Prednisone is an extremely effective drug and may be necessary to control active lupus. Those individuals with organ-threatening disease (i.e., heart, lung, brain, kidney, liver) usually need steroids in order to prevent loss of function in the organ. People who tolerate steroids poorly or do not respond optimally often benefit from the addition of steroid-sparing or immune suppressive drugs.
Corticosteroid treatment usually relieves most symptoms promptly. When pleurisy (inflammation around the lung) or pericarditis ( inflammation around the heart) occur, small or moderate doses of steroids are helpful. Steroids can often be avoided completely in mild cases of lupus (i.e., those involving only the joints and skin).
In addition to prednisone, some other cortisone derivatives include hydrocortisone , methylprednisolone (Medrol), and dexamethasone (Decadron). People with lupus should discuss the reasons for using steroids and other treatment alternatives which may be available with their physician.
Some of the more common side effects of steroids include changes in appearance such as acne, development of a round or moon-shaped face, and an increased appetite leading to weight gain. Steroids may also cause a redistribution of fat, leading to a swollen face and abdomen, but thin arms and legs. The skin becomes more fragile, which leads to easy bruising.
Psychological side effects of steroids include irritability, agitation, euphoria or depression. Insomnia can also be a side effect. These changes in appearance and mood are more apparent with high doses of steroids.
An increase in susceptibility to infections may occur with high doses of steroids. Prednisone may also aggravate diabetes, glaucoma, and high blood pressure, and often increases cholesterol and triglyceride levels in the blood. Steroids also can suppress growth in children. Steroids do not cause cancer.
Side Effects From Steroid Use
As mentioned before, there are side effects associated with steroid medications, although changes in appearance and mood are more apparent with high doses of steroids. However, steroids do not cause cancer.
Some of the more common side effects are:
- Changes in appearance
- development of a round or moon-shaped face
- weight gain due to increased appetite
- a redistribution of fat, leading to a swollen face and abdomen, but thin arms and legs
- the skin becoming more fragile, which leads to easy bruising.
- Psychological problems
- euphoria or depression
- An increase in susceptibility to infections may occur with high doses of steroids.
- Prednisone may aggravate:
- high blood pressure
- Prednisone often increases levels of:
- Steroids also can suppress growth in children.