study showed that up to 40% on a long-term treatment of prednisone have enough bone loss to lead to a fracture. People can also experience osteonecrosis, which is death of bone tissue because of reduced blood flow to the joints. This often manifests as hip and knee pain, but it can become severe and may require surgery. Most people lose bone mass within the first six to 12 months of prednisone therapy.

Cardiovascular Issues:

Prednisone can cause irregularities in potassium, calcium and phosphate levels, potentially leading to high blood pressure and heartbeat irregularities. People who take medium-high doses may develop premature atherosclerosis, a buildup of cholesterol in the arteries.

Cushing Syndrome:

Too much cortisol can trigger Cushing syndrome, which redistributes fat within the body. Signs of Cushing syndrome include the distribution of fatty tissue around the midsection, between the shoulder blades and in the face. Children with Cushing syndrome have experienced impaired growth.

Gastrointestinal Problems:

People who take prednisone increase their risk of developing gastric ulcer formation, gastritis and GI bleeding. The risk is four times higher when someone takes prednisone and an NSAID (such as ibuprofen) together. Other side effects include fatty liver and pancreatitis.

High Blood Sugar:

Anyone who takes prednisone should get their blood sugar tested and monitored while taking it. The drug can cause an increase in fasting blood sugar, a side effect especially serious for people with Type 2 diabetes. Blood sugar metabolism usually returns to normal after the medication is stopped.

Infection Risk:

Taking prednisone can increase the chances of developing mild, serious or life-threatening infections. Larger doses increase the risk, especially doses for immunosuppression. Older age and taking other medications that also suppress the immune system increases the risks. Doses of 10 mg or lower pose the least risk.

Muscle Weakness:

Prednisone and other corticosteroids can cause muscle weakness in the legs and arms. Severe cases may require hospitalization. Stopping treatment and performing exercises usually reverses this side effect.

Skin Problems:

Even at low doses, prednisone can cause skin issues. These include skin thinning, acne, excess hair growth (hirsutism), hair thinning, face redness, stripe-like marks on the skin (stria) and impaired wound healing.

Vision Changes:

Blurry vision is the most common eye problem associated with prednisone, but it’s usually not serious. However, the risk of cataracts in both eyes increases for people who take more than 10 mg of prednisone daily for longer than a year. The drug also increases eye pressure, potentially leading to glaucoma or even permanent damage to the optic nerve.

Fetal toxicity is a valid concern for pregnant women who have a medical reason for taking prednisone. Autoimmune diseases, including lupus, rheumatoid arthritis and inflammatory bowel disease, are potentially more damaging to unborn babies than prednisone.

Researchers hint at a small increased risk of babies being born with a cleft lip or without a cleft palate when their mothers took corticosteroids in the first trimester of pregnancy. But medical providers need much more hard research to document fetal toxicity and other issues, such as a link to gestational diabetes, related to prednisone.

Adrenal Insufficiency

Increased cortisol from prednisone (and other corticosteroids) can cause adrenal glands to shut down, leading to adrenal atrophy (wasting away) and adrenal insufficiency. Adrenal insufficiency is when the adrenal glands don’t produce enough hormones.

The condition leads to Addison’s disease, a life-threatening episode characterized by low blood pressure, low levels of blood sugar and high levels of potassium.

Symptoms of adrenal insufficiency include:

• Abdominal pain
• 
  Anorexia or weight loss
• 
  Body pains
• 
  Diarrhea
• 
  Fatigue
• 
  Fever
• 
  Headache in the morning
• 
  Nausea
• 
  Poor growth and weight gain in children
• 
  Psychiatric symptoms

Addison’s disease presents when damaged adrenal glands produce insufficient amounts of cortisol or aldosterone.

Mental Health Side Effects

Early in treatment (within several days), prednisone may increase feelings of well-being, anxiety, hypomania or mild euphoria. With long-term therapy, however, people may develop depression. Psychosis, referred to as corticosteroid-induced psychosis, can occur at doses of 20 mg or more per day with long-term use.

