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Is There An Alternative To Prednisone?. |
Methylprednisolone vs. prednisone: What's the difference? - Wellness inspired. Wellness enabled.
Compare prednisone alternatives Dexamethasone Methotrexate Mycophenolate Mercaptopurine Azathioprine Leflunomide Natural alternatives How to switch meds. While the immune system defends our body from infections and cancer, it can also cause health problems if not regulated properly.
Common diseases that arise from improper immune activity include inflammatory and autoimmune diseases. Prednisone can cause troublesome side effects in the short term, such as fluid retention, round face moon face , increased risk of infection, high blood pressure, cortisol insufficiency, and others. These side effects may be particularly problematic for patients who have pre-existing risks or health conditions such as osteoporosis, heart failure, hypertension, diabetes, glaucoma, or cataracts.
Despite its side effects, prednisone is an effective treatment for many diseases and might not always have a suitable replacement. In many cases, however, an adjunct agent can be used with prednisone to reduce the strength and duration of prednisone therapy. This article will discuss prednisone alternatives and steroid-sparing treatments that can reduce the dose of prednisone for patients with specific conditions. The table below lists common therapies that can replace prednisone or can be used as an adjunct therapy to reduce the cumulative dose of prednisone.
Some common uses, side effects, and dosing regimens are listed for each agent. Other corticosteroid-responsive conditions: 0. Transplant rejection: 0. Rheumatic disorders: 0. Heart or liver transplant: 1. SLE: Loading dose of mg by mouth daily x 3 days. Juvenile idiopathic arthritis: mg by mouth once daily based on weight Leflunomide coupons Other alternatives to prednisone Remicade infliximab Enbrel etanercept Humira adalimumab Tocilizumab Dupixent dupilumab for severe asthma Fasenra benralizumab Cinqair reslizumab Xolair omalizumab Lupkynis voclosporin NSAIDs Patients with arthritis may be able to use NSAIDs instead of prednisone if their disease activity is not too severe.
NSAIDs are not as effective as steroids for the treatment of arthritis, but if symptoms are adequately controlled with NSAIDs, patients may not need to take oral corticosteroids. Common over-the-counter anti-inflammatory drugs for arthritis include ibuprofen , naproxen , and diclofenac gel. It is important to seek advice from your pharmacist or healthcare provider when using over-the-counter treatments in conjunction with prescriptions as certain drug interactions may occur.
Dexamethasone is a suitable alternative to prednisone for the treatment of acute asthma. In general, dexamethasone is better tolerated and requires a shorter course of therapy five days of prednisone versus one to five days of dexamethasone. Dexamethasone is approximately six times as potent as prednisone, and a single dose is longer acting. Therefore, fewer doses are required compared with prednisone. A study in showed that two days of dexamethasone had similar efficacy to five days of prednisone and patients on dexamethasone had better compliance and fewer side effects.
A study in also demonstrated that two doses of dexamethasone are as effective as five days of prednisone in children with asthma exacerbation admitted to the emergency department. A meta-analysis in concludes that dexamethasone is associated with less vomiting compared to prednisone when used for asthma exacerbations.
Finally, dexamethasone is available in more dosage forms than prednisone. While prednisone is only available as an oral tablet, dexamethasone is available as a tablet or solution, and can be injected via the intravenous, subcutaneous, or intramuscular route.
Methotrexate is used as a steroid-sparing agent for many diseases. It is common to use DMARDs like methotrexate to reduce prednisone doses and allow for earlier discontinuation of prednisone.
Methotrexate is considered a steroid-sparing treatment for many forms of arthritis such as giant cell arteritis, juvenile idiopathic arthritis , rheumatoid arthritis, systemic lupus erythematosus, polymyalgia rheumatica, etc. Methotrexate is also commonly used as a steroid-sparing agent in the treatment of uveitis. Methotrexate may be a viable steroid-sparing agent for myasthenia gravis , although azathioprine is better studied and more commonly used for this purpose.
A study demonstrated that patients with myasthenia gravis who are treated with methotrexate had significant improvement in disease activity and reduced prednisone dosages. Two studies demonstrated that lupus patients taking mycophenolate and voclosporin could achieve clinical response while using much lower doses of oral prednisone. In fact, these two trials had the lowest peak steroid doses and faster steroid tapering than any other lupus nephritis trial.
