I just wanted to chime in here and say that although I know how terrible the side effects like weight gain, moon face, insomnia, munchies etc etc etc can be after watch my daughter suffer through its effects, one thing that is not being discussed here are the very serious side effects. Prednisone is a very serious medication and many of the doctors will not talk about
and the pharmacies do not disclose that it can cause Osteonecrosis (ON) (bone-death) (aka Avascular Necrosis AVN). I'm not trying to scare anyone, and my sole purpose in posting this response is to raise awareness...so that you can talk with your doctors about
how to prevent bone loss and bone death. My daughter, 22 has been diagnosis with this disease and we feel blindsided and kept in the dark about
the risk, especially after finding out that the medical community has known for 30 years about
this risk.
My daughter was struck with UC back in 06. Her first round of pred was 60mg with a taper. After coming off, she spiraled out of control. She was then hospitalized and put on IV steroids - 90 mg for a week then a taper because it was not working. She had a colectomy and jpouch within 4 months of the initial dose, but a year later was diagnosed with Osteonecrosis after developing a clicking popping sound in her knees which became swollen and painful. An MRI is the best tool in diagnosis this insidious disease.
Please do your research on this disease...I asked our pharmacist why this disease is not disclosed and he said "we don't want to scare anyone" Well, I say even very sick people want to know what they are facing SHOULD they be diagnosed so they know what symptoms to look for and get early treatment, not to mention the opportunity of making the decision for themself if they want to take this medication or not...it should be a choice.
Please know that Osteonecrosis is a silent disease that presents itself only in the later stages of the disease which, in many times, is too late for joint preserving surgical treatment to halt the progression of the disease. It will not show up on x-ray in the early stages.
"The steroid exposure threshold is approximately 2000 mg of prednisone administered continuously. However, avascular necrosis has been known to occur after use of lower doses. The risk of AVN is greater risk in patients treated for a short duration (6 wk) with high doses (³ 20 mg). The risk of AVN in association with low-dose steroid therapy is controversial. Some studies link such therapy to the disease, whereas others indicate no such link. High doses of steroids administered within a relatively short period are more of a causative factor than the cumulative dose or the duration of therapy....AVN may occur up to 3 years following cessation of therapy"...
"For AVN to be diagnosed at an early stage, the physician must have a high index of suspicion, especially regarding patients who have any of the risk factors and whose radiographic findings are negative. This is especially true with unilateral involvement because of the high risk of the development of AVN in the contralateral hip. These patients should be evaluated aggressively." "MRI is the most sensitive means of diagnosing avascular necrosis"
http://emedicine.medscape.com/article/386808-overview