2. BEFORE YOU TAKE PREDNISOLONE
Do not take this medicine and tell your doctor if:
- You are allergic (hypersensitive) to prednisolone, or any of the ingredients in these tablets (see Section 6: Further Information)
Signs of an allergic reaction include: rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue
- You have an infection that affects your whole body (systemic infection), which is not already being treated
Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking prednisolone.
Take special care and check with your doctor before you take prednisolone if:
- You have ever had severe depression or manic-depression (bipolar disorder). This includes having had depression before while taking steroid medicines like prednisolone.
- Any of your close family has had these illnesses.
- You have or ever had mental problems such as ‘depression’ or ‘psychoses.
If any of the above applies to you, talk to a doctor before taking prednisolone.
Mental problems while taking prednisolone
Mental health problems can happen while taking steroids like prednisolone (see also section 4 Possible Side Effects)
- These illnesses can be serious
- Usually they start within a few days or weeks of starting the medicine.
- They are more likely to happen at high doses.
- Most of these problems go away if the dose is lowered or the medicine is stopped. However, if problems do happen, they might need treatment.
Talk to a doctor if you (or someone taking this medicine), show any signs of mental problems. This is particularly important if you are depressed, or might be thinking about suicide. In a few cases, mental problems have happened when doses are being lowered or stopped.
Check with your doctor before taking this medicine if:
- You have epilepsy (fits)
- You or anyone in your family has diabetes
- You have high blood pressure
- You have kidney, liver or heart problems
- You have brittle or weak bones called osteoporosis
- You or anyone in your family has an eye problem called glaucoma
- You have or ever had a stomach ulcer
- You have ever had a bad reaction such as muscle weakness to any steroid
- You have or ever had an infection caused by a virus or fungus. This includes infections such as athlete’s foot, thrush, and cold sores
- You have or ever had ‘tuberculosis’ (TB)
If any of the above apply to you, your doctor may want to see you more often during your treatment.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because prednisolone and other medicines can affect the way each other work.
In particular, check with your doctor if you are taking any of the following medicines. Your doctor may want to change the dose of prednisolone, or the other medicine.
- Painkillers such as aspirin
- Aminoglutethimide - used for some types of cancer
- Medicines for thinning your blood (such as warfarin)
- Medicines for diabetes
- Medicines for epilepsy
- Medicines for tuberculosis (TB)
- Medicines which contain oestrogens including oral contraceptives
If you have just had any injections or vaccinations, tell your doctor before you take prednisolone. If you are going to have any injections or vaccinations, tell your doctor or nurse you are taking prednisolone. This includes those needed for a foreign holiday. Some vaccines should not be given to patients taking prednisolone. This is because prednisolone can affect the way some vaccines work.
If you are going to have an operation, tell your doctor or nurse you are taking prednisolone. Muscle relaxants are sometimes used during an operation or in an intensive care unit. Prednisolone and muscle relaxants can affect one another.
Pregnancy and breast-feeding
Talk to your doctor before taking prednisolone if:
- You are pregnant, plan to get pregnant, or think you may be pregnant
- You are breast-feeding, or planning to breast-feed
Prednisolone and infections
Taking Prednisolone can mean that you get infections more easily than usual, and these infections can be more serious.
Chickenpox or shingles
If you get chickenpox or shingles while taking prednisolone, you can become seriously ill
- Keep away from people who have chickenpox or shingles, if you have never had them. They could affect you severely. If you do come into contact with chickenpox or shingles, see your doctor straight away.
- If you do come into contact with someone with these infections, you must see your doctor or pharmacist straight away. Your doctor may want to give you a vaccination to help stop you from getting these infections.
- If you do catch Chickenpox or shingles, tell your doctor straightaway. Your doctor will advise you on how to take prednisolone. You may be told to increase the number of tablets that you take.
Blue steroid card
- If you take this medicine for more than three weeks, you will be given a blue ‘steroid card’ by your doctor or pharmacist
- It contains information about your medicine, including dose instructions. This is important if you fall ill or are in an accident
- You should carry the card with you at all times
Important information about some of the ingredients in Prednisolone
This medicine contains lactose. If you have been told that you cannot digest or tolerate some sugars, talk to your doctor before taking this medicine.
3. HOW TO TAKE PREDNISOLONE
Always take prednisolone exactly as your doctor has told you. The dose will depend on the illness being treated and any other medicines you are taking. You should check with your doctor or pharmacist if you are not sure.
Taking this medicine
- Swallow your tablets whole with a glass of water
- It is important to take your medicine at the right times
- The usual starting dose is 3 tablets, taken together each morning, after breakfast
- Your doctor may decide that you need more tablets than this each day
- Your doctor may tell you to take the medicine every other morning
- Your doctor may change your dose if you have been taking prednisolone for a long time, if you become ill or need to have an operation
Always follow your doctor's advice about how and when to take your medicine and always read the label on the pack. If you are not sure, ask your doctor or pharmacist.
If you take more Prednisolone than you should
Tell your doctor or go to the nearest hospital casualty department straight away. Remember to take with you any tablets that are left and the pack. This is so the doctor knows what you have taken.
