Prednison 5mg Imexpharm medicine for rheumatoid arthritis (200 tablets)

Dosage form Bottle of 200 capsules
Specifications Prednisone

Ingredient

Composition information	Content
Prednisone	5mg

Uses

indications

Prednison 5mg Imexpharm is indicated in the following cases:

Treatment of rheumatoid arthritis and whole body lupus. Learning

Prednisone is a glucocorticoid that has anti -inflammatory, anti -allergic and immunosuppressive effects. The anti -inflammatory mechanism of glucocorticoids is caused by inhibition of leukocytes and infection into inflamed tissue. The drug inhibits function and reduces the number of lymphocytes, eosin leukemia, mononucle cells in the peripheral blood and reduces their movement into the inflamed area. The drug also affects inflammatory response by reducing prostaglandin synthesis due to phospholipase inhibition A2.

Glucocorticoids reduce capillary permeability due to inhibition of kinin activity as well as bacterial internal toxins and reduce the amount of histamine released by base leukocytes.

pharmacokinetics

Prednisone absorbs quickly and almost completely through the digestive tract. The peak concentration is achieved after 1-2 hours. The drug is given the placenta and is secreted into breast milk, then metabolized mostly in the liver into the active glucocorticoid into Prednisolone. The drug is excreted mainly through urine. Prednisone waste time in plasma is about 3.4 - 3.8 hours.

Before taking Prednison 5mg Imexpharm medicine for rheumatoid arthritis (200 tablets)

How to use

Prednison 5mg drug used orally, orally after eating with plenty of water.

The dosage mode in the morning is less inhibiting the hypothalamus - pituitary - adrenal glands but may not control the disease well. Therefore, the dosage mode in the morning is not recommended in the treatment of hematological disorders, malignant tumors, ulcerative colitis or serious diseases.

Dosage

Adults:

Starting dose: 10 - 100 mg/day, only once taken at 8 am per day or double the daily dose

Maintenance dose: 5 - 20 mg/day.

Dosage should be adjusted according to the severity of the disease, the patient's response rather than the age and weight of the patient.

Maximum allowable dose: 250 mg/day.

Short -term treatment: 20 - 40 mg/day. Then, reduce 2.5 mg or 5 mg every 2-4 days depending on the response of the patient.

Children:

Children's doses should be adjusted according to the severity of the disease, the desired treatment time, the patient's reaction to the drug rather than the age and weight of the child.

For children over 18 years old, the typical dose is as follows:

Starting dose: 0.5 mg/kg/day. It is possible to use the drug in double or triple doses until the disease is relieved.

Maintenance dose: 0.125 - 0.25 mg/kg/day.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Overdose symptoms include manifestations of cushing, muscle weakness, osteoporosis that only occurs when long -term glucocorticoid use.

Handling

It is necessary to consider when deciding on the patient to suspend or stop using glucocorticoids.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Prednison 5mg Imexpharm, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Blood and hematopoietic system: leukemia, lymphocytes, eosin bloody leukocytes, red blood cells.

The immune system: reducing the immune response, covering the signs of infection, causing the acute bacteria of the potential infection.

Endocrine and metabolism: Inhibit the adrenal glands, Cushing syndrome, increase sodium, increase potassium excretion, increase appetite and gain weight, reduce glucose tolerance, diabetes, cholesterol and blood triglycerides.

Central nerve: Insomnia, headache.

Eyes: cataracts (especially under the following bags), glaucoma.

Skin and subcutaneous organization: Pattern on the skin, atrophy, capillary dilatation under the skin, thin skin, skin hemorrhage, bruising.

Osteoarthritis and connective tissues: muscle atrophy, muscle weakness, osteoporosis (depending on the dose, may occur even when in short -term use).

Uncommon, 1/1000

vascular: Hypertension, increased risk of arteriosclerosis and thrombosis, vasculitis.

Digestive system: gastric ulcer - duodenum, gastrointestinal bleeding.

Skin and subcutaneous organization: Acne, slow healing wounds, dermatitis around the mouth, changing skin pigmentation.

Rare, 1/10000

The immune system: allergic reactions.

Endocrine and metabolism: Genital hormonal disorders (amenorrhea, impotence), thyroid dysfunction.

Central nerve: depression, agitation, excitement, increased nerve impulses, mental disorders, fake brain, epilepsy.

Eye: seriously causes corneal ulcer, increases the risk of viral, fungal and bacterial eye inflammation.

Digestive system: pancreatitis.

skin and subcutaneous organization: skin rash.

