Mom asked
I took 5 days of prednisone (40 mg per day) for severe allergies. This, after 2 months of Claritin, Flonase, and eye drop for itchy eyes. It helped dramatically. On the 6th day I had terribly itchy and swollen eyes. I took 1/2 prednisone on day 7 and 8. I’m coping well. what are disadvantages of continuing this regime of 1/2 per day until tree pollen subsides?
Answer
Long term use of prednisone, or methylprednisolone for the treatment of seasonal allergies generally isn't recommended. Both drugs are considered corticosteroids and while extremely effective for stemming allergies reactions and reducing inflammation, there can be considerable side effects with long term use. In fact, most guidelines for seasonal allergies don't recommend the use oral steroids at all. Nevertheless, they are still prescribed but should only be used for severe exacerbations and on an as needed basis.
Short-course corticosteroids are often well tolerated and generally considered safe, although they may cause certain side effects like nausea, mood changes and insomnia. Long term use of corticosteroids have more severe side effects and can include:
- Elevated glucose levels (i.e. hyperglycemia)
- Reduced ability to fight infections (i.e. immunosuppression)
- Thinning of the skin
- Reduced production of endogenous steroids (i.e. adrenal suppression)
- Osteoporosis
- Joint pain
"Short term use" of corticosteroids isn't well defined but most review studies state that it equates to prednisone 40 mg to 60 mg daily for up to three to four weeks. However, repeated "short term" uses of steroids may have cumulative adverse effects. Sometimes it is recommended to "taper" your steroid dose when discontinuing to prevent disease relapse or flare-ups.
Be sure to follow the advice or your doctor in your situation. Prescribing corticosteroids like prednisone consistently isn't overly common for seasonal allergies, but severe exacerbations may be one reason for their use. They shouldn't be used however if not necessary or as a preventative in most situations.
