What does everyone think about using Prednisone as a treatment? I'm too worried about side effects.

Hi Connie,

I was diagnosed alittle over a year ago, before that for what seemd like forever, i suffered with swollen hands, fingers, wrists, feet. It was awful! Finally i saw the rheumatoid dr. I am soon to be 47 yrs old, and really never, ever took a pill for anything, i was alway afraid of side effects and felt i could get through anything without pills, until this, i'm sure you know the pain i'm talking about, the constint tiredness and everything else that seems to go with it.

My first visit i was totally blown away with what i was hearing, total disbelief, but yet, an anwer to why i have felt all of what i was feeling. The dr. left the room, came back and told me he was giving me a shot of prednosine in my butt, silly me, i said, but why there? My hands and wrist are so bad? ( i thought i would get the shot in a joint). i think its a mixture of pred. and something else, and then he gave me a pack of pred. pills to take also over a period of time. I truly panicked, again, i never really took pills! I went home with my now sore butt and pack of pills scared to death, thinking i too have heard so many bad things about pred. but, in the condition i was in, i knew i had to start somewhere. So i already had the shot, (which lasts about 2 months in my system) and started the pills, which for me, was short term, they blast you with alot of pills and slowly take you down to one a day, and then stop. As much as i was scared, the swelling went away and for the first time in i dont know how many months, i started to feel good again!! it seemed that dose kept me good for about 2-3 months, then it would start up again, and i would do that same treatment, and things were great. Pred. is a drug you dont want and really shouldnt be on long term, due to the side affects that could happen, but it is a god sent when you are in a flare up state. I also started the Methotrexate, which i fought to not take, but again realized, i have to do something to have a life.

To make a very long story short, i have over come my fear of the pred. and will take it when i flare up, being i see how wonderful it is at the time and the methotrxate has slowed down my deformities, i still have some pain and stiffness, some good days and really bad days, but over all, i keep moving forward and have to remember that not everyone's body reacts the same to medication, and that i will do more damage to my body without the drugs than with them. at this time i would encourage people to take them, i was really really scared at first, but saw they were helping me.

Hi Connie! I'm Joy, the manager of the site.

Prednisone can be tricky. There was a survey done last year that found that many rheumatoid arthritis patients weren't happy with prednisone therapy. But, the survey also found that the main reason they didn't like it was because of things they "heard" and a misunderstanding of the side effects, even though the treatment was effective for many of them.

You can check out this predinisone drug information page on our site that lists some of the side effects and a bunch of other informaton.

Side effects depend on the person and how long they take the drug. "Prednisone may cause euphoria, insomnia, mood changes, personality changes, psychotic behavior, or severe depression."

Yikes! And, as you mentioned a family history of heart disease, prednisone, at a high doses, may cause fluid retention and high blood pressure, which may then require a low-salt diet and a potassium supplement.

On the plus side, the delayed-release form of prednisone has been effective in reducing morning stiffness from rheumatoid arthritis.

Bottom line, let your doctor know about your concerns and ask every little question you have. Make sure you get the answers. If your doctor recommends that you try it, then you may want to do that, but carefully monitor and report any side effects.

Hi Connie,

I took prednisone about 10 years ago for a few acute flares of my RA that went beyond what the NSAIDs I was taking could manage. I took it in short 1-2 week treatments, and I remember that the dosage started higher and then tapered off over that time.  I tend to really flare in one or two joints at a time.  So this was effective and I don't remember having nausea or other side effects.

I can understand your concerns about prednisone.  My brother took it for a long time for his asthma and I remember him having the "moon face" and some of the other common side effects.  In my opinion, I think prednisone works for short term treatment of acute flares, but for long term treatment, I think there are other medications that might help just as much without some of the same osteoporosis concerns and other side effects (though each medication has risks of side effects).  For example, there are DMARDs like placquenil and methotrexate and quite a few biologics like Humira and Remicade - though these can be very expensive without strong health insurance coverage. 

