Medical News Today: How does prednisone treat an asthma flare-up?

Prednisone is a prescription medication that belongs to a class of drugs known as steroids or corticosteroids. Doctors sometimes prescribe steroids for treating severe asthma and for helping the lungs heal after a sudden asthma attack.

Prednisone is rarely the only asthma treatment someone will have. Instead, it is often used along with other medicines, such as inhalers.

In this article, we examine how prednisone helps with treatment of asthma, along with the side effects that it can cause. We also look at the alternative treatment options that are available.

How is prednisone used for asthma?

prednisone tablet, white round pill standing up on white background.
Prednisone may be prescribed to treat severe asthma attacks.

Doctors often prescribe prednisone for acute asthma exacerbations. This is the type of asthma attack where a person cannot breathe well or at all. Acute asthma exacerbations often require emergency medical attention.

When a person has a significant asthma attack, they often experience airway inflammation afterward. The airways become puffy and irritated. The effect is more like breathing through a straw than breathing through a wide airway.

A doctor prescribes corticosteroids to reduce the body’s inflammatory response after the asthma attack.

Prednisone is a laboratory-made medication, but it works much like the body’s steroid hormones. Some people call prednisone “prednisolone,” which is the name of the compound the body converts prednisone to so it can be used by the cells.

When a person takes prednisone, the body thinks it is a steroid hormone. These hormones enter the body’s cells and create chemical reactions that tell the body to stop making inflammatory compounds.

As a result, a person is ideally able to breathe more easily because their airways are less narrow. They also create less mucus, making it easier to breathe.

Prednisone is a short-acting steroid, with a half-life of between 18 and 36 hours. Doctors may prescribe prednisone instead of other steroids because it does not last as long in the body. The medicine lasts long enough to help a person overcome their acute asthma symptoms.

An initial dosage of prednisone will be between 5 and 60 milligrams per day. Doctors can then change the dosage until they find one that has a satisfactory effect.

According to older research, if corticosteroids are given in an emergency department setting within 1 hour of a person arriving, they may be less likely to require hospitalization.


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Side effects

Headaches and vertigo are common side effects of prednisone.
Headaches and vertigo are common side effects of prednisone.

When taken in the short term, a person is less likely to experience side effects. Short-term side effects of using prednisone for asthma include:

Taking oral steroids such as prednisone can also increase a person’s blood sugar. If someone has diabetes, this reaction should be taken into account.

People who use steroids for short periods of time do not usually experience any of the long-term side effects associated with taking oral steroids. The side effects of long-term use of oral steroids can include:

Doctors rarely prescribe steroids as a long-term asthma treatment, however.

If a doctor does prescribe long-term steroids, a person should never suddenly stop taking them. Doing so can cause symptoms, including dizziness, thirst, and vomiting. Instead, they may need to reduce the dosages slowly before stopping completely.


Alternatives

Usually, doctors do not prescribe prednisone alone for the treatment of asthma. Instead, they often prescribe prednisone alongside other medicines.

One example is beta-2 agonists, such as albuterol, which can reduce airway constriction that occurs in an asthma attack.

Another example is ipratropium, a medication that is administered with a nebulizer or inhaler. Ipratropium causes smooth muscle or airway relaxation to help a person breathe more easily.

Doctors can also administer intravenous steroids if an individual cannot take oral steroids. Examples include intravenous hydrocortisone and methylprednisolone.

In addition to medications, people can help manage their asthma by avoiding triggers that can include:

  • cigarette smoke
  • dust mites
  • foods that cause allergic reactions
  • pet dander

A doctor may also recommend individual asthma treatments based on a person’s overall health.


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When to speak to a doctor

Woman in pharmacy holding inhaler.
A doctor should be consulted if a “rescue” inhaler needs to be used frequently.

When a person has asthma, the goal is to help control their attacks so that they are infrequent or do not occur at all. Signs that indicate someone should see a doctor about managing their asthma include:

  • using a “rescue” inhaler, such as albuterol, more than twice a week
  • having asthma symptoms that disturb sleep at least once per week
  • having an acute asthma exacerbation that requires hospitalization

Many different medications are available to treat asthma. Doctors may need to try different combinations of these medicines to work out what will be most effective for a person.

Outlook

Prednisone is a short-term medication option to help children and adults who have experienced acute asthma exacerbations. These medications can reduce inflammation by lowering the body’s immune response to an asthma attack.

While long-term steroid use can be concerning, short-term use does not typically cause unwanted side effects.

Ideally, a person can adjust their medications and asthma treatment plan after a significant asthma attack to reduce the likelihood of one happening again.

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