Online message boards often get flooded by patients who've recently received prescriptions for prednisone. Much of this on-line traffic pertains to the adrenal gland and tapering the dose of prednisone. Patients read product information and understandably wonder what they're in for. While prednisone will never be an "easy" drug, the reality about tapering the dose rarely lives up to the anticipatory dread that some patients experience.
Corticosteroids
Among their many functions, the adrenal glands produce a family of compounds call corticosteroids. This family includes cortisol, also called hydrocortisone. Cortisol and other corticosteroids are the body's own natural anti-inflammatory agents. Corticosteroids are also called glucocorticoids because they increase the level of glucose in the blood.
Effects
Prednisone and related drugs such as solumedrol and prednisolone act as super-corticosteroids by reducing inflammation related to everything from poison ivy to serious kidney disease. This seemingly miraculous effect comes at a price however, because when patients take prednisone, their adrenal glands stop making corticosteroids which is undesirable. The cessation of of corticosteroid production by the adrenals makes tapering necessary.
Dosing
Doctors mitigate the effects of prednisone on the adrenal glands by prescribing it for use every other day, when possible. This allows the body's ability to make corticosteroids to kick back in between doses.This is done more commonly when the initial dose is relatively high compared to body size or when the patient is taking the drug for a relatively long time. By mitigating the effects of prednisone, tapering makes its use easier on the body.
Tapering
Doctors also provide elaborate instructions for how to taper off their prednisone dose gradually. Tapering instructions are highly variable and depend on how long the patient was on prednisone and other factors such as the intractability of the condition and the initial dose. This tapering period can last from a few days to over six months.
Tapering of dosage allows the body's ability to make corticosteroids to "wake up" again.
Caution
Failure to follow tapering instructions is very hard on the body because it puts the patient into corticosteroid withdrawal--the adrenal gland does not kick back in automatically overnight. MayoClinic.com lists the symptoms of corticosteroid withdrawal as severe fatigue, weakness, body aches, nausea or vomiting, lightheadedness when standing (low blood pressure).
Never abruptly discontinue this drug without notifying your doctor first.
