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Steroid Tablets

Prednisolone

This guide takes you through the different types of medications that may be prescribed following your consultation with the LBSM physicians.

If you have any further questions or are unsure about the medication you have been prescribed, please do not hesitate to contact us.

  1. What is Prednisolone
  2. Who can take prednisolone tablets and liquid
  3. Who may not be able to take prednisolone tablets and liquid
  4. How and when to take prednisolone tablets and liquid
  5. Side effects of prednisolone tablets and liquid
  6. Pregnancy, breastfeeding and fertility while taking prednisolone tablets and liquid
  7. Taking prednisolone with other medicines and herbal supplements
  8. Alternatives to Prednisolone

1. What is Prednisolone

Prednisolone is a medicine used to treat a wide range of health problems including allergies, blood disorders, skin diseases, joint inflammation and infections. 

It helps by reducing swelling (inflammation) and can also calm down your immune system. This helps autoimmune conditions, like rheumatoid arthritis, where your immune system mistakenly attacks its own tissues. 

Persistent inflammation in the body can sometimes inhibit healing and disrupt rehabilitation. Prednisolone can be used to help reduce unnecessary inflammation in the body to aid recovery and rehabilitation. In the content of a sports medicine clinic, Prednisolone will only be prescribed as a short course lasting no more than 1-2 weeks, usually when there is severe inflammation in the body e.g. trapped nerve in the back.  

Prednisolone is a steroid or corticosteroid medicine. Corticosteroids are not the same as anabolic steroids that some body builders use for example. 

Prednisolone is available only on prescription as tablets and as a liquid you swallow. It can also be given by injection depending on the clinical need and indication. Prednisolone will often be used in conjunction with a Non-Steroid Anti-Inflammatory. 

2. Who can take prednisolone tablets and liquid 

Most adults and children can take prednisolone tablets and liquid.

3. Who may not be able to take prednisolone tablets and liquid

To make sure prednisolone is safe for you, tell your doctor or pharmacist before taking it if you:

  • have ever had an allergic reaction to prednisolone or any other medicine
  • have an infection (including eye infections) or any unhealed wounds
  • are trying to get pregnant, are already pregnant or you are breastfeeding
  • have recently been in contact with someone with shingles, chickenpox or measles
  • have recently had, or are about to have, any vaccinations
  • have liver problems
  • have ever had or any close family members have had mental health problems
  • have heart failure or have had a recent heart attack
  • have high blood pressure (hypertension)
  • have diabetes
  • have epilepsy
  • have glaucoma
  • have an underactive thyroid
  • have thinning bones (osteoporosis)
  • have ever had a stomach ulcer

4. How and when to take prednisolone tablets and liquid

It’s important to take prednisolone as your doctor has advised. 

Dosage and strength 

The dose of prednisolone you’ll take depends on your health problem and whether you are taking it as a short course or for longer. 

The usual dose varies between 5mg and 60mg daily but occasionally higher doses may be prescribed. 

The strength of tablets range from 1mg to 25mg. There are 2 strengths of liquid with either 1mg or 10mg in every 1ml. 

In children, the dose may be lower than for an adult with the same problem because it is calculated based on their height and weight. 

Changes to your dose 

Your dose may go up or down. 

Once your health problem or condition starts to get better, it’s likely that your dose will go down. 

Your doctor may reduce your dose before you stop treatment completely. This is to reduce the risk of withdrawal symptoms. 

Your dose may go up if your symptoms get worse. 

How to take it 

Unless your doctor or pharmacist gives you different instructions, it’s best to take prednisolone as a single dose once a day, with breakfast. For example, if your dose is 40mg daily, your doctor may tell you to take 8 tablets (8 x 5mg) all at the same time. 

Take prednisolone with breakfast so it does not upset your stomach. Taking prednisolone in the morning also means it’s less likely to affect your sleep. 

If your prednisolone tablets are labelled as “enteric coated” or “gastro resistant”, you can take these with or without food but make sure to swallow them whole. Do not take indigestion medicines 2 hours before or after taking enteric coated or gastro resistant tablets. 

