Deltasone (prednisone) is a cornerstone systemic corticosteroid medication prescribed for its potent anti-inflammatory and immunosuppressive properties. It is a synthetic glucocorticoid, a man-made version of the natural hormone cortisol produced by the adrenal glands. This medication works by modifying the body’s immune response to various stimuli, effectively reducing inflammation and suppressing an overactive immune system. It is a critical agent in managing a wide spectrum of acute and chronic conditions, from autoimmune disorders to severe allergic reactions.

Features

• Active Pharmaceutical Ingredient: Prednisone.
• Drug Class: Synthetic glucocorticoid corticosteroid.
• Standard Available Strengths: 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg scored tablets.
• Administration Route: Oral.
• Mechanism of Action: Enters cells and binds to glucocorticoid receptors, influencing the transcription of genes involved in inflammatory and immune responses.
• Bioavailability: Requires hepatic conversion from prednisone to its active metabolite, prednisolone.
• Onset of Action: Systemic effects are typically not immediate; physiological effects may be seen within 1-2 hours, with peak plasma concentrations of prednisolone occurring in about 1-2 hours post-ingestion.

Benefits

• Rapid and potent suppression of widespread inflammatory processes, providing relief from pain, swelling, and redness.
• Effective management of autoimmune diseases by dampening the erroneous immune attack on the body’s own tissues.
• Can be life-saving in acute hypersensitivity reactions, such as anaphylaxis, when epinephrine is not sufficient.
• Provides control over severe asthma exacerbations and chronic obstructive pulmonary disease (COPD) flare-ups by reducing airway inflammation.
• Induces and maintains remission in various inflammatory bowel diseases like Crohn’s disease and ulcerative colitis.
• Offers a treatment option for certain types of cancer, such as lymphomas and leukemias, as part of combination chemotherapy regimens.

Common use

Deltasone is indicated for a broad range of conditions where potent anti-inflammatory or immunosuppressive effects are required. Its use spans multiple medical specialties. In rheumatology, it is a mainstay for managing systemic lupus erythematosus, rheumatoid arthritis, polymyalgia rheumatica, and giant cell arteritis. Within pulmonology, it is used for severe asthma, sarcoidosis, and organizing pneumonia. Dermatologists prescribe it for severe cases of pemphigus vulgaris, severe psoriasis, and exfoliative dermatitis. Gastroenterologists utilize it for ulcerative colitis, Crohn’s disease, and autoimmune hepatitis. It is also used in hematology/oncology for its lympholytic effects in treating leukemias and lymphomas, and as an antiemetic in chemotherapy regimens. Furthermore, it is crucial in managing acute transplant rejection and certain adrenal insufficiency conditions (in combination with a mineralocorticoid).

Dosage and direction

Dosage of Deltasone is highly individualized and must be strictly determined by a physician based on the specific disease, its severity, and the patient’s response. There is no standard dosage.

• Dosing Philosophy: The fundamental principle is to use the smallest effective dose for the shortest possible duration to achieve the desired clinical effect while minimizing adverse events.
• Initial Dosing: For severe, acute conditions, initial doses may be high (e.g., 40-60 mg per day or more, often divided throughout the day). For less severe or chronic conditions, initial doses are lower (e.g., 5-20 mg per day).
• Administration: Tablets should be taken with food or milk to minimize gastric upset. They can be crushed if necessary but should not be chewed.
• Tapering (Crucial): Long-term therapy (longer than two weeks) must NOT be stopped abruptly. The hypothalamic-pituitary-adrenal (HPA) axis becomes suppressed, and the body may not produce enough natural cortisol. A gradual dose reduction (taper) is mandatory to allow the HPA axis to recover and to avoid adrenal insufficiency. The pace of the taper is determined by the dose, duration of therapy, and the underlying disease activity.
• Alternate-Day Therapy: For some chronic conditions, a physician may prescribe a double dose every other morning. This regimen can help minimize certain side effects like HPA axis suppression and growth retardation in children while still providing therapeutic benefit.

Precautions

Extreme caution and close medical supervision are required when using Deltasone.

