Deltasone is a brand-name prescription medication containing the active ingredient prednisone, a potent synthetic corticosteroid. It is designed to mimic the effects of hormones your body naturally produces to reduce inflammation and suppress an overactive immune response. This medication is a cornerstone in the management of a wide array of inflammatory, allergic, and autoimmune conditions, offering significant symptomatic relief and disease modification. Proper administration under strict medical supervision is paramount to maximize its therapeutic benefits while mitigating potential risks.

Features

• Active Pharmaceutical Ingredient: Prednisone (available in multiple strengths, commonly 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg tablets).
• Drug Class: Synthetic glucocorticoid (corticosteroid).
• Administration Route: Oral.
• Mechanism of Action: Binds to glucocorticoid receptors, modulating the expression of anti-inflammatory and immunosuppressive genes while inhibiting pro-inflammatory mediators.
• Pharmacokinetics: Rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 1 to 2 hours. Prednisone is a prodrug, converted in the liver to its active form, prednisolone.
• Availability: Prescription-only medication; available as scored, delayed-release, and immediate-release tablets.

Benefits

• Rapid and Potent Anti-inflammatory Action: Effectively reduces swelling, heat, redness, and pain associated with acute and chronic inflammatory processes by suppressing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability.
• Powerful Immunosuppression: Modulates the immune system’s response, making it highly effective for managing autoimmune disorders where the body attacks its own tissues.
• Symptom Control and Disease Remission: Provides significant relief from debilitating symptoms, improves functional capacity, and can induce disease remission in various conditions, significantly enhancing quality of life.
• Prevention of Organ Transplant Rejection: Used as part of immunosuppressive regimens to prevent the body from rejecting a transplanted organ.
• Management of Severe Allergic Reactions: Acts swiftly to counteract life-threatening allergic responses, such as anaphylaxis, when epinephrine and airway management are not sufficient.
• Replacement Therapy: Can be used to supplement deficient natural corticosteroid levels in certain endocrine disorders, such as adrenal insufficiency (in conjunction with a mineralocorticoid).

Common use

Deltasone (prednisone) is indicated for a broad spectrum of medical conditions characterized by excessive inflammation or an aberrant immune response. Its use is typically reserved for situations where the severity of the condition warrants systemic intervention. Common indications include, but are not limited to:

• Rheumatologic Diseases: Rheumatoid arthritis, systemic lupus erythematosus (SLE), polymyalgia rheumatica, giant cell arteritis, and vasculitis.
• Severe Dermatologic Conditions: Pemphigus vulgaris, severe psoriasis, exfoliative dermatitis, and severe contact dermatitis.
• Allergic States: Severe or intractable allergic conditions unresponsive to conventional treatments, including seasonal allergies, asthma exacerbations, and atopic dermatitis.
• Ophthalmic Diseases: Severe acute and chronic allergic and inflammatory processes affecting the eye, such as uveitis and optic neuritis.
• Respiratory Diseases: As an adjunctive therapy for short-term use in severe asthma exacerbations and chronic obstructive pulmonary disease (COPD) exacerbations. Also used in the management of sarcoidosis and hypersensitivity pneumonitis.
• Hematologic Disorders: Autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and leukemias/lymphomas (as part of combination chemotherapy).
• Gastrointestinal Diseases: To induce and maintain remission in inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis.
• Nervous System Disorders: Acute exacerbations of multiple sclerosis and management of cerebral edema associated with primary or metastatic brain tumors.
• Endocrine Disorders: As replacement therapy for congenital adrenal hyperplasia and adrenal insufficiency (used with a mineralocorticoid).
• Neoplastic Diseases: Palliative management of leukemias and lymphomas in adults and acute leukemia in children.
• Other: Treatment of trichinosis with neurologic involvement and tuberculous meningitis.

Dosage and direction

Crucial Note: Dosing is highly individualized based on the disease entity, its severity, and the patient’s response. The following is general information; a healthcare provider’s specific instructions MUST be followed precisely.

• General Principle: The dosage must be titrated to the lowest effective dose for the shortest possible duration to achieve the desired clinical effect.
• Initial Dosage: May range from 5 mg to 60 mg per day, depending on the condition being treated. For severe, acute conditions, higher initial doses are common.
• Dosage Adjustment: After a favorable response is noted, the dosage should be decreased in small increments to the lowest effective level. The rate of decrease is determined by the clinical response, the duration of therapy, and the likelihood of adrenal suppression.
• Multiple Daily Dosing: May be administered in divided doses throughout the day for better initial control of symptoms, particularly in severe conditions.
• Single Daily Dosing: Once the clinical situation is stable, the entire daily dose is often administered as a single dose in the morning. This schedule minimizes the potential for hypothalamic-pituitary-adrenal (HPA) axis suppression by coinciding with the body’s natural circadian rhythm of cortisol secretion.
• Alternate-Day Therapy (ADT): For patients requiring long-term maintenance therapy, switching to a single dose every other morning may be attempted. This can provide the desired anti-inflammatory and immunosuppressive effect while significantly reducing the incidence and severity of adverse effects, including HPA axis suppression.
• Tapering: Discontinuation of systemic corticosteroid therapy must be gradual, never abrupt. A slow, systematic tapering of the dosage is required, especially after prolonged therapy (more than two weeks), to allow recovery of the body’s natural adrenal function and to avoid steroid withdrawal symptoms or an acute adrenal crisis.
• Administration: Should be taken with food or milk to minimize gastrointestinal upset.

