Round pill held in one hand and glass of water held in the other
One of the main treatments for inflammation of the airways as a result of asthma is prednisone.

Prednisone for Asthma

Asthma causes symptoms including wheezing, coughing and shortness of breath. Along with narrowing of the airways, asthma also causes inflammation. Treatment for asthma addresses the constriction and the inflammation of the airways to improve airflow. One of the main treatments for inflammation is prednisone.

What is Prednisone for Asthma?

Prednisone is a medication classified as a corticosteroid. It decreases inflammation in the body. Prednisone is sometimes used to treat an asthma exacerbation. The medication works by binding to specific cells and decreasing the inflammatory immune system response. Various diseases that cause inflammation are often treated with prednisone, including asthma.

How Much Prednisone Should I Take?

Prednisone is usually prescribed in pill form for asthma. It can also be administered through a liquid. Prednisone is available in 1 milligram, 2.5 milligram, 10 milligram, 20 milligram and a 50 milligram doses. The dosage of prednisone prescribed may vary depending on the person’s age and the severity of their symptoms.

Adults who are having an asthma exacerbation are often prescribed between 20 and 60 milligrams of prednisone a day. A low dose is considered less than 20 milligrams. A moderate dose of prednisone is 20 to 30 milligrams, and a high dose is 40 to 60 milligrams.

Usually, the maximum dose for an adult with asthma is 60 milligrams a day. The dosage is sometimes adjusted based on the response and side effects. Finding the right dose to control inflammation with as few side effects as possible may take a little trial and error.

In many cases, when an asthma attack is severe, patients will start with a high dose of prednisone to get symptom relief quickly. The dose may gradually be reduced over the course of a week as symptoms decrease. Tapering the dosage helps decrease the side effects that can occur with suddenly stopping steroids. If a small dose was given or the medication was only taken for a short time, tapering the dose may not be needed.

Prednisone for asthma is sometimes prescribed for a short course, which may be three or four days. In other instances, it is taken for two or three weeks.

What Does Prednisone for Asthma Do?

Prednisone for asthma decreases inflammation in the airways and reduces symptoms. Fortunately, prednisone often works quickly when used to treat asthma. In fact, it tends to work quicker than other types of steroids, which is why it is often used to treat asthma attacks. The half-life of the drug is anywhere from 18 to 36 hours, which means it takes that long for 50% of the prednisone to get out of your system.

Benefits and Side Effects of Prednisone for Asthma

Prednisone has beneficial effects for someone with asthma, which usually take effect in a few hours. As inflammation decreases in the airways, breathing becomes easier. Chest tightness and shortness of breath often diminish.

Asthma is also treated with bronchodilators, which reduces constriction of the airways. But people with asthma also have inflammation.

Bronchodilators alone do not treat inflammation. So, even if narrowing of the airways is treated and decreased, symptoms may remain due to the inflammation. That’s why prednisone is needed.

As with most medications, there are benefits and also side effects with prednisone. The risk of side effects increases with higher doses of the drug. Also, people who are on prednisone for a longer period of time are also at an increased risk of experiencing side effects.

Side effects may include the following:

  • Restlessness.
  • Irritability.
  • Increased hunger.
  • Weight gain.
  • Difficulty sleeping..
  • Headaches.
  • Increased blood pressure.

Prednisone also can increase blood sugar levels. People who have diabetes should monitor their glucose levels often. The dose and duration of prednisone should be carefully considered when being prescribed to someone who is a diabetic. If you take prednisone, it is vital to talk with your doctor and let them know about the side effects you have experienced.

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Long-Term Risks of Prednisone

In most cases, prednisone is only given short-term to treat a flare-up of asthma symptoms that are not controlled with other medications, such as bronchodilators. But prednisone may be used for longer in people with severe asthma who are at high risk for a fatal asthma attack.

It's difficult to state an exact dosage or duration of usage that leads to long-term side effects. Not everyone tolerates prednisone the same way. Also, other medications may interact with prednisone, or co-existing medical conditions may also increase the risk of certain long-term side effects.

But usually, the longer a person takes prednisone or the higher the dose, the more likely they are to have long-term side effects.

The long-term risks of prednisone include the following:

  • Increased risk of infection.
  • Bone loss leading to osteoporosis.
  • Thinning of the skin.
  • Gastrointestinal bleeding.

Inhaled Corticosteroids versus Prednisone

Prednisone is not the only steroid used to treat asthma. Inhalers that contain corticosteroids are also prescribed. Steroid inhalers may come in different forms including dry powder, meter dose inhaler and nebulizer solution. Examples of inhaled steroids include:

  • Budesonide (Pulmicort).
  • Fluticasone (Flovent).
  • Mometasone (Asmanex).

These types of inhaled steroids can be part of an asthma treatment plan. But inhaled steroids are used differently than prednisone. Prednisone treats sudden symptoms of asthma. Inhaled steroids are used to prevent symptoms from developing.

Inhaled steroids are usually taken once or twice a day to prevent inflammation of the airways. They help prevent asthma symptoms and are taken as a maintenance medication.

Inhaled steroids may also have some side effects, such as a fungal infection in the mouth. But the side effects tend to be much less systemic, which means they do not affect the whole body. Instead, they may only affect the mouth or the back of the throat. Taking inhaled steroids does not replace the need for prednisone during an acute asthma attack

Although prednisone can have certain side effects, it is often needed in the case of a severe asthma attack. If inflammation is not decreased, asthma symptoms may increase, which can lead to a life-threatening situation.

Prednisone taken for the short-term is not likely to cause serious side effects. In some instances, it may prevent more serious complications due to an asthma exacerbation.