Prednisone For Asthma: Usage, Side Effects, And Alternatives

Prednisone¹ is a drug used to lower inflammation in the body by inhibiting the production of certain chemicals. It can be used to reduce airway inflammation in people with asthma

If used for an extended period, prednisone can suppress immune system function. Thus, it is mainly used for short-term treatment, particularly in acute exacerbations. However, doctors may prescribe it for long-term treatment if your asthma is severe and uncontrollable.

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How does prednisone work for asthma?

When you experience an asthma attack, your airway tissues usually become inflamed and narrow, resulting in wheezing, chest tightness, coughing, and shortness of breath. These symptoms are the result of an exaggerated immune response.

Prednisone reduces the immune system’s response that would otherwise result in inflammation of the airwaves.

Is prednisone safe to use for asthma?

Prednisone can be used for severe asthma when a healthcare professional deems it necessary. It is generally safe for short-term treatment but has side effects that can become more severe if you take the medication for an extended period. 

Some side effects include:

  • Headache

  • Dizziness

  • Extreme mood swings

  • Sleeping difficulties

  • Stomach upsets

  • High blood pressure

  • Osteoporosis

  • Extreme fatigue

  • Profuse sweating

The long-term, major side effects of prednisone include:

  • Skin thinning, purpura, and/or ecchymoses

  • Weight gain

  • Acne

  • Hirsutism

  • Fluid retention

  • Hypertension

  • Premature arteriosclerosis

  • Arrhythmias

  • Gastritis

  • Peptic ulcer disease

  • Osteoporosis

  • Myopathy

  • Dysphoria/depression

  • Insomnia

  • Mania/psychosis

  • Hyperglycemia

  • Increased risk of infections

There are also contraindications for prednisone. It would thus be best if you informed your doctor if you have any of the following conditions:

  • Systemic fungal infections, administration of live/live attenuated vaccines with immunosuppressive doses of prednisone

  • Peptic ulcer disease

  • Herpes simplex of the eye, measles, chickenpox

  • Uncontrolled viral/bacterial infection

  • Any allergies to prednisone or any component thereof

  • Other medications you are talking

It is best to avoid prednisone if you are allergic to it or have a fungal infection that requires oral antifungal treatment. Since prednisone suppresses the body’s immune system, it is also in your best interest to take precautions such as staying away from sick people.

You should inform your doctor if you believe you have been in contact with a sick individual.

Long-term use of corticosteroids such as prednisone can result in bone loss, especially if you have a history of osteoporosis. It is thus also advisable to consult your doctor before putting yourself or your child on prednisone to avoid these risks.

If you are scheduled to have surgery, you should inform the healthcare professional that you are on prednisone. Consider wearing a bracelet or carrying a card should you need an emergency treatment where you cannot communicate this information.

Prednisone can also cause a spike in your blood sugar level. Its cause is the augmentation of hepatic gluconeogenesis (formation of glucose by the liver), inhibition of glucose uptake by adipose (fat) tissue, and the alteration of receptor functions in all cells.

You should thus inform the doctor if you have a condition such as diabetes so they can advise you accordingly regarding prednisone usage.

Dosage of prednisone for asthma

If you are an adult with severe persistent asthma, you can alleviate the symptoms by taking 5 mg to 60 mg² of prednisone per day, while the recommended dose for children is 1 mg/Kg daily. You should consult your doctor before use. 

Health professionals typically recommend that you start with the lowest possible dose and only gradually increase the dosage if the asthma symptoms do not reduce.

Prednisone is available in oral tablets and oral liquid solutions. It is advisable to take the medication as directed. It would be best if you did not take more, less than instructed, or longer than prescribed.

If using the liquid form, consider using the marked dropper that accompanies the medication, as it enables you to measure the proper dose. You are at liberty to mix the liquid solution with juice or other flavored beverages and soft foods. If in tablet form, it is advisable to swallow the tablet whole instead of crushing or chewing it.

The doctor may advise you to change your dosage depending on how it works. For instance, they may recommend that you slow down on the medication if it negatively impacts your health. Make sure to keep the doctor updated on your health status to enable them to make the right decision for you.