In patients with lupus without renal involvement, mycophenolate was shown to be superior to azathioprine when combined with steroids, and thus may be a better option than azathioprine for reducing prednisone doses. Mycophenolate can be used to reduce steroid use in many different inflammatory and immune diseases other than lupus. Mycophenolate has similar steroid-sparing effects as methotrexate when used for uveitis.
In a head-to-head study comparing mycophenolate and azathioprine for the treatment of pemphigus, patients taking mycophenolate required significantly lower steroid dose to achieve clinical remission compared to patients taking azathioprine.
Mercaptopurine may be a great option to reduce prednisone doses in patients with inflammatory bowel disease. The brand name of mercaptopurine is Purinethol. Azathioprine is another DMARD that can reduce steroid doses in patients with inflammatory bowel disease. It is often used along with infliximab for this purpose. Azathioprine may also be used to reduce the use of steroids in patients with myasthenia gravis. A study comparing methotrexate and azathioprine in patients with myasthenia gravis demonstrated that both drugs had a similar degree of steroid-sparing effects.
Azathioprine may also be effective at reducing the cumulative steroid dose in patients with giant cell arteritis, although data is mostly limited to case studies.
Azathioprine may effectively lower the need for steroids in patients with recurrent pericarditis. In one study , Leflunomide is an effective steroid-sparing agent for various kinds of arthritis.
In a small study, lower steroid doses were required in patients with polymyalgia rheumatica and giant cell arteritis after taking leflunomide. Leflunomide is also an effective steroid-sparing option for patients with pulmonary sarcoidosis. Another lung disease, chronic hypersensitivity pneumonitis cHP , may be treated with leflunomide in some cases. A study showed that leflunomide had a significant steroid-sparing effect—half of the patients discontinued prednisone entirely.
In patients with inflammatory diseases related to IgG4 antibodies collectively known as IgG4-related disease , leflunomide can lower the cumulative dose of steroids needed to achieve and maintain remission. Adding leflunomide to steroid therapy can also shorten the time to complete response and maintain a longer duration of remission compared to steroids alone. Natural remedies are not a replacement for prednisone, but they may work alongside prednisone to help fight inflammation.
Antioxidants such as flavonoids and carotenoids protect tissue from damage by reactive oxygen species and other free radicals. They may have an even stronger effect when taken together. By preventing tissue damage, these antioxidants prevent unwanted inflammatory responses from occurring. Other anti-inflammatory supplements such as omega-3 fatty acids , zinc , and turmeric curcumin fight inflammation that is already present.
They provide the building blocks of natural molecules our body needs to resolve inflammation. Avoid inflammatory foods such as margarine, corn oil, deep-fried foods, and processed food products to reduce inflammation.
It is well known that refined sugar and simple carbohydrates like white four, white rice, and high fructose corn syrup contribute to chronic inflammation. Replace these processed items with plant-based foods that are high in fiber, like fruits, vegetables, and whole grains.
Staying hydrated helps our bodies clear out toxins. When metabolic waste products and toxins accumulate in the body, they contribute significantly to inflammation.
Perhaps the most obvious example of this effect is when dehydration leads to higher concentrations of uric acid, triggering a gout flare. Water also has a lubricating effect on joints. Synovial fluid provides a cushion at the joints to prevent bones from coming into contact.
When we become dehydrated our synovial fluid does not provide as much lubrication. A deficiency of synovial fluid can lead to damage and inflammation of the joints. According to a recent study , patients aiming to reduce inflammation should avoid long endurance exercise as it can contribute to chronic inflammation.
Instead, opt for moderately intense exercise with frequent resting periods. Another study in concluded that 20 minutes of moderate exercise is sufficient to produce an anti-inflammatory response. It is no secret that stress leads to many health problems.
That is why rest and relaxation are key to lowering inflammation. Not sleeping enough has immediate pro-inflammatory effects. A healthy lifestyle should include eight hours of regular sleep each night.
See our guide to improving sleep. Chronic stress contributes to chronic diseases by contributing to inflammation. During this state, the body releases stress hormones cortisol and adrenaline.
It also releases pro-inflammatory molecules called cytokines. These molecules plan an important role in fighting off different forms of danger, but when they are chronically released into the body, they can wreak havoc. To combat chronic stress , practice yoga or some form of meditation.
This could be as simple as writing your thoughts down in a journal, discussing your concerns with a friend, or taking a nature walk. The first step to replacing prednisone is discussing alternatives with a healthcare provider.
