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Prednisone Use Long-Term

Prednisone Use Long-Term

New List of Prednisone Use Long-Term

Did you know that before now, a list of long-term prednisone uses did not exist? How can that be?

The United States Food & Drug Administration (FDA) approved prednisone in 1955. When the FDA added new requirements like side effects and which diseases it’s approved for, they “grandfathered in” prednisone. That means no drug company owns the patent or provides testing on which conditions it works for.

If no one else will, let’s create that list! Follow the instructions at the end of this article to add long-term conditions to this list of prednisone uses.

Prednisone Use Long-term versus Short-Term Use

Because prednisone causes over 150 toxic and harmful side effects, prednisone should be saved for only certain situations. Normally this means to follow the guideline, “Use the lowest effective dose for the shortest duration.” Another way to put that… only use prednisone if you absolutely must. Then only use the lowest dose that helps you.

Short-Term Prednisone Use

Doctors usually prescribe prednisone for the shortest time possible. Check out my other article about all the reasons doctors prescribe prednisone, including those short-term prednisone uses.

Harmful Conditions

However, some people suffer from diseases, diagnoses, and conditions so harmful to justify using prednisone long-term. Usually this means that the condition is so dangerous, harmful, painful, or deadly that the side effects pale in comparison. Read more about balancing benefits and risks at this article I wrote.

My Example

In my case, my doctor diagnosed me with Immune Thrombocytopenia (ITP). Essentially this means my doctor worried that I could bleed to death. Dying of bleeding to death > prednisone side effects? That’s what we tried for over 8 months, until I resorted to chemotherapy.

Prednisone Use Long-Term

Scientific articles define long-term prednisone as greater than three months. If you use prednisone less than three months, then that’s short-term. Several side effects increase and worsen the longer you take prednisone, and the higher the total dose (cumulative dose) you take. For example, bone loss continues to worsen as you continue to take prednisone.

Video Explanation

Watch Dr. Megan explain what prednisone is used for long-term below!

Health Conditions Which Use Prednisone and other Corticosteroids Long-term

Generally, steroids are used for severe autoimmune and inflammatory disorders.

I created this list based on which conditions the FDA-approved label or package insert listed as long-term. Also I added several conditions from well-respected medical references.

Type of Condition

Prednisone Indication

Allergic StatesChronic Rhinosinusitis with Nasal Polyps
Allergic disorders
Seasonal or perennial allergic rhinitis
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
Skin – Dermatologic DisordersAtopic dermatitis
Severe psoriasis
Severe rashes
Endocrine DisordersPrimary or secondary adrenocortical (adrenal) insufficiency
GI – Gastrointestinal DiseasesCrohn’s disease
Ulcerative colitis
Blood – Hematologic DisordersImmune thrombocytopenia (formerly known as idiopathic thrombocytopenic purpura)
Cancer – Neoplastic DiseasesProstate cancer (metastatic)
Palliative management of leukemias and lymphomas
Nervous System – NeurologyDuchenne muscular dystrophy
Myasthenia gravis
Autoimmune encephalitis
Chronic inflammatory demyelinating polyneuropathy
Multiple sclerosis exacerbation
Eye – Ophthalmic DiseasesChorioretinitis
Diffuse posterior uveitis
Optic neuritis
Kidney – Renal DiseasesProteinuria in lupus erythematosus
Focal segmental glomerulosclerosis (FSGS)
Proteinuria in the nephrotic syndrome
Lung – Respiratory Disease PulmonologistsAsthma
Chronic obstructive pulmonary disease (COPD) exacerbation
Idiopathic pulmonary fibrosis
Symptomatic sarcoidosis
Rheumatic DisordersAnkylosing spondylitis
Giant cell arteritis
Polymyalgia rheumatica
Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis
Systemic lupus erythematosus
Liver – HepatologyAutoimmune hepatitis
TransplantHeart, Liver, Kidney Transplants
Heart – CardiologyPericarditis

Let’s Grow This List!

Was your long-term condition listed in this chart? If not, please contact Dr. Megan and we can add it to the list! See the list growing below…

Conditions Suggested by Prednisone Warriors:

  • Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
  • Polymyalgia Rheumatica (PMR)

Prednisone Warnings

When taking prednisone, the lowest effective dose should be prescribed. It might start out high, but the goal should be to get the dose as low as will keep your condition stable. NEVER stop taking prednisone without talking to your doctor, as there are severe withdrawal effects. Your body stops creating certain hormones (cortisol) when you take prednisone, and so in order to give your body time to kick in the hormone-making factory, the adrenal gland, you must slowly stop taking it over weeks to months.

NEVER stop taking prednisone suddenly.

Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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