From the Guidelines
Prednisone is indicated for moderate to severe allergic reactions, particularly those involving significant inflammation, and is used as an adjunct to first-line treatments like antihistamines and epinephrine. The indications for prednisone in allergic reactions include severe urticaria (hives), angioedema, allergic rhinitis, and allergic contact dermatitis. According to the most recent and highest quality study, for acute allergic reactions, a typical adult dosage ranges from 20-60 mg daily, often given as a short course of 3-10 days with a tapering schedule to prevent rebound symptoms 1.
Key Points
- Prednisone is used for moderate to severe allergic reactions
- It is particularly useful for reactions involving significant inflammation
- Typical adult dosage ranges from 20-60 mg daily for acute reactions
- Lower doses of 5-20 mg daily may be used for chronic allergic conditions
- Prednisone works by suppressing the immune response and reducing inflammation
Important Considerations
- Side effects increase with dose and duration, so the lowest effective dose should be used for the shortest time necessary
- Patients should take prednisone with food to minimize gastrointestinal irritation
- Those on longer courses need monitoring for potential complications like hyperglycemia, hypertension, and bone density loss
- In severe cases like anaphylaxis, prednisone serves as an adjunct to epinephrine and antihistamines, helping to prevent biphasic or prolonged reactions 1.
Additional Guidance
- For allergic rhinitis, intranasal corticosteroids are recommended as first-line treatment, with oral corticosteroids like prednisone considered for more severe cases or those not responding to initial therapy 1
- The use of prednisone in allergic reactions should be guided by the severity of symptoms and the patient's response to initial treatments, with the goal of minimizing morbidity, mortality, and improving quality of life 1.
From the FDA Drug Label
Allergic Reactions anaphylactoid or hypersensitivity reactions, anaphylaxis, angioedema The indications for prednisone in allergic reactions are not explicitly stated in the drug label for treatment purposes, but it does mention various allergic reactions as potential adverse effects.
- Key points:
- The label lists allergic reactions as adverse reactions.
- It does not provide information on the use of prednisone for treating allergic reactions.
- Prednisone is a corticosteroid, and corticosteroids are commonly used to treat allergic reactions, but the label does not directly support this indication. 2
From the Research
Indications for Prednisone in Allergic Reactions
The use of prednisone in allergic reactions is a complex topic, with various studies highlighting both the benefits and risks associated with its administration.
- Prednisone is a corticosteroid commonly used to treat allergic reactions, asthma, and other inflammatory conditions 3, 4.
- However, there have been reports of anaphylactic reactions to prednisone, particularly in patients with a history of asthma and drug intolerance 5, 4, 6, 7.
- The incidence of adverse reactions to systemic glucocorticoids, including prednisone, is estimated to be around 0.3% 7.
- Skin tests and oral or parenteral challenges can be used to diagnose steroid allergy, including allergy to prednisone 3, 6.
- In some cases, patients may experience worsening of asthma symptoms despite adequate treatment with prednisone, suggesting corticosteroid-induced bronchospasm 7.
Key Considerations
- Patients with a history of asthma, aspirin intolerance, or previous allergic reactions to corticosteroids may be at higher risk of anaphylactic reactions to prednisone 5, 4, 6, 7.
- The mechanism of anaphylactic reactions to prednisone is thought to be IgE-mediated hypersensitivity 5, 6.
- Alternative corticosteroids, such as hydrocortisone or methylprednisolone, may be considered in patients who experience adverse reactions to prednisone 5, 4, 6.