Mental health issues start within 3 to 4 days after starting prednisone therapy, but they can occur at any time. Some people continue to have symptoms, including depression, even after therapy stops.

Children who get prednisone for acute lymphoblastic leukemia (ALL), may develop mood fluctuations, depression, manic behavior or euphoria. For most, symptoms go away when therapy concludes.

Prednisone Side Effects in Women and Men

Because corticosteroids, such as prednisone, impact hormones, they can affect men and women differently. Women are more likely to develop osteoporosis, a serious side effect from prednisone use. And women who are pregnant, who want to get pregnant or who are breastfeeding should not take prednisone.

For men, prednisone can cause erectile dysfunction and change testosterone levels. Some men reported reduced sperm counts and infertility.

Men and women experience similar side effects, including depression, mood swings and stomach pain. But overall, doctors need more research to understand the specific role of gender in reactions to corticosteroids.

How to Reduce Your Risk of Prednisone Side Effects

The best thing you can do to minimize side effects from taking prednisone is to maintain a healthy lifestyle. That means eating smart, exercising regularly and getting plenty of sleep.

While taking prednisone, you should avoid smoking and drinking alcohol, and add supplements to your diet.

Once you start on a course of prednisone, pay attention to signals your body sends. Weight gain, fluid retention, nausea, mood swings, sleeplessness and overall weakness are signs to watch. This is especially true for someone on a long-term treatment plan. Exercise helps with fluid retention, depression and high blood sugar.

Tips to help you manage, mitigate and reduce the risk of side effects include:

Fluid retention:

While it might seem counterintuitive, drinking more water helps maintain a proper fluid balance and reduce water retention. But if you notice ankle swelling, speak with your doctor.

Gastrointestinal symptoms:

Take your doses of prednisone with some food in your stomach. If the drugs irritate your stomach, mix in antacids for help.

Infection:

Prednisone and other corticosteroids suppress the immune system, which may need a boost. Stay updated on your vaccines, including an annual flu shot and for long-term vaccines and boosters for shingles, tetanus, pneumonia and COVID-19.

Insomnia:

Before relying on sleeping pills, develop a bedtime routine that includes relaxation techniques, such as guided meditation or deep breathing.

Osteoporosis:

Anyone who takes prednisone should increase their sources of calcium from supplements and food groups to offset bone loss. Peas, beans, lentils, almonds, sesame seeds, amaranth, dark leafy greens (such as collard greens and spinach), broccoli and Brussels sprouts are quality sources of calcium.

Weight gain:

Gaining weight while taking prednisone is a genuine concern, especially because one side effect from the medication is increased appetite. Monitor your food intake and develop a regular exercise routine.

Make time for other things you enjoy: reading, writing, fishing, hiking, dancing, crafting, painting, yoga, Pilates and tai chi can help people find balance. Community centers often have free or inexpensive classes several times a week.

How Prednisone Dosage Impacts Side Effects

Dosage and duration are two aspects of your prednisone prescription that affect the likelihood and severity of side effects.

The higher your dose of prednisone, the more likely you are to notice side effects. The same is true if you must take the medication for longer than 30 days. In fact, most side effects stem from long-term use.

Even if you experience negative side effects, don’t stop taking your prednisone. It is a strong medication, and doctors recommend a gradual step-down approach to end the prescription cycle.

Prednisone Side Effects

Please seek the advice of a medical professional before making health care decisions.

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Prednisone oral tablet side effects: Mild to serious

Prednisone (Rayos) is a generic prescription medication, and as with other drugs, it can cause side effects. Prednisone is used to treat certain conditions, including:

• hormone conditions, such as adrenal insufficiency
• autoimmune conditions, such as rheumatoid arthritis, lupus, and multiple sclerosis
• skin conditions, such as Stevens-Johnson syndrome
• allergic conditions, such as asthma or allergies
• eye conditions, such as optic neuritis
• breathing problems, such as pneumonitis
• blood conditions, such as thrombocytopenia
• leukemia and lymphoma
• ulcerative colitis

Your doctor may prescribe prednisone short term or long term, depending on your condition.

