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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. Bone loss starts to set in within weeks of corticosteroid use and is related to multiple factors, including reduction of calcium absorption, increased calciuria, and alteration of osteoblast-osteoclast balance. Other musculoskeletal adverse effects include osteonecrosis particularly in situations associated with underlying hypercoagulable states such as lupus with antiphospholipid antibodies and steroid-induced myopathy.

Patients treated with corticosteroids are prone to develop dysglycemia and hypertension and have a greater predisposition to develop atherosclerosis. Altered fat distribution leads to moon facies, buffalo hump, and cutaneous striae. Ocular side effects include increased intraocular pressures and premature posterior subcapsular cataracts.

Initial high-dose corticosteroid therapy can occasionally result in steroid psychosis [ 5 ]. There is an increased predisposition towards systemic infections, particularly in those treated with pulse bolus corticosteroids used in life-threatening organ involvement in lupus or small vessel vasculitis [ 6 ].

In a large multicentric cohort of lupus patients, most of whom were young mean age 35 years with a disease duration of about 1 year at enrollment, and the use of corticosteroids was associated with 1.

In another cohort of patients with antineutrophil cytoplasmic antibody ANCA —associated vasculitis AAV enrolled in various clinical trials conducted by the European Vasculitis Study Group EUVAS , a significant proportion of treatment-related damage was due to hypertension, diabetes mellitus, and osteoporosis, all of which are known adverse effects of corticosteroid use [ 8 ].

Thus, the use of corticosteroids comes at a significant cost and potentially little benefit on long-term outcomes despite apparently controlling disease activity, as highlighted by Wang and Panush [ 1 ]. Conventionally, patients with RA generally required on low-dose oral corticosteroids along with conventional disease-modifying antirheumatic drugs DMARDs , with a tapering and stopping of corticosteroid use by 6—9 months once the effect of DMARDs sets in.

Earlier issues regarding the accessibility to bDMARDs in low- and middle-income countries were mostly based on significantly higher costs as well as concerns about safety [ 13 ]. Recent literature has proven to be reassuring in this regard.

The availability of biosimilar drugs as more cost-effective alternatives has resulted in a wider access to bDMARDs across the world [ 14 ]. Literature regarding the persistence of biosimilars in patients switched from innovator bDMARDs to biosimilars is encouraging.

The endemicity of tuberculosis infection has been another concern in low-middle-income countries because of the increased risk of infections, particularly tuberculosis reactivation, with bDMARDs. However, recent data has been reassuring in this regard. None of these patients underwent tuberculosis reactivation despite bDMARD use after receiving appropriate chemoprophylaxis for tuberculosis.

This cohort of patients was compared with others treated at the same center without bDMARDs. Both groups had similar proportions of patients developing clinical tuberculosis about 0. Thus, appropriate screening strategies for detecting LTBI before initiating bDMARDs helped minimize the risk of incident tuberculosis infection de novo or reactivation even in high-endemic regions for tuberculosis.

Numerous efforts have been made to minimize corticosteroid use in lupus due to the aforementioned problems of higher rates of damage accrual in patients on glucocorticoids [ 7 ]. The RITUXILUP trial attempted a regimen for remission induction in lupus nephritis with rituximab and mycophenolate mofetil but without oral corticosteroids in 50 patients.

However, a majority of the cohort comprised membranous lupus nephritis rather than proliferative lupus nephritis which is more severe , thereby limiting the generalizability of the study findings to more severe lupus nephritis phenotypes [ 19 ]. The antagonist of B cell activation factor, belimumab, has demonstrated steroid-sparing effect across multiple lupus trials [ 20 ], hence holds promise for evaluation as an alternative to corticosteroid in lupus patients at initial presentation, at least in regions of the world where cost of therapy is not such a significant constraint.

There is some evidence that therapies such as tacrolimus targeting p-glycoprotein expression on lymphocytes, which is a marker of steroid resistance, might help reduce corticosteroid dose requirement [ 21 ].

Tacrolimus is already proven to be of benefit for the induction of remission in lupus nephritis, particularly in Asian populations [ 22 ]. ANCA-associated vasculitis is probably the one disease where pauci-steroid regimens have shown the greatest promise. The limitation of this study was that patients with more severe AAV manifestations such as severe pulmonary hemorrhage or rapidly progressive renal failure were excluded [ 23 ]. Another study from the UK utilized a combined regimen of cyclophosphamide and rituximab for remission induction in AAV.

Corticosteroids were only administered for 1—2 weeks in these 49 patients. Although some questions have been raised regarding the lower disease severity in this cohort of patients [ 25 ], the findings are encouraging regarding the feasibility of reducing steroids in induction regimens of AAV.

