What is prednisone?
Prednisone is a type of steroid medicine that your body does not make by itself, but it acts like a natural hormone your body uses to control swelling. Doctors use it to treat many problems, such as asthma, bad allergies, and eye inflammation like uveitis. When you have uveitis, prednisone can help the swelling go down so your eye can heal. It does not fix the cause of uveitis, but it can make the swelling and symptoms much better while your doctor investigates for a cause of the uveitis and starts long term treatment.
How is it given?
For uveitis, prednisone is usually given as a pill, often once a day in the morning with food so it is gentler on your stomach. Sometimes, people with eye inflammation also use steroid eye drops or other medicines along with the prednisone pills, depending on how severe the uveitis is. For very bad cases of uveitis, prednisone can also be given through a vein in the arm, called “IV” (intravenous) treatment. This IV form lets the medicine get into the body very quickly to calm the eye swelling fast, and after this, the doctor may switch to pills once the eye starts to improve. Your doctor will choose the dose that is right for you and may change the dose slowly over time as your eyes get better. It is very important not to stop prednisone suddenly; your doctor will tell you how to “taper,” or slowly lower, the dose when it is time to come off the medicine.
Is it safe?
Prednisone can be very helpful and is usually safe when used for a short time and exactly as the doctor tells you. But it is a strong medicine and can cause side effects, such as weight gain, feeling hungrier, mood changes (like feeling more grumpy or anxious), trouble sleeping, higher blood sugar, higher blood pressure, and weaker bones if used for a long time. Tell your doctor if you have diabetes or high blood pressure before starting prednisone, because you may need to be watched more closely to help prevent side effects. Because of these risks, doctors try to use the lowest dose that works and for the shortest time needed. During pregnancy, prednisone is often one of the safer choices if a steroid is needed, but it should be used only when the doctor thinks the benefits are greater than the risks, and the pregnant person should be watched closely by both the eye doctor and the pregnancy doctor.
What to expect when taking prednisone
When you start prednisone for uveitis, your eye may start to feel better in a few days, with less pain, less redness, and less light sensitivity. You might notice body changes, like feeling more hungry, feeling more energetic or restless, or having a harder time falling asleep; tell your doctor about any changes you notice. If you need prednisone for a long time, it can increase the chance of problems such as weaker bones (osteoporosis), infections, cataracts or higher pressure in the eyes, and changes in blood sugar, so your doctor may do blood tests and eye checks to keep you safe. Because long‑term steroid use can be risky, your doctor may suggest adding or switching to other medicines called “steroid‑sparing” immunosuppressants (Adalimumab or methotrexate for example); these medicines help control the uveitis so you can use less prednisone or stop it, lowering the chance of long‑term side effects.