Prednisone comes as an oral tablet. The drug also comes as an oral solution but this article does not cover that form. (For details, talk with your doctor.)

Read on to learn about potential common, mild, and serious side effects. For a general overview of this drug, including what prednisone tablets are used for, refer to this article. Your doctor can also tell you more about prednisone.

Prednisone can cause certain side effects (also called adverse effects), some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took the brand-name version of prednisone (Rayos) in clinical trials:

• edema (swelling due to excess fluid)
• muscle weakness
• bloating (swelling due to excess fluid or gas, often in the abdomen)
• thin skin
• sweating*

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

Mild side effects can occur with prednisone. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to prednisone’s prescribing information.

Mild side effects that have been reported with prednisone include:

• edema (swelling due to excess fluid)
• muscle weakness
• bloating (swelling due to excess fluid or gas, often in the abdomen)
• thin skin
• excitement
• changes in menstrual bleeding
• confusion
• restlessness
• nausea or vomiting
• acne
• moon face*
• weight gain*
• headache*
• sweating*
• difficulty sleeping*
• mild allergic reaction*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Prednisone and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

Prednisone may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to prednisone’s prescribing information.

If you develop serious side effects while taking prednisone, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

• Heart problems, such as congestive heart failure. Symptoms may include:
  • difficulty breathing
  • swelling in the legs or feet
  • rapid heart rate
• Mood changes, such as depression. Symptoms may include:
  • feeling sad or hopeless
  • insomnia or sleeping more than usual
  • loss of interest in activities that you typically enjoy
• Low blood potassium level. Symptoms may include:
  • constipation
  • fatigue
  • heart palpitations
• High blood pressure. Symptoms may include:
  • headache
  • shortness of breath
  • anxiety
• Infection. Symptoms may include:
  • fever
  • sore throat
  • cough
• Osteoporosis or bone fractures. Symptoms may include:
  • back pain
  • swelling or bruising
  • pain or numbness
• Stomach ulcers. Symptoms may include:
  • abdominal pain
  • bloating
  • nausea
• Pancreatitis (pancreas inflammation). Symptoms may include:
  • abdominal pain
  • fever
  • nausea or vomiting
• High blood sugar or diabetes. Symptoms may include:
  • feeling more thirsty than usual
  • unexplained weight loss
  • blurry vision
• Eye problems, such as cataracts or glaucoma. Symptoms may include:
  • cloudy vision
  • headache
  • blurry vision
• Severe allergic reaction.*

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

In most cases, side effects in children taking prednisone are similar to side effects in adults taking the drug.

However, prednisone may cause decreased growth in children who take the drug. This may mean that if your child is taking prednisone, especially if they take the drug for a long time, they may not grow as tall.

Due to this risk, your doctor may monitor your child’s growth while they’re taking prednisone. If you have additional concerns about side effects that may occur while your child is taking prednisone, talk with their doctor.

Prednisone may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Will stopping prednisone treatment cause withdrawal symptoms?

It’s possible that stopping prednisone treatment suddenly can cause withdrawal symptoms. These are symptoms that occur when your body becomes used to a medication and you suddenly stop taking it. Symptoms may include fatigue or changes in mood, such as depression.

To help prevent prednisone side effects of withdrawal, your doctor may taper your dosage. This means following a schedule that slowly reduces your dosage of the drug over time. The goal is to gradually help your body adjust to a lower level of prednisone, which may help reduce the risk of withdrawal symptoms.

It’s important that you do not stop taking prednisone without consulting your doctor. If you’re thinking about ending your treatment, be sure to talk with your doctor first. They can recommend the best way to stop treatment and reduce your risk of withdrawal symptoms.