Prednisone should not be stopped abruptly or without medical advice. This is called a dose taper. Patients who have been on high doses or long courses of prednisone will need more gradual tapers. The steroid-sparing agents discussed above help treat disease so that less prednisone is required to control symptoms. The lifestyle modifications and health information listed above may help mitigate disease systems, possibly allowing for lower doses of prednisone.
Ask a doctor about the recommendations and alternatives in this article if you are interested in switching to a low dose prednisone or replacing prednisone with a different treatment. Skip to main content Search for a topic or drug. Prednisone alternatives: What can I take instead of prednisone? Prednisone doesn't work for everyone. Dexamethasone, methotrexate, mycophenolate, mercaptopurine, azathioprine, and leflunomide are some prednisone alternatives.
Get the full list here.
❿Substitute for prednisone -
Any alternatives for Prednisone • Johns Hopkins Arthritis Center
They are usually given to people who need a little more treatment beyond a steroid inhaler. These medicines do not have the side effects of prednisone , and they are generally not as strong as prednisone either. But they work well for some people. Please talk to your PCP about trying something to control your asthma symptoms. You certainly do have options. A week or 10 days of small doses of prednisone is like a magic bullet.
All asthma symptoms completely disappear, only to return gradually after a month or so. What is implied when asthma symptoms are so responsive to prednisone - does it mean that the symptoms are more allergy-based?
I don't manifest allergic symptoms like runny nose or itchiness. My symptoms are more classically asthma-like. Would that prednisone were not so generally ill-advised! Prednisone is an extremely effective anti-inflammatory medicine and, fortunately, anti-inflammatory treatment works for you. Since the source of your inflammation is unclear, allergy evaluation with skin testing seems warranted. A combination of inhaled steroids and antihistamines drugs that block the action of histamines , which can cause itching, sneezing and watery eyes or antileukotrienes medications that inhibit the action of substances called leukotrienes, which trigger asthma symptoms will probably be extremely effective for you and reduce the need for oral steroids.
I cannot live without prednisone. Taking corticosteroids for more than a month, which doctors consider long-term use, increases the likelihood of adverse effects occurring. It is important to note that these drugs can reduce the activity of the immune system, which makes it harder for the body to fight infection.
Complications are more likely to affect people who have or have had certain medical conditions, such as:. Methylprednisolone and prednisone are corticosteroids that can have a significant impact on the body. They are effective medications for reducing inflammation. Both medications can produce a range of side effects and complications.
Methylprednisolone is more potent than prednisone. Doctors can give methylprednisolone orally or through an injection, while prednisone is only available as an oral treatment. Methylprednisolone may, therefore, be more appropriate for people with digestive issues that stop them from taking or fully absorbing oral drugs.
A doctor will decide which medication is best in each situation. People should ensure that their doctor is aware of all their previous health conditions and current medications when discussing taking corticosteroids.
Rheumatoid arthritis RA is an inflammatory disease that affects the joints and also produces symptoms throughout the body. Find out more about how…. While researchers do not know exactly what causes rheumatoid arthritis RA , they do know that heredity plays a role.
Learn more about RA and genetics…. Doctors use a combination of blood tests to help them diagnose rheumatoid arthritis. Learn more about these tests and what else the diagnostic process….
Rheumatoid arthritis causes pain, swelling, and inflammation in joints and can affect organs throughout the body. Find out more here. The exact causes of rheumatoid arthritis are unclear, but researchers have identified several risk factors. Learn about 10 of these here. Is there another drug that can replace prednisone for this kind of long-term use? Many people are stuck on prednisone for long periods of time.
Unfortunately, it's unlikely that anything currently available could replace it completely, but some drugs are also sometimes used to reduce dependence on prednisone.
It is common to use DMARDs like methotrexate to reduce prednisone doses and allow for earlier discontinuation of prednisone. Methotrexate is considered a steroid-sparing treatment for many forms of arthritis such as giant cell arteritis, juvenile idiopathic arthritis , rheumatoid arthritis, systemic lupus erythematosus, polymyalgia rheumatica, etc.
Methotrexate is also commonly used as a steroid-sparing agent in the treatment of uveitis. Methotrexate may be a viable steroid-sparing agent for myasthenia gravis , although azathioprine is better studied and more commonly used for this purpose. A study demonstrated that patients with myasthenia gravis who are treated with methotrexate had significant improvement in disease activity and reduced prednisone dosages. Two studies demonstrated that lupus patients taking mycophenolate and voclosporin could achieve clinical response while using much lower doses of oral prednisone.
