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Treatments & Procedures

Lung Transplant: Waiting and Preparing

Why is this drug prescribed?

Classified as a corticosteroid or a steroid hormone, prednisone is similar to the steroid hormone your body produces naturally. Prednisone may be given along with other immunosuppressive medications to prevent and treat organ rejection.

The body's immune system protects you from infection. Immune cells recognize the transplanted lung as different from the rest of the body and attempt to destroy it; this is called rejection and is your body's way of not accepting the new organ.

How and when should prednisone be used?

Prednisone is available in many generic brands and in several dosages. Generally, you will be prescribed the 5-mg tablets that can be easily broken in half if necessary.

Your prescription label tells you how much to take at each dose and how often to take the medication. Follow these instructions carefully and ask your pharmacist or doctor to explain any part that you do not understand.

Once prescribed prednisone, your doctor will gradually decrease the dosage over a period of time (generally 6 months) until the permanent dosage is achieved. This type of program is called a taper schedule. Taper schedules are individualized to meet each person's special needs. Never change the dose of your prednisone without the advice of your doctor.

It is important that you take this medication regularly as prescribed; do not stop taking it. You will need to take immunosuppressant drugs every day for the rest of your life to prevent rejection.

Your health care provider may reduce or even stop prednisone when you are being treated for certain infections. This allows your body to effectively fight the infection.

What special instructions should I follow while using this drug?

  • All of the prescribed amount of prednisone must be taken to maintain enough immunosuppression to prevent organ rejection. Follow your dosage schedule carefully.
  • Be sure that you always have enough medication on hand. Check your supply before holidays or other occasions when you may be unable to fill your prescription.
  • Keep all appointments with your doctor and the laboratory so that your response to the drug can be monitored. You will have frequent blood tests to monitor the amount of prednisone in your system. These blood tests will also help your health care provider adjust the dosage of your medication if necessary.
  • Do not have any immunizations or vaccinations without your doctor's approval.
  • Do not drink alcohol while taking this medication; alcohol can interfere with the effectiveness of methylprednisolone and cause serious side effects.
  • Do not take any new medications (prescription or nonprescription) without notifying your transplant health care team first. Several drugs may interfere with the effectiveness of prednisone.
  • Try to avoid infection while taking this medication.

What should I do if I forget to take a dose?

If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and then return to your regular dosage schedule. Do not take a double dose.

If you have forgotten more than one dose, contact your doctor or transplant center for instructions.

What are the side effects of this drug?

Even though the side effects of prednisone could be very serious, remember that this drug is necessary to prevent rejection. Precautions will be taken to detect these side effects and treat them before they become harmful.

Please see the guidelines below to reduce side effects while taking prednisone.

Prednisone may cause dose-related side effects, which will subside as your dosage is reduced. If any of the following symptoms occur, report them to your health care provider.

  • High blood pressure
  • Increased appetite, which may result in weight gain. Prednisone alters brain chemicals which can increase hunger and fluid retention.
  • "Steroid-induced diabetes" may result from high doses of prednisone, which may or may not require treatment. Or, if you currently have diabetes, you may have to adjust your medication dosage to control your blood sugar.
  • Vision changes, cataracts or glaucoma
  • Skin changes including acne, easy bruising, thinning of the skin, stretch marks, and increased sensitivity to the sun.
  • Excess hair growth on the face, back, arms, and legs
  • Increased swelling of the face, hands, or ankles
  • Mouth sores
  • Stomach irritation or ulcers
  • Mood swings and depression
  • Joint pain and muscle weakness
  • Increased risk of infection
  • Increased risk of developing osteoporosis

Please see the guidelines below for information on what you can do to help treat these symptoms.

What storage conditions are necessary for this drug?

  • Store this medication at room temperature. DO NOT store this medication in direct heat or light.
  • DO NOT store this medication in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause it to break down.
  • Keep this medication in the container it came in, tightly sealed.
  • Do not use this medication after the expiration date on the bottle.
  • Keep this and other medications out of the reach of children.

When should I call my health care provider?

Call your health care provider right away if you have any of these warning signs of infection:

  • Fever over 100°F (38°C)
  • Sweats or chills
  • Skin rash
  • Pain, tenderness, redness, or swelling
  • Wound or cut that won't heal
  • Red, warm, or draining sore
  • Sore throat, scratchy throat, or pain when swallowing
  • Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones
  • Persistent dry or moist cough that lasts more than two days
  • White patches in your mouth or on your tongue
  • Nausea, vomiting, or diarrhea
  • Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy"
  • Trouble urinating: pain or burning, constant urge, or frequent urination
  • Bloody, cloudy, or foul-smelling urine or black, tarry stools

Also contact your health care provider if you have any other symptoms that cause concern or if you have any questions.

What can I do to reduce the side effects of steroid medications?

To reduce troublesome side effects, your dosage may be decreased as soon as it is safe. In the meantime, there are some daily practices that can help you prevent or decrease the side effects of prednisone: eat well-balanced meals to avoid excess weight gain and to lower your risk of high blood pressure, diabetes, ulcers, and bone and muscle problems, such as osteoporosis. In addition, decrease your salt intake.

In addition, there are other ways you can prevent or decrease side effects of prednisone:

Possible Side Effects What You Should Do
High blood pressure Caused by increased fluid retention. Take your medication as prescribed, and reduce the amount of salt and fluid in your diet. Also measure your blood pressure and record it every day. Ask your health care provider what your blood pressure range should be.
Increased appetite, excess weight gain Eat well-balanced, nutritious meals and visit a dietitian regularly to discuss ways you can maintain a healthy lifestyle.
Steroid-induced diabetes If you formerly controlled your preexisting diabetes without medication, you may now need to take insulin or pills to control diabetes.
Vision changes, cataracts, glaucoma Visit an ophthalmologist yearly.
Acne Practice good hygiene; wash your face with an antibacterial soap to control acne and reduce the risk of infection. Avoid soaps with lanolin or cold cream, which tend to clog pores. Acne may be controlled with medications such as benzoyl peroxide (Clearasil). Acne subsides when your dosage is lowered.
Excess hair growth To remove unwanted hair, use safe bleaching techniques or creams.
Easy bruising Avoid accidental bumps and cuts by taking extra safety precautions before beginning any task.
Increased sensitivity to the sun Avoid the sun whenever possible. When outdoors, wear a sunblock with a SPF of at least 15. Report any skin changes to your physician.
Increased swelling of the face, hands, or ankles Swelling is caused by fluid retention. Watch weight gain. Swelling will subside in 3 to 4 months if weight is maintained.
Mouth sores Practice good oral hygiene to prevent mouth sores and oral infections. Report any sores to your health care provider. Visit your dentist every 6 months, and notify your Transplant physician before any dental procedures.
Stomach irritation, ulcers Take your medication after meals (with a full stomach) and use antacids (as directed) between meals. Report any stomach problems to your health care provider.
Mood swings Try relaxation techniques.
Increased risk of infection Avoid anyone who may have an infection, and report any signs or symptoms of infection to your physician or nurse.
Joint pain, increased risk of osteoporosis Avoid gaining excess weight and include low impact exercises in your daily schedule to avoid a possible need for joint replacement.
References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/12/2012...#6480