I’m taking prednisone for an allergic reaction. What side effects can I expect?

If you’re taking prednisone to treat an allergic reaction, you’ll likely experience the same side effects as people taking the drug for other uses. Because treatment of allergic reactions is typically short term, you may be at a lower risk of side effects such as moon face or weight gain. (These tend to occur with long-term prednisone treatment.)

For more information on the possible side effects of prednisone, see the more common, mild, and serious side effect lists above. You can also talk with your doctor or pharmacist.

Do prednisone’s side effects vary depending on the dose I take, such as 10 mg or 20 mg?

Yes, it’s possible for the side effects of prednisone to vary based on your dose. If you take a higher dose of medication, your body is exposed to more of the drug. And when you have more prednisone in your body, side effects may be more likely to occur.

For example, the risk of side effects with a 20-milligram (mg) dose of prednisone is higher than with a 10-mg dose.

Before starting prednisone treatment, you may want to talk with your doctor about your risk of side effects and what dose is right for you.

Are there long-term side effects of prednisone?

Prednisone may cause long-term side effects. However, these weren’t common in clinical trials of the brand-name version of prednisone (Rayos). Examples of long-term side effects that may occur during your treatment with prednisone can include:

• heart problems, such as congestive heart failure
• high blood pressure
• osteoporosis or bone fractures
• stomach ulcers
• eye problems, such as cataracts or glaucoma

For symptoms, see “Prednisone: Serious side effects” above. If you’re concerned about long-term side effects with prednisone, talk with your doctor before starting treatment.

Does prednisone cause constipation?

It’s not likely that you’ll experience constipation from taking prednisone. In clinical trials, constipation was not reported as a side effect of the drug.

However, constipation may be a symptom of a side effect of prednisone: a low level of potassium in the blood.

If you become constipated during your treatment with prednisone, talk with your doctor. They can help determine the cause. This may include ordering a blood test to measure the level of potassium in your blood. If it’s low, your doctor can recommend an appropriate treatment.

Most side effects of prednisone are similar in males and females.* However, this medication may cause changes in menstrual bleeding in females. For example, taking prednisone may cause irregular periods or periods that are heavier than usual.

If you have questions about side effects that prednisone may cause in males or females, talk with your doctor.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Learn more about some of the side effects that prednisone may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for prednisone.

Moon face

Prednisone may cause a condition called moon face, in which your face becomes rounder. It can happen when excess fluid or fat makes your face look round or puffy. The condition isn’t harmful. However, some people may not like the change in their appearance.

Moon face can occur with long-term use of steroid drugs such as prednisone. Clinical trials of the medication didn’t report how often this side effect occurred.

What you can do

To help prevent moon face, your doctor may prescribe prednisone for the shortest amount of time possible to treat your condition.

If you notice that your face looks round or puffy while taking prednisone, talk with your doctor. They can suggest treatment options, such as consuming less salt to help reduce puffiness. Or they may recommend a drug other than prednisone.

Weight gain

It’s possible for prednisone to cause weight gain. In fact, weight gain was one of the most common side effects reported in people taking a brand-name version of prednisone called Rayos.

Prednisone is a generic drug that comes as an immediate-release tablet. It starts working right away. Rayos comes as a delayed-release tablet. With this form, the release of the drug is delayed for a time, so its effects occur later.

What you can do

If you gain weight during your treatment with prednisone, talk with your doctor. They can help determine the cause. Weight gain can be due to conditions such as heart problems, which are a possible side effect of prednisone. Your doctor can also recommend ways to manage your weight.

Headache

Headaches may occur with prednisone. It wasn’t reported how often this side effect happened in clinical trials of people taking prednisone.

What you can do

If you have headaches while taking prednisone, talk with your doctor. They may be able to recommend a headache treatment. An example is the over-the-counter (OTC) medication acetaminophen (Tylenol). An OTC drug is one that you can purchase without a doctor’s prescription.