Sometimes, your doctor may advise you to take prednisolone on alternate days only. 

How long to take it for 

This depends on your health problem or condition. 

You may only need a short course of prednisolone for up to 1 week. 

You may need to take it for longer, even for many years or the rest of your life. 

If you forget to take it 

If you miss a dose of prednisolone, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take the next one at the usual time. 

Do not take a double dose to make up for a forgotten one. 

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. 

Stopping prednisolone 

It can be dangerous to stop taking prednisolone suddenly, especially if you have been on a high dose for a long time. 

Your health condition may flare up again. You may also get withdrawal side effects including: 

  • severe tiredness 
  • weakness 
  • body aches 
  • joint pain 

These side effects are most likely to happen if you have taken prednisolone for more than a few weeks or you take more than 40mg daily. 

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects. 

Important 

Do not stop taking prednisolone without talking to your doctor – you will need to reduce the dose gradually. 

If you take too much 

Taking too many prednisolone tablets is unlikely to harm you. 

If you’re worried, talk to your doctor or pharmacist. 

5. Side effects of prednisolone tablets and liquid 

The higher the dose of prednisolone that you take and the longer you take it for, the greater the chance of side effects. You’re less likely to get side effects if you take a relatively low dose of prednisolone daily. 

If you have been taking prednisolone for more than a few weeks, check with your doctor before stopping it suddenly to reduce your chances of withdrawal side effects. 

Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months. 

Common side effects 

These common side effects of prednisolone happen in more than 1 in 100 people. There are things you can do to help cope with them: 

  • Weight gain 
  • Indigestion 
  • Problems sleeping (insomnia) 
  • Feeling restless 
  • Sweating a lot 
  • Mild mood changes 

Speak to a doctor or pharmacist if the advice on how to cope does not help and any of these side effects bother you or last more than a few days.  

Serious side effects 

You are more likely to have a serious side effect if you take a higher dose of prednisolone or if you have been taking it for more than a few weeks. 

Call a doctor or contact 111 straight away if you get: 

  • a high temperature, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva (yellowish and possibly with streaks of blood), pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection 
  • sleepy or confused, feeling very thirsty or hungry, peeing more often, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar 
  • weight gain in your upper back or belly, “moon face” (a puffy, rounded face), very bad headaches and slow wound healing – these can be signs of Cushing’s syndrome 
  • a very upset stomach or you’re being sick (vomiting), very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems 
  • muscle pain or weakness, muscle cramps, or changes in your heart rate – these can be signs of low potassium levels 
  • severe stomach pain, severe back pain, severe upset stomach or you’re being sick – these can be signs of pancreas problems 
  • breathlessness 
  • swelling in your arms or legs 
  • changes in your eyesight 
  • any bruising or bleeding that is not normal 
  • red or black poo 

Mood changes 

You may notice mood changes and mental health problems while taking prednisolone. 

Talk to your doctor or contact 111 if you have any mood changes including: 

  • feeling depressed 
  • feeling high, or moods that go up and down 
  • feeling anxious, having problems sleeping, difficulty in thinking, or being confused and losing your memory 
  • feeling, seeing or hearing things that do not exist (hallucinations) 
  • having strange and frightening thoughts, changing how you act, or having feelings of being alone 

The higher the dose, the more intense the mood changes can be.

6. Pregnancy, breastfeeding and fertility while taking prednisolone tablets and liquid 

Prednisolone and pregnancy 

You can take prednisolone while you’re pregnant. It has occasionally been linked to problems in the first 12 weeks of pregnancy and possible effects on the baby’s growth, however, the benefits of taking it usually outweigh any risks. 

Only small amounts can cross over the placenta, so your baby is exposed to very little prednisolone in the womb. 

If you take prednisolone in pregnancy, your baby’s growth will be checked regularly. 

It’s important that immune and inflammatory problems are well treated as these can affect you and your baby’s wellbeing. 

Speak to your doctor if you become pregnant. They will discuss the risks and benefits with you and help you decide on the best treatment for you and your baby. 