It would be ill-advised to abruptly stop taking the medication without consulting your doctor. You may experience withdrawal symptoms, such as fatigue, weight loss, excessive shedding of the skin, nausea, vomiting, headache, and fever.

If you skip a dose, you should take it as soon as you remember, but if it is almost time for your next one, continue taking the medication as per the schedule. Taking an extra dose to make up for the one skipped can adversely affect your well-being.

How long does it take for prednisone to take effect?

Prednisone in tablet or liquid form is usually absorbed into the bloodstream within 2 hours, while delayed-release tablets typically start working in 6 hours. Studies demonstrate that a benefit is seen as early as 4–6 hours.

It also doesn’t last long in the body and will be excreted within 11 to 16.6 hours of intake. It lasts long enough in the body to help you overcome asthma symptoms.

Why is prednisone being used for asthma?

Prednisone is usually used to stop the inflammation in your airways from worsening and is often used in conjunction with other interventions, such as prescribed inhalers. It can also help lower your risk of developing a life-threatening asthma attack. It is an option if your healthcare professional realizes you are having difficulties controlling your asthma symptoms. 

Prednisone is typically a short-term intervention when there is a flare-up of asthma symptoms or an attack. Once this subsides, your doctor will likely take you off the medication, but you may continue with the other interventions.

However, your doctor may advise continued long-term use of prednisone if they determine that the inhaler is incapable of controlling asthma symptoms and add-on treatments are required.

Alternative treatment options for asthma

You could also use the following anti-inflammatory drugs to alleviate symptoms of asthma.

Inhaled corticosteroids

These are the most commonly used drugs used for the long-term control of asthma symptoms. Inhaled corticosteroids work by decreasing the swelling and tightening in your airways. They are typically administered through inhalers and are available in metered-dose inhalers, dry powder inhalers, and nebulizer solutions.

Inhaled corticosteroids help prevent asthma symptoms. They don’t cause serious side effects, but you may experience mouth or throat irritation and an oral yeast infection. If using a metered-dose inhaler, you should rinse your mouth to get rid of any drug remaining in your mouth.

Mast cell stabilizers (Cromoglycates)

The mast cell stabilizers’ mechanism of action entails preventing mast cells, a type of immune cell in the body, from initiating an immune response that would result in inflammation. Healthcare professionals usually use mast cells to treat mild persistent asthma in children and adolescents as an alternative to inhaled glucocorticoids. 

Mass stabilizers are generally administered 2 to 4 times daily for this demographic. However, they're typically not commonly utilized due to increased dosing requirements and unavailability in the US.

Leukotriene receptor antagonist (LTRA)

Leukotriene receptor antagonists are proven to alleviate asthma symptoms and work by blocking naturally occurring compounds known as leukotrienes which take part in inflammation.

The medication is available in pills you can take 1 to 2 times daily. LTRAs are considered an alternative treatment for mild persistent asthma. However, inhaled glucocorticoids are still preferred due to greater and more consistent effects.

When to see a doctor

If you have asthma, you should see a doctor when you have difficulties controlling the symptoms and if they frequently occur despite your attempts to curb them through previously effective interventions. 

It is advisable to visit your doctor if you:

  • Continue to experience asthma symptoms such as wheezing, coughing, and shortness of breath even after prednisone use

  • Experience the above-mentioned side effects after prednisone use

  • Get or plan to get pregnant

  • Feel ill or have come in contact with a sick person

Visit a doctor if you experience symptoms of illness, even when they have nothing to do with asthma, as prednisone can weaken your immune system, leaving you susceptible to disease.

The lowdown

Prednisone is a medication you can use to relieve inflammation in your airways if you have asthma. It prevents asthma symptoms such as wheezing, coughing, and shortness of breath. 

Prednisone works by suppressing the immune system so that the body cannot mount a response that would otherwise result in the inflammation of your airwaves. It is thus used as a short-term treatment to alleviate asthma exacerbations. 

Before getting on the treatment, you should consult your doctor and inform them of your medical history, including allergies to prednisone or the constituents in its formulation.

While prednisone has side effects, most occur during long-term use. It also interacts with other drugs and may not be prescribed for people with some medical conditions. You should thus visit a doctor before commencing use.

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