Prednisone
The good, the bad, and the ugly — guide to side effects
What is prednisone?
Prednisone (PRED-ni-sone) is used to treat or prevent graft-versus-host-disease (GVHD) in bone marrow, cord blood and peripheral blood stem cell transplant patients. It has strong healing effects and is used to treat many other conditions. Your doctors will decide how much prednisone you take and how often, based on many important factors.
Prednisone can be life saving, but has some common, unpleasant side effects to your body and mind (emotions).
This information covers some of the physical and emotional side effects you may have while taking prednisone.
What will the side effects be like?
The side effects of prednisone vary from person to person. The longer you are taking prednisone, the more often you take prednisone and the bigger the dose effects which side effects you may or may not have. Please talk to your doctor if you have questions. Your doctor will also be watching you carefully for side effects.
When will it get better?
Remember most side effects of prednisone will decrease as you take less or taper off and stop taking the medicine. Some of the side effects of prednisone may not happen at all if you take it every other day instead of every day. Your doctor will make the complicated decision about how much you need. It is very important to follow your doctorís instructions when you take your prednisone.
You should never stop taking prednisone suddenly as this can harm your body. Prednisone must be reduced (tapered) slowly, so that your body can gradually take over making it on itís own again.
Please talk with the transplant team about how to handle any of the physical or emotional side effects you may have.
Physical side effects of taking prednisone can include:
• More risk for infection
• High blood pressure
• Increases in blood sugar
• Keeping too much fluid and salt in your body • Increased hunger and weight gain
• Muscle pain and weakness
• Rounding or filling out of the face
• Bone thinning
• Upset stomach
• Skin changes; color, thinning, acne
• Slower growth and delayed puberty
• Cataracts
<Section here going more into detail on the possible physically side effects. Your doc has probably gone over all those, so I cut those out>
Emotional side effects of taking prednisone can include:
• Trouble with sleeping
• Mood swings
• Confusion
• Anxiety/panic
• Euphoria
(great happiness)
• Depression/withdrawal
Trouble with sleeping
You may have problems sleeping while taking prednisone. It can make you feel ìwiredî like you drank too much caffeine. You might find it hard to sleep at night or wake up several times in the night. Sometimes changing the times you take your prednisone can help; always talk with your nurse or doctor before making any changes to your medicines. Rest is important. Even just relaxing with soft music and being still and quiet, even if not sleeping, can help with being tired. Your doctor may also give you medicine to help you sleep.
Mood swings
Mood swings can be sudden and extreme! You may feel very happy one minute, and very sad the next and not know why. You may become angry and feel frustrated more easily than before. It is important to talk about your feelings with someone you trust and feel comfortable with. Remember that many people who take prednisone feel like this.
Confusion
You may feel unable to pay attention. This can affect reading and schoolwork, or even just talking and answering questions. You may feel mixed up or confused about things. Having a regular daily routine and writing down the things you need to do and remember can be very helpful.
Anxiety/Panic
Signs of anxiety include restlessness, a lot of worrying about things that probably will not happen, and not being able to pay attention or remain focused on a task. Sometimes the stress can get extreme and lead to panic attacks.
Panic attacks are short times of intense fear and anxiety, which often include quick heartbeats, shortness of breath, chest pain, dizziness or stomach problems.
Please talk with your doctor if you are having any of these signs.
Some things that may help lower your stress are:
• Getting enough rest (at least 8 hours a day) • Meditation (sitting quietly with your
thoughts)
• Talking about your feelings with someone you trust
• Listening to gentle music • Reading
• Massage
• Taking a warm bath
• Going for walks
• Regular exercise that you are used to doing
Euphoria (You-for-ee-a)
Euphoria is a feeling of great happiness and excitement (like how you might feel if you won the lottery). Some people have euphoria one minute then feelings of sadness the next minute.
This feeling may affect sleep and the ability to rest well. It is important not to get too tired, take breaks and rest often, and pay attention to what you are feeling from day to day. Keeping a journal, and reading back over good and bad days may help. If you are feeling so euphoric that you are unable to rest well, please talk with your doctor or nurse.
Depression/Withdrawal
Dealing with a serious illness causes a roller coaster of feelings. You may have feelings of helplessness and sadness during transplant and so can the people who care for you. Depression can make you feel empty, hopeless, negative, or restless. You may lose interest in hobbies or interests, feel unable to focus or concentrate, have trouble sleeping, or sleep much more than usual, lose your appetite or overeat.
Prednisone can also cause signs of depression. Talking about your feelings with someone who listens (parents, friends, child life, social worker, nurse, doctor, volunteer, psychologist), or sharing your experiences with someone who has also been through transplant can really help.
If you are having these feelings, or thoughts about hurting yourself please talk with your nurse or doctor at once. It is important to get professional help when needed. Counseling and/or medicine may help manage your depression.