Sweating

Increased sweating is a possible side effect of prednisone treatment. Clinical trials of the drug didn’t report how frequently sweating occurred.

What you can do

If you’re sweating more than usual while taking prednisone, be sure to talk with your doctor. They may be able to suggest ways to manage this side effect, such as wearing clothing that keeps moisture away from the skin. You can find other tips in this article.

Difficulty sleeping

It’s possible for prednisone to cause trouble sleeping. It wasn’t reported how often difficulty sleeping occurred in clinical trials. Difficulty sleeping may also be called insomnia. This may be trouble falling asleep or trouble staying asleep throughout the night.

What you can do

If you’re not sleeping well while taking prednisone, talk with your doctor. If you take prednisone once daily, your doctor may recommend taking your dose early in the morning. This could make it less likely that the drug will keep you awake at night. Your doctor may also recommend an OTC medication to help with insomnia, such as melatonin.

Allergic reaction

As with most drugs, prednisone can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

• skin rash
• itching
• flushing
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking prednisone. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take prednisone. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered to be drug-condition or drug-factor interactions. The conditions and factors to consider include:

Active infections. Before starting prednisone treatment, tell your doctor if you have an active infection (one that’s causing symptoms). This medication can weaken your immune system. If you have an untreated infection, taking prednisone may worsen it. Your doctor will likely treat your infection before prescribing prednisone.

Heart disease. If you have heart disease, tell your doctor before taking prednisone. This medication can cause certain heart problems, such as congestive heart failure. If you already have heart disease, taking prednisone may worsen it. So your doctor may monitor your heart more often than usual while you take prednisone. It’s also possible that they may recommend a different treatment option.

Kidney problems. Prednisone is removed from your body by your kidneys. If your kidneys aren’t working correctly, the drug can build up in your body. If you have a kidney problem, tell your doctor before starting prednisone treatment. Your doctor may monitor your kidneys while you take the medication.

Allergic reaction. If you’ve had an allergic reaction to prednisone or any of its ingredients, your doctor will likely not prescribe prednisone. Taking prednisone could cause you to have another allergic reaction. Ask your doctor what other medications may be better options for you.

Eye problems. Before starting prednisone treatment, tell your doctor if you have any eye conditions, such as glaucoma. This medication may increase your risk of certain eye conditions, including glaucoma and cataracts. If you already have such a condition, taking prednisone may worsen it. Because of this, your doctor may monitor your eyes more often than usual when you take prednisone. In some situations, they may recommend a different treatment.

Stomach or intestinal problems. It’s possible for prednisone to cause stomach or intestinal problems, such as ulcers. If you already have a condition that affects your stomach or intestines, tell your doctor before starting prednisone treatment. Taking the drug can worsen it. Your doctor can advise you on whether prednisone is safe for you.

Mood problems. If you have any mood conditions, such as depression, tell your doctor before taking prednisone. This medication may increase your risk of mood problems. If you already have a mood condition, taking prednisone can worsen it. Your doctor may monitor your mood more frequently than usual. In some situations, they may recommend a different treatment option.

Alcohol with prednisone

There aren’t any known interactions between alcohol and prednisone. However, it’s possible that drinking alcohol while taking prednisone could increase your risk of certain side effects. For example, both alcohol and prednisone can cause:

• nausea
• vomiting
• headache
• confusion
• pancreatitis (pancreas inflammation)

If you drink alcohol during prednisone treatment, these side effects could be more likely to occur. Your doctor can help determine whether it’s safe for you to consume alcohol while taking prednisone.

Pregnancy and breastfeeding while taking prednisone

Here’s some information about pregnancy, breastfeeding, and prednisone.

Pregnancy. Your doctor may recommend that you do not take prednisone while pregnant.

Prednisone may cause harm to a developing fetus if it’s taken during pregnancy. The drug can cause cleft palate and decreased birth weight. In addition, babies may have hormone problems, such as low levels of adrenal hormones, once they’re born. This could cause problems such as fatigue and trouble feeding. Your doctor may monitor your newborn for symptoms of low hormone levels if you took prednisone while pregnant.