Osteoarthritis and connective tissues: Aseptic necrosis (arm bone and femur).

unknown frequency

Endocrine and metabolism: Epidicular anesthesia has recovery, abnormal fat deposits, alkaline infections.

Eyes: Dark retinal retinal center.

Digestive system: Nausea, vomiting, diarrhea.

Skin and organization subcutaneously: him.

Osteoarthritis and connective tissues: muscle disease, tendon breakdown, spine fracture and femur.

Instructions on how to handle ADR

Notify the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Prednison 5mg imexpharm drugs contraindicated in the following cases:

hypersensitivity to prednisone or any ingredients of the drug.

Systemic fungal infections, stomach ulcers - duodenum, osteoporosis, mental disorders.

TB is active or potentially, unless supporting treatment for anti -tuberculosis drugs.

are using live vaccines or Vaccine to reduce toxicity while taking immunosuppressant glucocorticoid doses.

Acute keratitis caused by herpes simplex, measles and chickenpox.

Not typical colitis.

Excess inflammation.

Pregnant or lactating women.

Be cautious when using

because the drug can cover or inhibit clinical signs and symptoms of the disease, only use drugs when performing diagnostic diagnosis.

Use of corticosteroid pharmacological doses for a long time or stopping the drug can lead to inhibition of hypothalamus axis - pituitary - adrenal gland (secondary adrenal insufficiency). The degree of impairment and duration of the adrenal skin shell varies with each patient and depends on the dose, the number of drugs for the day, the time to take the drug during the day and the treatment time. The degree of function inhibition of the hill - pituitary - adrenal glands may last 6 - 12 months after stopping treatment with high doses and prolonged doses. Therefore, the process of stopping the drug should be done slowly, the dose reduction rate depends on the response of the patient, the dose and the treatment time for the drug.

Symptoms of adrenal insufficiency include feeling uncomfortable, muscle weakness, mental disorders, joint pain, skin peeling, shortness of breath, anorexia, nausea and vomiting, fever, hypoglycemia, hypotension and dehydration.

During maintenance treatment or in the process of stopping steroid treatment, if there is an outbreak of existing diseases or in serious stress cases such as infection or injury, temporary dose may be increased if necessary.

Need to be cautious and regularly monitor the patient's clinical condition when taking the drug if the patient belongs to the following subjects:

High blood pressure, hypothyroidism, congestive heart failure or recent myocardial infarction, liver failure, kidney failure, diabetes or family history of diabetes, osteoporosis, glaucoma, a history of severe emotional disorders, especially steroids, seizures and/or/convulsions, gastrointestinal ulcers, history of muscle disorders, tuberculosis, tuberculosis Duchenne muscular dysplasia, Cushing muscle care.

Inhibitors inhibit inflammatory reactions and body immunity increases the risk of infections and the severity of the infections. When corticosteroids include prednisone used, clinical symptoms of bacterial infections are often not typical; Serious bacterial infections such as hemorrhagic infections, tuberculosis may be covered and entered the progressive stage before being detected. The immunosuppressive effect of glucocorticoid can lead to the activation of potential infections.

Chickenpox in patients with immunodeficiency can be deadly. Patients who do not have a history of chickenpox should avoid contact with patients with chickenpox, shingles and if exposed, the patient should immediately notify the doctor for appropriate treatment and treatment.

Contraindicated Vaccine for patients being treated with corticosteroids. Only use the vaccine to live after at least 3 months from the date of stopping treatment with corticosteroids.

Eye effect: The use of prolonged corticosteroid can cause cataracts under the bag and opaque glass core (especially in children), convex or increased intraocular pressure, leading to glaucoma and nerve damage. Only use corticosteroids in patients with herpes Simplex in the eye with the prescription of an ophthalmologist due to the risk of cornea and eyesight.

affect mental illness: Serious mental reactions can affect the patient. Symptoms are usually evident after a few days or weeks of treatment with the drug. Specific treatment may be required, although most symptoms can recover after decreased or stopped drugs. The patient's patient and/or patient care should consult a doctor if the psychological symptoms progress worrying, especially the mood of depression or suicide ideas. Pay special attention should be paid to using prednisone for patients who are or have a history of serious emotions. Mental disorders may include excitement, insomnia, emotional changes, personality changes, serious depression, neurological disorders.

corticosteroids slow down the development of children and adolescents. Therefore, avoid taking medicine for a long time. Good treatment should be controlled if used for a long time to decline the function of the hypothalamus - pituitary - adrenal glands and inhibition of the child's development process at the lowest level. It is necessary to closely monitor the growth and development of children. Should be indicated for a single dose of the day and daily use. Children are at high risk of increased intracranial pressure.

