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Is Reduced Dosage Of Prednisone While Having BP Of 156/90 Safe?
my husbands blood pressure is 156/90. he has addisons disease and seratic arthritus. he was taking prescribed cortef and another doctor prescribed him prednisone. so since last year he has been taking both steriods. Yesterday he saw his internal doctor. Doctor told him to cut the prednisone in half for two weeks then go off it completely. But his blood pressure has been running about 156/90. do i need to be concerned?
Wed, 10 Sep 2014
Hi,
Thank you for your query. I can understand your concerns.
CORTEF Tablets contain hydrocortisone which is a glucocorticoid.
Prednisone is a synthetic corticosteroid drug.
Glucocorticoid replacement for the treatment of chronic adrenal insufficiency/Addison's disease should be administered at a dose that replaces the physiologic daily cortisol production, which is usually achieved by the oral administration of 15–25 mg hydrocortisone in two to three divided doses.
Long-acting glucocorticoids such as prednisone are not preferred as they result in increased glucocorticoid exposure due to extended glucocorticoid receptor activation at times of physiologically low cortisol secretion.
Hence you have to gradually reduce the dose of prednisone and stop it completely. There was no need to take both hydrocortisone & prednisone,at th first place. On withdrawal of prednisone his BP will come down but so long his BP remains equal to or less than 140/90 mm hg and above 120/80 mm hg you need not be concerned.
Regards
Dr. T.K. Biswas M.D.
Mumbai
Thank you for your query. I can understand your concerns.
CORTEF Tablets contain hydrocortisone which is a glucocorticoid.
Prednisone is a synthetic corticosteroid drug.
Glucocorticoid replacement for the treatment of chronic adrenal insufficiency/Addison's disease should be administered at a dose that replaces the physiologic daily cortisol production, which is usually achieved by the oral administration of 15–25 mg hydrocortisone in two to three divided doses.
Long-acting glucocorticoids such as prednisone are not preferred as they result in increased glucocorticoid exposure due to extended glucocorticoid receptor activation at times of physiologically low cortisol secretion.
Hence you have to gradually reduce the dose of prednisone and stop it completely. There was no need to take both hydrocortisone & prednisone,at th first place. On withdrawal of prednisone his BP will come down but so long his BP remains equal to or less than 140/90 mm hg and above 120/80 mm hg you need not be concerned.
Regards
Dr. T.K. Biswas M.D.
Mumbai
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