In fact, these two trials had the lowest peak steroid doses and faster steroid tapering than any other lupus nephritis trial. In patients with lupus without renal involvement, mycophenolate was shown to be superior to azathioprine when combined with steroids, and thus may be a better option than azathioprine for reducing prednisone doses. Mycophenolate can be used to reduce steroid use in many different inflammatory and immune diseases other than lupus. Mycophenolate has similar steroid-sparing effects as methotrexate when used for uveitis.
In a head-to-head study comparing mycophenolate and azathioprine for the treatment of pemphigus, patients taking mycophenolate required significantly lower steroid dose to achieve clinical remission compared to patients taking azathioprine. Mercaptopurine may be a great option to reduce prednisone doses in patients with inflammatory bowel disease. The brand name of mercaptopurine is Purinethol. Azathioprine is another DMARD that can reduce steroid doses in patients with inflammatory bowel disease.
It is often used along with infliximab for this purpose. Azathioprine may also be used to reduce the use of steroids in patients with myasthenia gravis. A study comparing methotrexate and azathioprine in patients with myasthenia gravis demonstrated that both drugs had a similar degree of steroid-sparing effects.
Azathioprine may also be effective at reducing the cumulative steroid dose in patients with giant cell arteritis, although data is mostly limited to case studies. Azathioprine may effectively lower the need for steroids in patients with recurrent pericarditis. In one study , Leflunomide is an effective steroid-sparing agent for various kinds of arthritis.
In a small study, lower steroid doses were required in patients with polymyalgia rheumatica and giant cell arteritis after taking leflunomide. Leflunomide is also an effective steroid-sparing option for patients with pulmonary sarcoidosis. Another lung disease, chronic hypersensitivity pneumonitis cHP , may be treated with leflunomide in some cases. A study showed that leflunomide had a significant steroid-sparing effect—half of the patients discontinued prednisone entirely.
In patients with inflammatory diseases related to IgG4 antibodies collectively known as IgG4-related disease , leflunomide can lower the cumulative dose of steroids needed to achieve and maintain remission.
Adding leflunomide to steroid therapy can also shorten the time to complete response and maintain a longer duration of remission compared to steroids alone. Natural remedies are not a replacement for prednisone, but they may work alongside prednisone to help fight inflammation.
Antioxidants such as flavonoids and carotenoids protect tissue from damage by reactive oxygen species and other free radicals. They may have an even stronger effect when taken together.
I have chronic asthma and have been on 20 mg of prednisone for more than 20 years. Is there another drug that can replace prednisone for this kind of long-term use? Many people are stuck on prednisone for long periods of time. Unfortunately, it's unlikely that anything currently available could replace it completely, but some drugs are also sometimes used to reduce dependence on prednisone.
These are very strong drugs as well and must be used with caution, but sometimes they can have good effects when taken in small amounts or as a short-term alternative to prednisone. According to a study published in the July issue of the Journal of Allergy and Clinical Immunologytwo Chinese herbal supplements - ASHMI and FAHF-2 - were seen to have some effects that were similar to those of prednisone on the signs and symptoms of asthma and food allergies, respectively.
Depending on the advice of your doctor, ASHMI might be a supplement you could try to ease both your asthma symptoms and your dependence on prednisone as a long-term therapy. Keep in mind that I am not a doctor and can't diagnose you here or tell you how these options would affect you.
Always check with your doctor before taking any medication or herbal remedy. You should know: The answer above provides general health information that is not intended to replace medical advice or treatment recommendations from a qualified healthcare professional.
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They include methotrexate, Arava, and the anti-TNF drugs such as Enbrel, Humira, and Remicade. These are very strong drugs as well and must be. Osteoporosis, increased risk of heart disease, increased risk of infections, weight gain are all assocaited with low dose prednisone use. Deflazacort (Calcort--Shire) is an oral corticosteroid licensed for use in adults and children. When deflazacort first became available last year. Prednisalone/Prednisone is a broad spectrum, cheap, easily available immuno-suppressant. It has it's own side effects, but can be minimized under supervised. They include methotrexate, Arava, and the anti-TNF drugs such as Enbrel, Humira, and Remicade. These are very strong drugs as well and must be. A careful examination of your living and working environments may be in order, once you know more about allergens. Albuterol is a symptom reliever. They have similar effects on the body but differ in their available forms and some of the side effects they cause. Perhaps the most obvious example of this effect is when dehydration leads to higher concentrations of uric acid, triggering a gout flare. Always check with your doctor before taking any medication or herbal remedy.I'm an asthma sufferer who was diagnosed after developing thyroid disease. I have allergy-induced asthma, and I am allergic to albuterol. My physicians have me take prednisone when I have an attack. Are there any other options for me? I always suffer when I take the steroid.
