The corticosteroid prednisone is the drug of choice for treating pemphigus and pemphigoid. Prednisone is a powerful anti-inflammatory that also suppresses the immune system. It is a synthetic form of the naturally occurring steroid hormone cortisone. Prednisone should not be confused with the dangerous anabolic steroids used by athletes to increase muscle mass. Prednisolone, another form of prednisone, is more commonly used outside the United States.

Sometimes large doses of prednisone are needed to bring pemphigus or pemphigoid under control. This may take weeks, months, or in some cases, years. Generally, once the disease has been controlled, the prednisone is gradually reduced or "tapered." Tapering of prednisone is important not only to reduce the side effects or recurrence of disease activity, but because your own body's ability to make natural cortisone is stopped. Tapering allows your natural process to begin again.

Prednisone or prednisolone is generally given as a pill. The initial dose is usually 1 mg/kg (about .5mg/lb) of body weight. The dose may be higher if the disease is severe. Prednisone can also be injected directly into a lesion, or in very mild cases it can be put on lesions in gel or cream form. In some severe cases, large doses of corticosteroids, called "pulse steroids," are administered intravenously in a hospital setting over a period of a few days.

Side Effects and Precautions

Unfortunately, high doses of prednisone or prolonged prednisone treatment often have undesirable side effects. The seriousness of side effects caused by prednisone generally depends on the amount of and length of time the prednisone is taken. Side effects include weight gain, increased blood pressure, thinning of the bones or osteoporosis, stomach problems, glaucoma, salt retention, steroid-induced diabetes, acne, cataracts, mood changes, and increased susceptibility to infection. Remember, although prednisone can cause all these side effects not all patients will have all of these problems.

Living successfully with pemphigus or pemphigoid, therefore, includes making some lifestyle changes in order to manage these side effects. You may also find you will need to take additional medication to control certain side effects.

To learn more about the side effects of prednisone and ways to manage them, See: IPPF Quarterly, Winter 2000, Vol. 24, What you need to know about prednisone.

References

IPPF Quarterly, Winter 2000, Vol. 24 : What you need to know about prednisone

IPPF Quarterly,… Nutrition and Prednisone

Related Websites

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601102.html

http://www.medicinenet.com/prednisone/index.htm

http://www.rxmed.com/