Main indications in lupus

Lupus with joint involvement or visceral involvement (kidney, pleura, pericardium ...).

Dosage

0.3 to 1 mg / kg / day in initial intensive treatment with the objective of gradually reducing the doses to the minimum effective dosage: generally of the order of 0.1 to 0.15 mg / kg depending on the clinical situation

Tablets of 20 mg, 10 mg, 5 mg and 1 mg; intramuscular solution 2.5 mg, syringes for subcutaneous injection

Orally (in 1 dose per 24 hours in the morning at breakfast), intravenous, intramuscular, subcutaneous

Key Drug Interactions

- Combination with nonsteroidal anti-inflammatory drugs may increase the risk of gastric ulcer

- The combination with diuretics may promote hypokalaemia (abnormal decrease in potassium levels)

- The combination with enzyme inducer drugs (rifampicin, barbiturates ...) must be done carefully

- In case of taking gastric acid inhibitors, wait at least 2 hours before taking Prednisone

Main side effects

- Water and salt retention (weight gain)

- Hypokalaemia (abnormal decrease in potassium levels)

- Osteoporosis

- Aseptic osteonecrosis

- Muscle weakness

- Epigastric pain (in the stomach area)

- Digestive ulcers

- Psychic disorders (euphoria, excitement, insomnia, confusion)

- Increased risk of infection (viral, parasitic, bacterial)

- Skin disorders: acne, skin atrophy, bruising (blue), hypertrichosis (excess hair on one area or over the whole body)

- Clouding of the lens (cataract), increased eye pressure (glaucoma)

- Rare immediate allergic reaction to sulphite excipients and parabens

Contraindications

- Infectious states (viruses, bacterial infections) or uncontrolled mycoses

- Progressive peptic ulcer

- Psychotic disorders

- Decompensated cirrhosis

- High blood pressure and/or condition

uncontrolled cardiac

Precautions for use

- Pregnancy: increased risk of diabetes and high blood pressure, especially for high doses >20 mg/day

- Breastfeeding: to be avoided when taking high doses >20 mg / day

- Diet: the diet must be rich in calcium, potassium, low in carbohydrates and fats, rich in proteins with the addition of calcium, vitamin D

Monitoring

- Blood glucose, kalemia, densitometry

- Clinical monitoring: assessment of tolerance, weight, blood pressure