- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
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April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology and Internal Medicine at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale University School of Medicine and had been with Mayo Clinic in Rochester, Minn., between 1991 and 2002 when she relocated to Mayo Clinic, Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
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Question
Prednisone withdrawal: What are the symptoms?
Why does prednisone have to be gradually tapered off? Why can't I just stop taking it?
Answer
from April Chang-Miller, M.D.
If prednisone isn't discontinued gradually, you run the risk of developing prednisone withdrawal symptoms. So you shouldn't stop taking the drug without first consulting your doctor.
Prednisone is corticosteroid medication used to treat many conditions, including arthritis and asthma. Because long-term use of prednisone can cause serious side effects, doctors try to use the lowest dose possible for the shortest time possible. Still, there are instances when long-term prednisone therapy is needed.
Prednisone is similar to cortisol, a hormone naturally made by your adrenal glands. If you take prednisone for more than a few weeks, your adrenal glands stop making cortisol. A gradual reduction in prednisone dosages gives your adrenal glands time to resume their normal function.
If you abruptly stop taking the drug or taper off too quickly, you'll develop symptoms of prednisone withdrawal — also known as cortisol deficiency. Signs and symptoms include:
- Severe fatigue
- Weakness
- Body aches
- Nausea or vomiting
- Lightheadedness when standing (low blood pressure)
The amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take anywhere from a week to several months. If you experience prednisone withdrawal symptoms as you are tapering off the drug, contact your doctor.
- Furst DE, et al. Glucocorticoid withdrawal. http://www.uptodate.com/home/index.html. Accessed May 20, 2009.
- Nieman LK. Clinical manifestations of adrenal insufficiency in adults. http://www.uptodate.com/home/index.html. Accessed May 20, 2009.