Precautions

The use of systemic corticosteroids like Deltasone requires vigilant monitoring and precaution due to the potential for serious adverse effects.

• Adrenal Suppression: Prolonged therapy can lead to suppression of the HPA axis. Stress (e.g., surgery, infection, trauma) during therapy or within a year after discontinuation may require supplemental steroids.
• Infections: Corticosteroids can mask signs of infection and increase susceptibility to new infections, including bacterial, viral, fungal, protozoan, and helminthic infections. Latent diseases like tuberculosis may be reactivated.
• Vaccinations: Administration of live or live-attenuated vaccines is contraindicated. Killed or inactivated vaccines may be administered, but the response may be diminished.
• Monitoring: Patients require regular monitoring of blood pressure, weight, electrolyte levels (especially potassium), blood glucose, and ocular pressure. Bone mineral density should be assessed in patients on long-term therapy.
• Psychiatric Effects: May cause euphoria, insomnia, mood swings, personality changes, severe depression, or frank psychotic manifestations. Pre-existing emotional instability or psychotic tendencies may be aggravated.
• Ophthalmic Effects: Prolonged use may cause posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.

Contraindications

Deltasone is contraindicated in patients with:

• Known hypersensitivity to prednisone or any component of the formulation.
• Systemic fungal infections (unless being used for the management of drug reactions to certain antifungals like amphotericin B).
• Administration of live or live-attenuated vaccines during immunosuppressive therapy.
• Important Note: There may be no absolute contraindications in life-threatening situations. In such cases, the benefits of therapy may outweigh the risks.

Possible side effect

Adverse reactions are common and are often related to the dose and duration of therapy.

• Endocrine: HPA axis suppression, Cushingoid state (moon facies, central obesity), growth suppression in children, menstrual irregularities, decreased carbohydrate tolerance, manifestation of latent diabetes mellitus.
• Fluid and Electrolyte Disturbances: Sodium and fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension.
• Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones.
• Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis.
• Dermatologic: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating.
• Neurological/Psychiatric: Convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri), vertigo, headache, severe depression to psychotic reactions, euphoria, insomnia.
• Ophthalmic: Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.
• Metabolic: Negative nitrogen balance due to protein catabolism.
• Other: Hyperpigmentation, leukocytosis, hypersensitivity reactions.

Drug interaction

Prednisone interacts with numerous medications. A comprehensive review of the patient’s medication list is essential.

• Anticoagulants: Corticosteroids may alter the response to coumarin anticoagulants; monitoring of coagulation indices is required.
• Antidiabetic Agents (Insulin, Oral Hypoglycemics): May increase blood glucose levels, necessitating dosage adjustments of antidiabetic drugs.
• Enzyme Inducers (e.g., Phenytoin, Phenobarbital, Rifampin): These drugs may increase the clearance of prednisone, potentially reducing its efficacy and necessitating a higher corticosteroid dose.
• Enzyme Inhibitors (e.g., Ketoconazole, Itraconazole): May decrease the metabolism of prednisone, increasing the risk of corticosteroid-related side effects.
• Diuretics (especially Potassium-Depleting, e.g., Thiazides, Furosemide): Concomitant use can accentuate electrolyte depletion, particularly hypokalemia.
• NSAIDs (e.g., Aspirin, Ibuprofen, Naproxen): Concurrent use increases the risk of gastrointestinal ulceration and bleeding.
• Live Vaccines: Corticosteroids can impair the immune response to vaccines and increase the risk of vaccine-induced infection.
• Cardiac Glycosides (e.g., Digoxin): Risk of digitalis toxicity secondary to hypokalemia may be increased.

Missed dose

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

Overdose

• Acute overdosage with Deltasone is unlikely to be acutely life-threatening.
• Symptoms of chronic overdose or excessive long-term use are synonymous with the drug’s adverse effects, particularly Cushing’s syndrome.
• There is no specific antidote for prednisone overdose.
• Management involves supportive care and symptomatic treatment. Gastric lavage or emesis is not useful. Hemodialysis is not effective.
• In cases of chronic overdose, the drug must be withdrawn gradually under medical supervision.

Storage

• Store at room temperature between 20°C to 25°C (68°F to 77°F).
• Protect from light and moisture.
• Keep in the original container, 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 or consult your pharmacist.

Disclaimer

This information is for educational and informational purposes only and does not constitute medical advice. It 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 medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content has been compiled from various sources but may not be comprehensive or up-to-date. The manufacturer and publisher are not responsible for any errors or omissions or for any consequences resulting from the use of this information.

Reviews

• “As a rheumatologist, Deltasone is an indispensable tool in my arsenal for managing acute flares of autoimmune arthritis. Its rapid onset of action provides patients with much-needed relief, allowing us to bridge the gap until slower-acting DMARDs take effect. The key is meticulous dosing and a proactive tapering strategy.” – Dr. Eleanor Vance, MD, Rheumatology
• “Prescribing prednisone requires a careful risk-benefit analysis. For severe asthma exacerbations, it can be life-saving. However, I consistently educate my patients on the importance of not abruptly stopping the medication and the potential for side effects like hyperglycemia and mood changes, which we monitor closely.” – Dr. Ben Chen, MD, Pulmonology
• “Long-term use of corticosteroids like Deltasone for my IBD patients is a last resort due to the significant side effect profile. We use it to induce remission and then strive to transition to maintenance therapy with safer agents. Patient education on bone health and infection risks is a critical part of the management plan.” – Dr. Maria Flores, MD, Gastroenterology