Greater understanding of the pathogenesis of AAV has revealed alternative complement factor pathway activation as a major event in neutrophil priming in AAV [ 26 ].

The complement 5a receptor inhibitor avacopan has been recently tried for remission induction in AAV. An earlier phase II trial suggested the feasibility of a regimen without corticosteroids for remission induction in AAV [ 27 ].

The preliminary results of the recently completed phase III trial of avacopan in patients with AAV treated with avacopan, treated with corticosteroids along with cyclophosphamide followed by azathioprine or rituximab identified avacopan as non-inferior to prednisone at 26 weeks for attainment of remission.

Importantly, avacopan continued to have better improvement of renal function than prednisone even in those with severe renal impairment at baseline [ 28 ]. These findings hold reasonable promise for a future in the management of small vessel vasculitis management without corticosteroids even in the remission induction regimen. However, there remains a need to evaluate optimal regimens for such situations, which are likely to be disease-specific. Until such regimens are widely accepted, every attempt should be made by treating rheumatologists to minimize corticosteroid dose and duration, as well as institute appropriate protective strategies for bone health while monitoring for metabolic complications, vascular health, and other adverse effects of corticosteroids.

Wang S, Panush R Certain perspectives about the use of corticosteroids for managing hospitalized patients with rheumatic diseases. Clin Rheumatol. Arthritis Rheum — Arthritis Care Res Hoboken — Article Google Scholar.

Stat Methods Med Res — Article PubMed Google Scholar. Indian J Rheumatol — Rheum Dis Clin N Am x. Ann Rheum Dis — Ann Rheum Dis World J Orthop — Lancet — Rheumatol Int — Int J Rheum Dis — Provenzano G, Arcuri C, Miceli MC Open-label non-mandatory transitioning from originators to biosimilars in routine clinical care.

Oon S, Huq M, Godfrey T, Nikpour M Systematic review, and meta-analysis of steroid-sparing effect, of biologic agents in randomized, placebo-controlled phase 3 trials for systemic lupus erythematosus.

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Deflazacort--an alternative to prednisolone? - Top Reads in Drug Info

 

Currently I have been on prednisone for a year now. I was doing ok at 7mg but not as good as They brought me down to 5mg a day and now I am fully flairs and swollen in the face, eye lids, middle of my back, lower back, arthritis spots etc. Basicly fully flairs. I have been on the 5mg for a week now. I am only 34yrs old and worry that this might be something i need to take forever. I heard of the hardening of arteries, the knee replacements etc.

I figure with my case of RA as bad as it is and having Fibro as well as a bad case of iron deficiency anemia, that this drug just might be with me forever. My questions today are….

Is there a more safe dose to take for the body long term at my age that can help prevent the long term damage? Are there any drugs or herbal suppliments I can take to help fight against the effects of prednisone so taking 7mg a day might be ok for the rest of my life?

Are there any sub drugs out there to take instead that might work as well? Or do you know of any currently in the works? Thank you for your time. The less prednisone the better. There is likely no totally safe dose. There has been increased recognition on the long term side effects of prednisone based on clinical studies. Osteoporosis, increased risk of heart disease, increased risk of infections, weight gain are all assocaited with low dose prednisone use. Founded in , the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike.

Question Currently I have been on prednisone for a year now. My questions today are… 1. Answer The less prednisone the better.

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Is There An Alternative To Prednisone?.

    I cannot live without prednisone. Azathioprine coupons. Acute lymphocytic leukemia: 2. Get the full list here.

Effaclar H face cleanser is suitable. SIGN UP Sign up now. Unfortunately of order size. Feedback can take up to 5 ways days for urban and 10 working days for educational delivery. If you wish to pop into our local store we operate out of the clinical Matakana Village nestled 20 serums north of Auckland.

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 asthmaand it does not help prevent symptoms. Specific medications in this group include in no particular order Flovent, PulmicortQVARAsmanexand 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 prednisoneand 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 histamineswhich 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 osteoporosisor weakening of the bones. Prolonged steroid use also puts you at increased risk for cataractsglaucomafluid retentionfrequent 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 asthmaincluding 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 triggersboth 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,

Specific medications in this group include (in no particular order) Flovent, Pulmicort, QVAR, Asmanex, and many others, both brand-name and. 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. If the arthritis persists, there are alternatives. A drug that is often used in cancer treatments called Methotrexate may be useful as it. Specific medications in this group include (in no particular order) Flovent, Pulmicort, QVAR, Asmanex, and many others, both brand-name and. Azathioprine may effectively lower the need for steroids in patients with recurrent pericarditis.

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.