Deltasone is the brand name for the systemic corticosteroid medication prednisone. It is a potent anti-inflammatory and immunosuppressive agent prescribed to manage a wide spectrum of medical conditions characterized by an overactive or misdirected immune response. By mimicking the effects of hormones your body naturally produces in the adrenal glands, Deltasone works to swiftly reduce inflammation, suppress immune system activity, and alleviate associated symptoms like pain, swelling, and allergic reactions. Its efficacy and rapid onset of action make it a cornerstone therapy in both acute interventions and the management of chronic autoimmune and inflammatory diseases.

Features

• Active Pharmaceutical Ingredient: Prednisone (a synthetic glucocorticoid).
• Available in oral tablet form for systemic delivery.
• Standard tablet strengths include 1mg, 2.5mg, 5mg, 10mg, 20mg, and 50mg.
• Designed for high bioavailability upon oral administration.
• Functions as a prodrug, converted in the liver to its active form, prednisolone.

Benefits

• Rapid Reduction of Inflammation: Quickly targets and diminishes inflammatory processes, providing relief from pain, swelling, and redness associated with numerous conditions.
• Effective Immunosuppression: Calms an overactive immune system, making it essential for managing autoimmune disorders where the body attacks its own tissues.
• Symptom Control in Allergic Reactions: Effectively manages severe allergic responses that are unresponsive to conventional antihistamines.
• Prevention of Organ Transplant Rejection: Used as part of immunosuppressive regimens to help prevent the body from rejecting a transplanted organ.
• Management of Hematologic Cancers: Helps control the proliferation of cancerous cells in certain types of leukemia and lymphoma.
• Restoration of Endocrine Function: Provides replacement therapy for patients with adrenal insufficiency (Addison’s disease), ensuring critical hormonal balance.

Common use

Deltasone (prednisone) is indicated for a vast array of conditions where reducing inflammation or suppressing the immune system is therapeutically beneficial. Its use spans multiple medical specialties. Common applications include:

• Rheumatologic Diseases: Rheumatoid arthritis, systemic lupus erythematosus (SLE), polymyalgia rheumatica, giant cell arteritis, and vasculitis.
• Allergic Conditions: Severe asthma exacerbations, contact dermatitis, severe allergic rhinitis, and serum sickness.
• Dermatologic Diseases: Severe psoriasis, pemphigus vulgaris, and severe erythema multiforme.
• Ophthalmic Diseases: Uveitis and optic neuritis.
• Respiratory Diseases: Sarcoidosis and as part of management for chronic obstructive pulmonary disease (COPD) exacerbations.
• Gastrointestinal Diseases: Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease.
• Hematologic/Oncologic Conditions: Autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and as part of chemotherapy regimens for leukemias and lymphomas (e.g., acute lymphoblastic leukemia, Hodgkin’s lymphoma).
• Neurologic Diseases: Exacerbations of multiple sclerosis and myasthenia gravis.
• Organ Transplantation: To prevent and treat graft rejection.
• Endocrine Disorders: Replacement therapy for adrenal insufficiency.

Dosage and direction

Crucial Note: Dosing is highly individualized and MUST be determined by a qualified healthcare professional based on the specific condition being treated, its severity, and the patient’s response. Never self-adjust the dose.

• Administration: Tablets are taken orally, typically with food or milk to minimize gastrointestinal upset.
• Timing: Often prescribed as a single daily dose, preferably in the morning (around 7-8 AM) to coincide with the body’s natural cortisol rhythm and reduce the potential for adrenal suppression and insomnia.
• Dosing Schemes:
  • High-Dose Therapy: Used for acute, severe exacerbations (e.g., severe asthma attack). Doses can be high initially (e.g., 40-60 mg/day) and are then tapered down.
  • Low-Dose Maintenance Therapy: Used for chronic disease management (e.g., rheumatoid arthritis). Doses are typically lower (e.g., <10 mg/day).
  • Alternate-Day Therapy: Sometimes used for long-term management to further reduce side effects. A double dose is taken every other morning.
• Tapering: Perhaps the most critical aspect of Deltasone therapy. After more than a few weeks of use, the dose must be gradually reduced (tapered) under medical supervision. Abrupt cessation can lead to life-threatening adrenal insufficiency, withdrawal symptoms, and a flare-up of the underlying disease. The tapering schedule is slow and methodical, often reducing the dose by small increments (e.g., 2.5-5 mg) over weeks or months.

Precautions

Patients taking Deltasone must be closely monitored by their physician. Key precautions include:

• Adrenal Suppression: Prolonged use can cause the adrenal glands to stop producing natural cortisol. This necessitates slow tapering and means the body may not be able to handle physical stress (e.g., surgery, infection, trauma). A medical alert bracelet is advised.
• Infections: Deltasone masks signs of infection (like fever) and increases susceptibility to new infections or can cause latent infections (e.g., tuberculosis) to reactivate. Report any potential signs of infection promptly.
• Vaccinations: Live vaccines (e.g., MMR, varicella, nasal flu vaccine) are generally contraindicated during therapy due to the risk of causing the disease. Inactivated vaccines may have a diminished response.
• Monitoring: Regular checks of blood pressure, blood glucose, weight, electrolytes, bone density (DEXA scan), and ocular pressure may be required during long-term therapy.
• Surgery: Inform all surgeons and dentists of current or recent Deltasone use, as stress-dose steroids may be required perioperatively.