Yes, there are other options for you. Albuterol is a symptom reliever. It relaxes and opens the airways and works within a few minutes to relieve chest tightness and that dry asthma cough. Albuterol does not treat the inflammation in the lung linings that actually causes the symptoms of asthma , and it does not help prevent symptoms. Specific medications in this group include in no particular order Flovent, Pulmicort , QVAR , Asmanex , and many others, both brand-name and generic.
These are medicines that are similar to prednisone, but the dose is much lower than prednisone taken by mouth, and the side effects are dramatically reduced. Inhaled corticosteroids work because the medicine is delivered directly to the lung. Another type of controller medication, which is different from either albuterol or steroids, are the pills for asthma, Accolate zafirlukast and Singulair montelukast.
These medications are taken orally each day, and treat inflammation in the lungs. They are usually given to people who need a little more treatment beyond a steroid inhaler.
These medicines do not have the side effects of prednisone , and they are generally not as strong as prednisone either. But they work well for some people. Please talk to your PCP about trying something to control your asthma symptoms. You certainly do have options. A week or 10 days of small doses of prednisone is like a magic bullet. All asthma symptoms completely disappear, only to return gradually after a month or so. What is implied when asthma symptoms are so responsive to prednisone - does it mean that the symptoms are more allergy-based?
I don't manifest allergic symptoms like runny nose or itchiness. My symptoms are more classically asthma-like. Would that prednisone were not so generally ill-advised! Prednisone is an extremely effective anti-inflammatory medicine and, fortunately, anti-inflammatory treatment works for you.
Since the source of your inflammation is unclear, allergy evaluation with skin testing seems warranted. A combination of inhaled steroids and antihistamines drugs that block the action of histamines , which can cause itching, sneezing and watery eyes or antileukotrienes medications that inhibit the action of substances called leukotrienes, which trigger asthma symptoms will probably be extremely effective for you and reduce the need for oral steroids.
I cannot live without prednisone. How harmful to my body is this? I have tried every new asthma medication on the market. Nothing works for long. Only prednisone works. I am sure that there will be long-term effects on my body. I have already been diagnosed with diabetes and high blood pressure. I was told the prednisone was the cause. Will prednisone eventually kill me? Prednisone is an extremely effective anti-inflammatory medicine. Unfortunately, there are many side effects associated with it, the most common being osteoporosis , or weakening of the bones.
Prolonged steroid use also puts you at increased risk for cataracts , glaucoma , fluid retention , frequent infections, weight gain, skin problems, and mood disorders. Oral steroids like prednisone should only be used as maintenance medication in the most severe cases of asthma. There are many excellent treatments for asthma , including a variety of inhaled steroids, which are the cornerstone of modern asthma therapy. Keep working with your asthma specialist.
It would be prudent for you to be re-evaluated to see if a combination of the existing remedies helps with your symptoms and allows you to cut back on the prednisone.
You may also benefit by working with an allergist to identify potential asthma triggers , both inside and outside the home. A careful examination of your living and working environments may be in order, once you know more about allergens.
Many asthma triggers can be eliminated or avoided, and in your case this would be time and effort well spent. I have chronic severe asthma and I have attacks every morning. I have recently stopped taking high doses of prednisone, which I took for 14 years straight. I do not want to take prednisone anymore. I want to know how to prevent these really scary attacks - any ideas? You should follow up with your physician so that he or she can discuss with you the numerous asthma controller medications such as inhaled corticosteroids, long-acting bronchodilators, leukotriene modifiers, mast cell stabilizers, methylxanthines, anti-IgE therapy if appropriate and possibly others that are currently available and will hopefully eliminate or at least minimize your need for prednisone.
Learn more in the Everyday Health Asthma Center. Health Conditions A-Z. Health Tools. See All. DailyOM Courses. By Dr. Anna Feldweg. Reviewed: July 6,
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