Prednisolone and breastfeeding 

If your doctor or health visitor says that your baby is healthy, it’s OK to take prednisolone while breastfeeding. 

Prednisolone passes into breast milk in small amounts. It has been used for many years in breastfeeding women without side effects in their babies. 

If you’re taking a dose of more than 40mg of prednisolone each day for a long time, your baby may need extra monitoring. 

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible. 

Prednisolone and fertility 

There’s no clear evidence to suggest that taking prednisolone reduces fertility in either men or women. 

7. Taking prednisolone with other medicines and herbal supplements 

There are many medicines that can affect the way prednisolone works, or increase the risk of side effects. It’s very important you check a medicine is safe to take with prednisolone before you start taking it. 

This includes anti-inflammatory painkillers such as ibuprofen and aspirin. 

Mixing prednisolone with herbal remedies or supplements 

There’s very little information about taking herbal remedies and supplements with prednisolone. 

It’s not possible to say that herbal remedies and supplements are safe to take with prednisolone. They’re not tested in the same way as pharmacy and prescription medicines. 

8. Alternatives to Prednisolone 

Your LBSM doctor may also be able to recommend different medicines and therapies depending on the health problem you have. 

Medication are often used in used in conjunction with a wider rehabilitation programme. 

Always follow the instructions that come with your medicine. 

Please feel free to contact us if you have any queries about your medication. Look forward to seeing you at your next appointment.  

Wishing you a speedy recovery 

The LBSM team. 

The information in this article has been cited from www.nhs.uk to align with best clinical practice standards.

 

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    Orla Mulligan
    Administration and Social Media Manager
    Administration, LBSM

    Orla Mulligan is the administration and social media manager for LBSM. She has a strong background in sport having herself played netball at an elite standard for the U21s Northern Ireland team in the European Championships as well as the U21s competition for Saracen Mavericks.

    She understands youth sport pathways having herself played and training in the netball Kent regional pathway. She has a keen interest in most sports and a good understanding of how injury and illness can impact on the mind and body, as well as rehabilitation pathways.

    She looks forward to speaking and assisting LBSM patients and gives her best support to them during their treatment pathway.

    A day in the life of Orla involves communicating with patients via phone and email, managing and organising clinics, operations and media management.

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    Associate, LBSM
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    She is particularly interested in helping her patients improve their quality of life and achieve their personal goals, working closely with Foot and Ankle Consultants, Sports Medicine Doctors and Physiotherapists.

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    Having graduated from University of Brighton with a MSc (hons) in Podiatry, Maddie focused her career in Podiatric Sports Injuries and Biomechanics. Previously she completed a BSc (hons) in Sport Science at Loughborough University.

    A day in the life of Maddie involves consulting patients in clinic, performing gait and biomechanical assessments, measuring and fitting orthotics and braces. She also regularly teaches and presents at sports medicine and podiatry conferences.

    Outside of work, Maddie still finds time to play hockey and enjoys running and skiing.

    Mr Prakash Saha
    MBBS, PhD, FRCS
    Consultant Partner, LBSM
    Consultant in Vascular Surgery

    Mr Prakash Saha is a Consultant Vascular Surgeon at LBSM. He takes pride in providing the best possible results for his patients by using the most appropriate non-surgical and surgical methods based on clinical evidence, patient results and satisfaction.

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    Mr Saha studied medicine at the United Medical & Dental Schools at Guy’s and St. Thomas’ Hospitals before completing his higher surgical training in London and the South East. During this time, he was awarded the prestigious NIHR Clinical Lectureship in Vascular Surgery at St. Thomas’ Hospital, giving him comprehensive training in open and endovascular techniques for treating arterial and venous disease. Prakash completed his aortic surgery training at the St. George’s Vascular Institute before carrying out a specialist fellowship at the Royal Prince Alfred Hospital, Sydney.