• Adrenal Suppression: Prolonged use can lead to secondary adrenal insufficiency. Stress doses may be required during surgery, trauma, or severe illness.
• Infections: Corticosteroids mask signs of infection and can increase susceptibility to new infections or reactivate latent ones (e.g., tuberculosis, herpes viruses). Any sign of infection must be reported immediately.
• Vaccinations: Live vaccines are contraindicated during therapy. Response to killed or inactivated vaccines may be diminished.
• Monitoring: Regular monitoring of blood pressure, weight, blood glucose, electrolytes, and bone density is often necessary during prolonged therapy.
• Ophthalmic Exams: Periodic eye examinations are recommended to check for cataracts and glaucoma.
• Psychological Effects: May cause emotional instability, psychosis, or exacerbate pre-existing psychiatric conditions.

Contraindications

Deltasone is contraindicated in patients with:

• Known hypersensitivity to prednisone or any component of the formulation.
• Systemic fungal infections (unless being used for management of adrenal insufficiency with concomitant antifungal therapy).
• Administration of live or live-attenuated vaccines in patients receiving immunosuppressive doses.
• Important Note: It may be used in life-threatening situations despite contraindications if the potential benefit outweighs the imminent risk.

Possible side effect

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

• Common: Fluid retention, weight gain, increased appetite, insomnia, nervousness, indigestion, nausea.
• Endocrine: Cushingoid state (moon face, central obesity), hypothalamic-pituitary-adrenal (HPA) axis suppression, growth suppression in children, menstrual irregularities, hyperglycemia.
• Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads.
• Ophthalmic: Glaucoma, increased intraocular pressure, posterior subcapsular cataracts.
• Gastrointestinal: Peptic ulcer disease with potential for perforation and hemorrhage, pancreatitis, abdominal distention.
• Dermatologic: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema.
• Neurological: Seizures, increased intracranial pressure with papilledema, vertigo, headache.
• Cardiovascular: Hypertension, congestive heart failure.
• Metabolic: Hypokalemia, alkalosis.

Drug interaction

Deltasone has the potential for numerous significant drug interactions. A healthcare provider must review all medications.

• Anticoagulants (e.g., Warfarin): Altered response; monitoring of INR is required.
• Antidiabetic Agents (Insulin, Oral Hypoglycemics): May antagonize hypoglycemic effects, requiring dose adjustments.
• CYP3A4 Inducers (e.g., Phenytoin, Rifampin, Carbamazepine): May increase the metabolism of prednisone, reducing its efficacy.
• CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole): May decrease the metabolism of prednisone, increasing the risk of toxicity.
• Diuretics (especially Potassium-Depleting, e.g., Furosemide, Thiazides): Enhances the risk of severe hypokalemia.
• NSAIDs (e.g., Ibuprofen, Naproxen): Concurrent use significantly increases the risk of gastrointestinal ulceration.
• Live Vaccines: Increased risk of vaccine-induced infection.
• Cardiac Glycosides (e.g., Digoxin): Risk of digitalis toxicity due to hypokalemia.

Missed dose

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

Overdose

An acute, single overdose is unlikely to be acutely life-threatening. However, chronic overdose manifests as the severe side effects listed above (Cushing’s syndrome, severe hyperglycemia, etc.).

• Symptoms of Acute Overdose: May include agitation, confusion, euphoria, flushing, headache, hypertension, hypokalemia, pancreatitis, peripheral edema.
• Management: Treatment is supportive and symptomatic. There is no specific antidote. Gastric lavage or activated charcoal may be considered if ingestion was very recent. Electrolyte levels (especially potassium) and blood glucose must be monitored and abnormalities corrected. Dialysis is not effective.

Storage

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

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• “As a rheumatologist, Deltasone is an indispensable tool for managing acute flares of autoimmune diseases. The rapid response it provides can be dramatic, but the long-term side effect profile demands the utmost respect and careful patient management.” – Dr. A. Vance, MD, Rheumatology
• “Prescribing this medication is always a careful risk-benefit analysis. For a patient in status asthmaticus, it’s life-saving. For chronic use, we are constantly balancing efficacy against the specter of osteoporosis, diabetes, and adrenal suppression. Patient education is paramount.” – Dr. L. Torres, MD, Pulmonology
• “After being diagnosed with giant cell arteritis, starting on Deltasone relieved my debilitating headaches and jaw pain within days. However, the side effects—weight gain, insomnia, and the ‘moon face’—have been challenging. My doctor is slowly tapering me down, and I understand it’s a necessary process.” – Patient M.S.
• “The potency of this drug cannot be overstated. It pulled my child out of a severe Crohn’s flare and allowed her to regain a normal life. We are vigilant about monitoring for side effects, but the benefit of being in remission has been worth the careful management.” – Parent of a patient