I’ve been on Prednisolone for nearly 3 years for GCA and PMR.
Am down to 2mg now but noticed the chemist gave me prednisone instead of prednisolone.
I’ve been feeling quite rotten with dizziness, light headed , fatigued more than normal. And eyes so blurry.
Could this be the change of prednisolone to prednisone and tapering from 2.5 down to 2mg.
Never had an issue tapering.
Somethings wrong whether it’s adrenals playing up??
Look forward hearing if others have experienced this.
About month ago you posted this reply in a other thread - I get dizzy more often than not.
Was this before the change in medication, or after. If before then not sure you can entirely blame the change, but that’s not to say it might have some effect if you are particularly sensitive to medication.
As a matter of interest where do you live? Most countries use one or other - Prednisolone or prednisone, not general procedure for mix and match…
Would say the issues you describe are typically adrenals stuttering - so maybe have a look at this - and the only way to get through that is a very slow taper, small drops, time and patience, lots of patience..and maybe stay and correct dose for a few months to let adrenals catch up…
healthunlocked.com/pmrgcauk...
Yes, I was dizzy back then but much worse now. I was just wondering if the prednisone could be doing it because I’ve always take prednisolone.
I am seeing my doctor tomorrow and plan to ask her if it could be the change of tablets making me worse. It’s hard to manage this disease.
What did the prescription say? Unless it said prednisone, you should get your usual prednisolone and if it is a mistake then the pharmacists needs to be informed. If the script says prednisone - your doctor needs to be informed.
They are directly equivalent in dose, the only difference is the onset of action with prednisone taking about an hour longer as it must be processed by the liver to convert it to prednisolone. The fillers in the tablets may be different - some people react badly to them.
And possibly if you have any liver issues, that may make a difference.
Otherwise - all those symptoms are typical in adrenal insufficiency and suggest you should slow down the tapering process - stay at the new dose for a couple of month to let your body catch up before trying to taper again.
Thanks for the advice. Will ask the doctor tomorrow her thoughts. But I guess, no one really knows. It’s just trial and error getting the meds right. And then letting your body catch up with the change.
It IS trial and error - but the effects are usually less pronounced when you proceed VERY slowly and with what might be called ridiculously small changes in dose. Doctors may whinge it is TOO slow - but it isn't slow when it works and patients have a better QOL. WHich IS the name of the game when all is said and done.
As Dorset Lady asked, in what country do you live? Prednisone is 100% converted to Prednisolone by first pass metabolism - endocrine-abstracts.org/ea/...
I live in Australia.
I saw the GP yesterday and she said it doesn’t matter which tablet to take, prednisone or prednisone do the same thing.
Surely you should take this up with your GP. I was on prednisolone for many years it was never changed. I've not heard of prednisone. Maybe the pharmacy have made a mistake.
I went the other direction, but I can’t remember why. lt might have been a side effect. But why did the pharmacist or doc change your meds?
I think the chemist dispensed the wrong tablet but upon speaking with my GP, she said it doesn’t matter and it shouldn’t be causing any different symptoms than the prednisolone was. I said that I was more fatigued and dizzy with light headed mess but she wasn’t concerned.
I have never had prednisone but I believe it's very similar to our normal pred. As for the dizziness, fatigue etc that you describe I had the same and it was a difficult time for me, but finally I was able to taper down to zero..sadly, by then i had started with Parkinsons and had to start Dopamine. d, but I began to feel really well with energy and enthusiasm to actually gthings done. So I have swapped one condition for another, but I'm doing well, and at least people have heard of this complaint.
The time when you lower the dose of pred is horrible and you have my sympathy. I remember I said to my husband that I was utterly sick of feeling ill all the time. But taken slow and steady it will pass eventually.
wishing you the very best
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Prednisone is a precursor to prednisolone which is processed in the liver to make prednisolone which is the active form. That is the ONLY difference. Either way - what you get in your body is prednisolone so the adverse effects are likely to be the same. Some adverse effects may be due to the fillers in the tablets - not the pred.
Thanks PMRpri. That’s what my GP said as well. The tablets are the same basically.
So I don’t really know what has made me extra dizzy and light headed.
Just a roller coaster ride managing these diseases.
Hi and sorry for late reply. Sorry to hear you've been feeling bad and I hope this improves soon. I think, from what I've read, prednisolone and prednisone are pretty much the same thing with prednisolone being prescribed in the UK and prednisone in the USA (and possibly other countries?) I'm sure you've had replies from people with much more expertise than me! But might be worth checking also with chemist and relevant medics.
For myself, I was diagnosed with GCA Feb 2024 and started Prednisolone. I've been tapering down (following Consultant's plan) and have just started the second week of being steroid free. I think this might be quite a quick reduction compared to a lot of people(?) but I've also been on tocilizumab injections since June and my Consultant thought this would be okay because of the tocilizumab. I'm not feeling particularly great (but I wasn't feeling particularly great on the steroids either!) Still getting quite a bit of fatigue / low energy. These have been the main issues for me for several months. Possible it's going to take a while for my body to readjust (if it ever does!) Possible (very probable?) that my adrenal glands aren't yet working properly again. I have a synacthen test coming up to assess this.
When I was tapering down, it was difficult to identify any clear pattern to how I was reacting. However, I did notice that - sometimes when I reduced - I'd feel rough for a day or two but then start to improve again. But not the same every time. I know that people say that, when you get down to the low doses, each reduction can be pretty significant. For example, 2.5mg down to 2 represents a 20% reduction.
Best wishes to you.
Prednisone is a pre-cursor that is processed by the liver to produce the active substance prednisone in a one to one quantity.
Ah okay. Thank you.
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