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What Are The Withdrawal Side Effects Of Prednisone?
Question: A family member was on prednisone for ulcerative colitis for past month and a half , started to taper to 30 MGM but ran out of med having hard time getting refill cuz moved out of state What are the actual side effects of abrupt withdrawal Only answer getting is very bad but I'm an RN and would like specifics I have advised her to go to ER if necessary to get med
Brief Answer:
Hello
Detailed Answer:
Hello,
Good day.
As you are aware, Prednisolone is a synthetic corticosteroid and if used beyond 2 weeks, can cause hypothalamo pituitary adrenal axis ( HPA axis) suppression for variable period of time. This is quite variable. The side effects are related to hypo adrenalism(low cortisol). They are tiredness, weight loss, nausea, vomiting and in the worst scenario, hypotension, collapse and death. Other than that, ulcerative colitis can get worse as well.
In normal conditions, body will still produce little amount of cortisol and it shouldn't be a problem. However, cortisol stress response is impaired for weeks to months. This means that, body will not be able to produce adequate amount of cortisol required to combat a crisis situation like infection or surgery etc. Hence these patients usually become symptomatic when met with a crisis ( infection and surgery etc) and they should always be covered with a stress dose of steroids during such situations till the HPA axis recover.
You should try to put her back on prednisolone ASAP ( or hydrocortisone /Dexamethasone if prednisolone not available). The conversion of prednisolone to Hydrocortisone is 1:4, Prednisolone to Dexamethasone is 1:20.
You may contact an endocrinologist later to assess her HPA axis and follow up
Kind regards
Binu
Hello
Detailed Answer:
Hello,
Good day.
As you are aware, Prednisolone is a synthetic corticosteroid and if used beyond 2 weeks, can cause hypothalamo pituitary adrenal axis ( HPA axis) suppression for variable period of time. This is quite variable. The side effects are related to hypo adrenalism(low cortisol). They are tiredness, weight loss, nausea, vomiting and in the worst scenario, hypotension, collapse and death. Other than that, ulcerative colitis can get worse as well.
In normal conditions, body will still produce little amount of cortisol and it shouldn't be a problem. However, cortisol stress response is impaired for weeks to months. This means that, body will not be able to produce adequate amount of cortisol required to combat a crisis situation like infection or surgery etc. Hence these patients usually become symptomatic when met with a crisis ( infection and surgery etc) and they should always be covered with a stress dose of steroids during such situations till the HPA axis recover.
You should try to put her back on prednisolone ASAP ( or hydrocortisone /Dexamethasone if prednisolone not available). The conversion of prednisolone to Hydrocortisone is 1:4, Prednisolone to Dexamethasone is 1:20.
You may contact an endocrinologist later to assess her HPA axis and follow up
Kind regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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