If you’re pregnant or planning to become pregnant, talk with your doctor. They can help determine the right treatment option for you.

Breastfeeding. It’s unknown whether it’s safe to take prednisone while breastfeeding.

It’s not known whether prednisone (a type of steroid) passes into breast milk or what effects the drug may have on a breastfed child. However, another steroid drug called prednisolone does pass into breast milk. This means that a child who is breastfed would be exposed to the drug. Prednisolone did not cause negative effects in children.

If you’re breastfeeding or thinking about it, talk with your doctor. They can help determine whether prednisone is right for you. Your doctor can also advise you on ways to feed your child.

Prednisone may cause side effects. However, most of them are mild. It’s possible to develop serious side effects from this medication as well. If you do, be sure to talk with your doctor.

If you’d like to learn more about prednisone, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug. Referring to the following articles about prednisone can provide you with additional information:

• More information about prednisone. For details about other aspects of prednisone, refer to this article.
• Drug comparison. To learn how prednisone compares with methylprednisolone, read this article.
• Cost. If you’d like to learn about prednisone and cost, see this article.
• A look at your condition. For details about some of the conditions prednisone treats, you can see our:
  • rheumatoid arthritis hub
  • dermatology hub
  • asthma and allergies hub
  • eye health hub
  • leukemia and cancer hubs
  • inflammatory bowel disease hub for information about ulcerative colitis

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Migraine – a directory of diseases – HealthInfo

HEADACHE – Hadassah Medical Moscow

Traditional migraine therapy consists of behavioral therapy, relief of an already developed attack and preventive treatment aimed at preventing attacks. Behavioral therapy, a necessary step in effective patient management, is carried out during a conversation with the patient and includes: explaining the benign nature of migraine, dissuading the presence of an organic disease, discussing the role of attack triggers and the need to avoid them, risk factors for migraine chronicity (taking a large number of painkillers, stress, psycho-emotional states), as well as substantiating treatment tactics (mechanisms of action of prescribed drugs).

Treatment of a migraine attack is prescribed depending on its intensity and the degree of maladaptation of the patient. With infrequent attacks of mild or moderate intensity, simple or combined analgesics are indicated; with severe nausea and vomiting – antiemetics. With a high intensity of pain and significant maladaptation, triptans are prescribed.

New groups of drugs for the relief of migraine attacks are now approved in the world. This, in turn, enables doctors to treat their patients more effectively, and for patients to reduce the number of days with a headache, improve quality of life, sleep, mood and performance.

Lasmiditan is a selective serotonin 1F receptor agonist that does not have vasoconstrictive activity. The role of lasmiditan in clinical practice has not yet been determined, but it is probably best suited for patients with relative contraindications to triptans due to cardiovascular risk factors.

In October 2019, the US Food and Drug Administration (FDA) approved lasmiditan oral tablets for the treatment of acute migraine in adults. The drug is currently not registered in the Russian Federation.

CGRP antagonists (Rimegepant and Ubrogepant) Monoclonal antibodies directed against the CGRP receptor or ligand. These are oral options available for the acute treatment of migraine in patients with insufficient response or contraindications (eg coronary artery disease) to triptan treatment.

Ubrogepant received US Food and Drug Administration (FDA) approval for the treatment of acute migraine in adults in December 2019year, and rimegepant received a similar FDA approval in February 2020. This group of drugs is not registered in the territory of the Russian Federation.

Preventive therapy is aimed at reducing the frequency, duration, intensity of attacks, the number of doses of painkillers and improving the quality of life of patients.

The main indications for course treatment: the frequency of days with GB> 4 per month, the lack of effectiveness of drugs for the relief of migraine attacks, the presence of risk factors for chronic migraine (abuses, depression), prolonged aura (> 60 min).