Contraindications

Deltasone is contraindicated in patients with:

• Systemic Fungal Infections: Unless being used for the management of life-threatening fungal infections with specific antifungals.
• Known Hypersensitivity: To prednisone, any other corticosteroid, or any component of the formulation.
• Live Virus Vaccination: Administration of live vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.
• Idiopathic Thrombocytopenic Purpura (ITP) via IM route: This is a specific contraindication for intramuscular administration in this condition.

Possible side effect

The side effect profile is extensive and is closely related to both dosage and duration of therapy.

• Common: Fluid retention, weight gain, increased appetite, indigestion, nausea, insomnia, mood swings (euphoria, depression), nervousness, easy bruising, thinning skin, facial rounding (“moon face”), acne.
• Serious (require immediate medical attention):
  • Endocrine: Hyperglycemia (may trigger steroid-induced diabetes), Cushing’s syndrome, hypothalamic-pituitary-adrenal (HPA) axis suppression, growth suppression in children.
  • Cardiovascular: Congestive heart failure in susceptible patients, hypertension.
  • Musculoskeletal: Osteoporosis, vertebral compression fractures, avascular necrosis of the hip/joint, muscle weakness (myopathy).
  • Ophthalmic: Glaucoma, cataracts.
  • Gastrointestinal: Pancreatitis, peptic ulcer with potential for perforation and hemorrhage.
  • Dermatologic: Impaired wound healing.
  • Neurologic: Seizures, increased intracranial pressure.
  • Psychiatric: Severe depression to psychotic episodes.

Drug interaction

Deltasone interacts with numerous medications. A comprehensive list must be reviewed with a doctor or pharmacist. Key interactions include:

• Anticoagulants (e.g., Warfarin): Corticosteroids may alter the response to anticoagulants, requiring more frequent INR monitoring.
• Antidiabetic Agents (Insulin, Oral Hypoglycemics): Deltasone increases blood glucose, necessitating dosage adjustments of diabetes medications.
• Diuretics (e.g., Furosemide, Hydrochlorothiazide): Concomitant use increases the risk of severe hypokalemia (low potassium).
• NSAIDs (e.g., Ibuprofen, Naproxen): Significantly increases the risk of gastrointestinal ulceration and bleeding.
• Live Vaccines: Increased risk of vaccine-induced disease.
• Enzyme Inducers (e.g., Phenobarbital, Phenytoin, Rifampin): These drugs may increase the clearance of prednisone, reducing its efficacy.
• Enzyme Inhibitors (e.g., Ketoconazole): May decrease the clearance of prednisone, increasing the risk of toxicity.
• Cardiac Glycosides (e.g., Digoxin): Risk of hypokalemia potentiates digitalis toxicity.

Missed dose

• If you miss a dose, take it as soon as you remember.
• However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
• Do not take a double dose to make up for a missed one.
• If you are on a tapered schedule and miss a dose, contact your healthcare provider for specific instructions, as this can disrupt the careful tapering process.

Overdose

• An acute, single overdose is unlikely to be acutely life-threatening.
• However, chronic overdose (taking too much for an extended period) will lead to the development or exacerbation of the drug’s serious side effects, such as severe Cushing’s syndrome, hyperglycemia, hypertension, and psychosis.
• In case of suspected overdose, contact a poison control center (1-800-222-1222) or emergency medical services immediately.
• Treatment is supportive and symptomatic, as there is no specific antidote. Management may include gastric lavage if ingestion was recent.

Storage

• Store at room temperature (68°F to 77°F or 20°C to 25°C) away from light, moisture, and heat.
• Do not store in the bathroom.
• Keep the bottle tightly closed.
• Keep all medications out of the reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The author and publisher are not responsible for any specific health or allergy needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application, or preparation, to any person reading or following the information in this document.

Reviews

• “As a rheumatologist, Deltasone is an indispensable tool in my arsenal for managing acute flares of autoimmune arthritis. The rapid symptomatic relief it provides can be dramatic for patients in severe pain. The challenge, of course, is managing the side effect profile with careful dosing and tapering.” – Dr. Eleanor Vance, MD, Rheumatology
• “After my kidney transplant, Deltasone was a critical part of my anti-rejection regimen. While I experienced some weight gain and moon face initially, my team adjusted my dose over time. I’m grateful for this medication that is helping to keep my new organ healthy.” – Patient M.K.
• “I have severe asthma, and a short course of Deltasone is what gets me through a serious exacerbation and avoids a hospital admission. It works quickly and effectively, though I always feel a bit ‘wired’ and have trouble sleeping while on it.” – Patient J.S.
• “Prescribing prednisone requires a constant risk-benefit analysis. For a patient with giant cell arteritis, it is sight-saving. However, I meticulously monitor my long-term patients for osteoporosis, diabetes, and hypertension, mitigating risks where we can.” – Dr. Ben Carter, MD, Internal Medicine