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Deflazacort--an alternative to prednisolone?.Top prednisone alternatives and how to switch your Rx
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.
❾-50%}Prednisone substitute.Deflazacort--an alternative to prednisolone?
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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 inthe 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.
Osteoporosis, increased risk of heart disease, increased risk of infections, weight gain are all assocaited with low dose prednisone use. Unfortunately, it's unlikely that anything currently available could replace it completely, but some drugs are also sometimes used to reduce. Unfortunately, it's unlikely that anything currently available could replace it completely, but some drugs are also sometimes used to reduce. Specific medications in this group include (in no particular order) Flovent, Pulmicort, QVAR, Asmanex, and many others, both brand-name and. If the arthritis persists, there are alternatives. A drug that is often used in cancer treatments called Methotrexate may be useful as it. 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. The steroid-sparing agents discussed above help treat disease so that less prednisone is required to control symptoms. Prednisone can cause troublesome side effects in the short term, such as fluid retention, round face moon faceincreased risk of infection, high blood pressure, cortisol insufficiency, and others. What is the difference between methylprednisolone and prednisone? Dementia vaccines: What are they, and when could they become available? I want to know how to prevent these really scary attacks - any ideas? Looking for a prescription?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 Immunology , two 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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