    Mr Saha regularly lectures and runs workshops across the globe on the latest surgical techniques to treat vascular disease. He has also been awarded a number of research grants from the Royal College of Surgeons, the Circulation Foundation, the Wellcome Trust, the Academy of Medical Sciences, and the British Heart Foundation, which has led to over 80 publications and the development of innovative technologies to help treat patients. For this work, Prakash has received a number of prizes, including the Venous Forum prize from the Vascular Society of Great Britain and Ireland, an International Young Investigator Award, and an Early Career Investigator Award from the American Heart Association.

    A day in the life of Mr Saha involves seeing patients in clinic, operating in surgical theatre or lecturing at his university. He also regularly teaches and presents at vascular and sports medicine conferences.

    Mr Saha is an avid cyclist and tennis player (although yet to get a set of Dr Seth!). Outside of work, he spends time with his family who consists of 3 children and enjoys travelling.

    Dr Gajan Rajeswaran
    MBBS, FRCR
    Consultant Partner, LBSM
    Consultant in Sports and Musculoskeletal Radiology

    Dr Gajan Rajeswaran is a Consultant Musculoskeletal Radiologist at LBSM, with an extensive background of working in elite sport. He is one of the most recognised radiologists in the sports medicine field. He provides top level imaging and medical diagnostic services for patients and athletes.

    Dr Gajan Rajeswaran completed his undergraduate medical training at Imperial College London and his radiology training at Chelsea & Westminster Hospital. He has obtained two post-CCT fellowships in musculoskeletal imaging. He was appointed as a consultant at Chelsea & Westminster Hospital in 2011.

    He has a passion for all sports having worked as a radiologist at the Glasgow Commonwealth Games and London World Athletic Championships and continues to support The Championships, Wimbledon. He also continues to work with a number of Premier League and Championship Football Clubs, Premier League Rugby Clubs, England Sevens Rugby, British Athletics and the Lawn Tennis Association.

    A day in the life of Dr Rajeswaran involves giving his expert opinion on investigations such as MRI and CT scans, x-rays and ultrasound. He also performs injection lists under ultrasound, CT and X-ray including spinal injections. He also regularly teaches and presents at sports medicine conferences.

    Dr Gajan Rajeswaran is an avid football fan and life-long fan of Tottenham Hotspur (for which he offers no apologies!). Outside of work, he spends time with his family and has a keen passion for photography.

    Dr Ajai Seth
    MBBS, BSc, MSc, MRCS, MRCGP, FFSEM
    Medical Director, LBSM
    Consultant in Sport and Exercise Medicine

    Dr Ajai Seth is a Sport and Exercise Medicine Physician. He has dedicated his career to helping people with sport and exercise related injury and illness. He consults and treats everyone from the elite athlete to the weekend warrior.

    Dr Ajai Seth is part of the British Tennis Sports Physician team at the LTA and has also provided cover to elite athletes at Wimbledon Tennis, European Tour Golf, Premier League Football, British Athletics, and the Men’s England Football academies as part of the FA.

    He also prides himself for working in disability sport and is currently the Chief Medical Officer for Team GB Wheelchair Tennis which has taken him to the Olympics and Paralympics.

    Dr Ajai Seth is dedicated to education, training and research and is a Senior Lecturer in Sports Medicine at King’s College London where he lectures in all aspects of Sports Medicine and Science.

    He also has a passion for travel and Expedition Medicine, which has seen him accompany medical, scientific and charity expeditions all around the world. He also has vast experience in treating musculoskeletal injuries from children and adolescents to veteran exercisers, both male and female.

    Dr Seth also has positions in leading Sport Medicine organisations, including the non-executive board for the UK’s largest Sports Medicine charity, BASEM and Past President for the Royal Society of Medicine. 

    A day in the working life of Dr Seth involves consulting his patients in clinic, performing diagnostics and ultrasound guided injections. He also regularly lectures and tutors students and presents at sports medicine conferences internationally. He also spends part of the working week at the National Tennis Centre, LTA, supporting British Tennis players.

    Outside of work, Dr Seth enjoys playing club tennis, triathlon, golf, running and skiing (but will give any sport a go!). He enjoys keeping fit and active and good quality family time with his wife and three children.