If you forget to take Prednisolone
If you forget to take a dose take it as soon as you remember, unless it is time for your next dose. Do not take a double dose to make up for a forgotten dose.
- You need to take Prednisolone regularly to get the maximum benefit.
- Don’t stop taking this medicine without talking to your doctor - you may need to lower the dose gradually.
- Stopping the treatment suddenly can sometimes cause problems such as a high temperature, a runny nose, sore, red, sticky eyes, aching muscles and joints, itchy skin and weight loss. Also, sickness (vomiting), headaches and drowsiness – this is more likely to happen in children
You may also notice the following symptoms if you stop treatment with prednisolone. If this happens, tell a doctor straightaway as these could be signs of a serious illness:
- Sudden, severe pain in the back, stomach and legs
- Being sick (vomiting) and diarrhoea
- Feeling faint or dizzy, this could be a sign of low blood pressure
4. POSSIBLE SIDE EFFECTS
Like all medicines, Prednisolone can cause side effects, although not everybody gets them.
Stop taking your medicine and see a doctor or go to a hospital straight away if:
- You get swelling of the hands, feet, ankles, face, lips or throat which may cause difficulty in swallowing or breathing. You could also notice an itchy, lumpy rash (hives) or nettle rash (urticaria).
This may mean you are having an allergic reaction to Prednisolone 25mg Tablets
- You pass black tarry stools or notice fresh or clotted blood in your stools (faeces). You may also notice dark bits that look like coffee grounds in your vomit. These could be signs of a stomach ulcer
- You get severe stomach pain which may reach through to your back. This could be a sign of pancreatitis
Serious effects: Tell a doctor straight away if you notice any of the following side effects:
Steroids including prednisolone can cause serious mental health problems. These are common in both adults and children. They can affect about 5 in every 100 people taking medicines like prednisolone. These side effects include:
- Feeling depressed, including thinking about suicide
- Feeling high (mania) or moods that go up and down
- Feeling anxious, having problems sleeping, difficulty in thinking or being confused and losing your memory
- Feeling, seeing or hearing things which do not exist. Having strange and frightening thoughts, changing how you act or having feelings of being alone
Other serious side effects include:
- A very sore throat. You may also have difficulty in swallowing and the inside of your mouth may have white areas on the surface
- headache, which is usually worse in the morning, on coughing or straining, and feeling sick (nausea). Also, fits, fainting, eyesight problems, painful eyes or confusion can occur
If you notice any of these problems talk to a doctor straight away.
Other side effects:
If any of these side effects gets serious or lasts longer than a few days, or if you notice any side effects not listed in the leaflet, please tell your doctor or pharmacist.
- Stomach or bowel problems such as feeling full or bloated, indigestion, heartburn or stomach pain
- Increase in appetite and weight gain including developing a rounder face. Or, you may lose weight or feel weak.
- Bones and tendons may break or tear more easily than usual (called osteoporosis)
- Irregular periods in women or they may stop altogether
- Hair, including body or facial hair, grows more than normal
- Increased thirst and needing to pass water more often than usual. These could be signs of diabetes. If you are already diabetic, your doctor may prescribe more of your diabetes medicine to balance the effect of prednisolone. You should discuss this with your doctor
- Raised blood pressure and increased water retention
- Tiredness, confusion, muscle weakness or muscle cramps. This may be due to low levels of potassium in your body
- Mood changes, difficulty in sleeping
- Becoming dependent on prednisolone (also called psychological dependence)
- If you have epilepsy you may notice you get fits (seizures) more often than usual or that they are more severe. If this happens, tell your doctor as he/she may want to change the dose of your epilepsy medicine while you are taking prednisolone
- If you have schizophrenia your symptoms may get worse
- If you have had tuberculosis (TB) in the past it may return
- Eye problems such as glaucoma and cataracts can happen if you take this medicine for a long time
- Eye infections (fungal or viral) may spread or return if you have had them in the past
- Increase in the risk of clots forming in your blood
- Blood problems such as leukocytosis
- Wounds and cuts do not heal as quickly as usual
- Skin problems such as acne, flushing, redness, thinning of the skin and appearance of stretch marks
- General muscle weakness or tiredness
- You may get infections more easily than usual
- Sudden or severe muscle weakness or tiredness following an operation or time spent as a patient in an Intensive Care Unit (see Section 2 above on ‘Vaccinations or operations’)
Some of the above effects are more likely to happen if you are elderly
Children and teenagers taking this medicine may grow less than normal. If you think this is happening to a child, tell your doctor.
If any of the side effects get serious or lasts longer than a few days, or if you notice any side effects not listed in the leaflet, please tell your doctor or pharmacist.
6. FURTHER INFORMATION
What Prednisolone 25mg Tablets contain:
Each tablet contains 25mg of the active ingredient, prednisolone.
Other ingredients are: lactose, potato starch, pregelatinised maize starch, magnesium stearate and purified talc.
What Prednisolone 25mg Tablets look like and contents of the pack:
Prednisolone 25mg tablets are white, round, bevel edged tablets with a break line on one side and plain on the other.
This medicine comes in blister packs of 56 tablets.
The Marketing Authorisation Holder is:
PO Box 611
The Manufacturer is:
Patheon UK Limited
This leaflet was revised July 2008.