Hope this is helpful.  And remember to stay positive, it can take a while to find the right drug or combination of drugs for you. 

Christine

Dear Connie- Please be VERY cautious in using this drug. Everyone has to decide what works for them in the long run but my experience with this drug (given for asthma) was that it caused massive mood shifts, I gained 100 lbs in one year, had hormone and temperature disruptions from the drug itself almost destroying my adrenal gland function and I practically gave up sleep for Lent. I was awake all night like a hoot owl and exhausted the next day. ( I later learned that the body's natural peak production of Cortisone was at about 7:00 am) which is about the time I could sleep and at 3:00 pm it was at its low point and so was I. I went back and forth from ultra alert jitteriness to sheer exhaustion. Long-term use of this drug can actually destroy joints. Get the drug insert and carefully read about adrenal insufficiency, because in a small group of patients (like me) this damaged my adrenal system and almost caused adrenal failure, which can be fatal. Do not stop this drug or taper the dose without an excellent physician on hand and WEAR A MEDICAL ALERT BRACELET if you take this. I have decided to avoid this drug at all costs in the future. This is also the "magic bullet" shot you are given when you go to the doc for bad colds, etc so BEWARE.

I have been taking prednisone for over three years, and I have never been off it, not even once.  That being said, I have experienced side effects from it, not all of them but some.  I have experienced weight gain, and calcium deficiency. However, I have been on many different medication and combination of medications from having severe RA, and prednisone has helped me more than anything I have tried.  Prednisone has allowed me to get out of bed in the morning.  And within a couple of hours of taking it first thing in the morning, I am able to bend my fingers and get thing around my house accomplished.  I am on a low sodium diet to combat the weight gain, and a calcium supplement.  You just get to the point where you have to ask yourself "is it worth it"?  Yes there are some scary side effects, but can you handle a little weight gain in order to have some relief?  I am not telling you that you should take it though.  I fully believe that you should never take anything that you are not comfortable taking.  But to me, I have never regretted taking prednisone.  I hope you find comfort for your pain!  Good luck and best wishes!

Hi Connie,

As with any other treatment, you have to weigh the pros and cons, look at the impact, both in terms of side effects and how the drug will help you.  How much does your RA affect your life?  How much does it limit you?  Will the change in your ability to live your life the way you want to be worth the risk of side effects?

My philosophy on the drugs with significant side effects is this: Big Problems require Big Drugs.  The question is how big is your problem and only you can answer that.

Good luck!

Connie,

Just came across this question. Anyway, I have been taking prednisone on the average 7 to 10 mg, daily for over ten years, and when I flare up (I have RA) I take up to 20 mg p/day for 2 days (my flare ups are all gone by that time) and then come down appropirately to my needed dosage.

I am on Enbrel and Methotraxite (how ever you spell that?), and a Non-Steriodal pills as well but I find that I could really do without all that stuff and just keep taking my prednisone pills and I would do just fine, but I am seeing an AR Doctor and he is making take that other stuff. He is also wanting me to stop taking the prednisone and if he cut's my prescription I will go to another doctor. That is how strong I feel about continuing these pills.

I am also a Karate instructor (part time, I am an engineer) and it does wonders for my training and joints. This drug does not effect me like others. I don't get mood swings, or anything else I notice, except for the weight problem. I am actively working out twice a day to maintain my proper weright but it a battle and my face has gotten fatter (oh well...), if that is the price I have to pay for feeling great, so be it.

I am now 53 and still going strong. Remember this drug effects everybody differently.

Vic

I understand your concern about Prednisone because I have the same feelings but I have used it for years when I got a sinus infection so did go on it when I was first diagnosed with RA. I tapered it down to 5 mg a day for a year. The only problem I had with it was weight gain but it did help my pain better than anything else. I stopped using it in May and I have noticed the pain coming back so may have to go back on it. Only you can decided what is right for you and if it is worth the risk.