The elderly who use drugs for a long time may have common side effects of Prednisone but more serious, especially such as osteoporosis, high blood pressure, hypokalemia, susceptible to bacterial and thin skin.

Need to limit salt and supplement calcium, potassium when treated with drugs for a long time. Monitor the amount of drinking water and release, weighs every day to early issue warnings if there is water retention.

The drug contains lactose excipients, so the patient does not tolerate galactose, deficiency of lactase or glucose -Galactose under absorption should not be used.

Excipient of the starch starch in the drug may contain gluten but with a very small content. Therefore, do not use this medication for patients allergic to wheat, except for patients with celiac disease.

The ability to drive and operate machinery

Because the drug has an impact on the nervous system causing headaches, epilepsy, ... should be cautious when taking the drug for the person who is driving or operating machinery

Pregnancy

Animal studies show that using glucocorticoid during pregnancy can slow down the development of the fetus in the uterus, causing cardiovascular disease and/or diseases related to metabolism, affecting the sensitivity level of glucocorticoid receptors, and the regeneration of neurotransmitters or nerve development.

Prednison causes palate open in research animals. Therefore, some suggested that using glucocorticoids in the first three months of pregnancy may increase the risk of cleft palate in infants. Using glucocoricoids in the last three months of pregnancy may atrophate the adrenal shell of the newborn.

Therefore, do not use drugs for pregnant women to ensure safety for mothers and children.

Lactation period

The drug is secreted into breast milk with small concentrations (maximum about 0.23% of the mother's dose).

Pharmacological dose is about 5 mg of Prednisone/day or less does not cause adverse effects on babies. However, higher prednison doses may slow down the development of children, affecting endogenous corticosteroids or causing unwanted effects. Therefore, do not use medication for breastfeeding people.

Interactive drug

Inhibition or liver enzyme induction: Liver enzyme induction drugs such as phenobarbital, phenytoin, rifampicin and liver enzyme inhibitors such as ketoconazole, erythromycin affect the liver transformation in the liver of prednisone. Adjust the dose of Prednison if needed.

Diabetes treatment: Prednisone can cause hyperglycemia, so it is necessary to adjust the dose of diabetes treatment.

Avoid simultaneous use of Prednisone with the following drugs:

Non-Stoid anti-inflammatory drugs (NSAID): can cause stomach ulcers.

Anticoagulants: can increase or decrease anticoagulant effects.

Digoxin: risk of hypertension and arrhythmia.

Salt diuretics/ laxatives: Increase potassium excretion.

Non -reducing muscle relaxants: Prolong the time of muscle relaxation.

Atropine and anti -cholinergic drugs: can increase internal pressure.

Prazancelel: Glucocorticoids can reduce the concentration of praziquantel in the blood.

chloroquine, hydroxychloroquine, mefloquine: increases the risk of muscle diseases (including myocardial).

Somatropine: Prednisone can reduce the effect of somatropine.

estrogen (such as oral contraceptives): Increases the effect of Prednisone.

Licorice: can inhibit the conversion of Prednisone.

cyclosporin: Prednisone may increase the concentration of cyclosporin in the blood, increase the risk of seizures.

amphotericin b: The risk of hypokalemia.

cyclophosphamide: Prednisone may increase the effect of cyclophosphamide.

Acetylcholininininthines inhibitors: Increased risk of changing blood counts.

Antacomic antacids containing aluminum and magnesi: may reduce the absorption of Prednisone.

Sodium -containing drugs or foods: The risk of sodium edema may increase.

anti -cholininalase: Pednisone can reduce the effects of anti -cholinesterase in myasthenia gravis.

Anti -vomiting (Aprepitant, Fosaprepitant), Calcium channel blockers, antiviral drugs: Increases the effect of Prednisone.

cholestyramine: may reduce the effect of prednisone due to obstacles.

Prednisone may also reduce the concentration/effect of Calcitriol; corticorelin, isoniazid, salicylate, inactivated vaccines.

Avoid alcohol while being treated with the drug (due to increased irritation of the stomach lining).

Prednisone affects calcium absorption.

Limit Cafeine when using the drug.

Rights to tests:

Skin reactions when doing allergy tests may be covered during medication. TSH quantitative results after protevelin injection in patients are stopping Prednisone may be lower than reality.

Glucocorticoid may reduce the absorption of I131 and the concentration of iodine associated with protein. This makes it difficult to observe the response of patients being treated with thyroid drugs.

Glucocorticoid may cause false negative results when performing nitroblue tetrazolium tests in system infections.

Storage

Store at temperatures below 30 ° C, avoid moisture and avoid light.

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