Thursday, February 9, 2017

Making Sense of Drugs Like Prednisone and DexPak and Why It Is So Important to Taper Them - Steroids

Recently I fell and sprained my knee which caused a lot of inflammation in my body due to my other health woes.  My doctor prescribed a 10-Day DexPak.  I have to take Prednisone a LOT, but I'd never taken the DexPak before and will NEVER take it again.

Here's what I have learned about these two drugs.  They are NOT the same:

Prednisone

Prednisone works by suppressing the body's immune system. In diseases like asthma, arthritis, lupus, and others, it is invaluable when your system becomes inflamed.  It reduces inflammation (heat, swelling and pain).

When it works it is a miracle drug, and I am very thankful that I can take it.  I just have to be very very very careful to taper it off as directed or it can harm me since I have to take it so often.

Prednisone can make it hard to fight off infections, so if I get a sinus infection or sore throat or something I have to be careful to have that treated right away when taking Prednisone.  If I don't then the infection will run rampant and make me very very sick.

Prednisone comes with a laundry list of side effects.  The worst one for me is I gain around 10 pounds everytime I have to take it.  I've gained over 80 pounds in the past 15 years mainly due to having to take Prednisone...as well as my hypothyroidism, but that is another story.

Many people experience worse side effects on Prednisone than me.  It does also make me bloat, have more trouble than usual sleeping, and tends to make me more angry and aggressive, but some people have a mixture of THESE side effects, which can even include cardiac arrest (heart attack).  This is a serious drug.  Know that before you take it, and please be aware that this drug must be tapered off.  NEVER suddenly stop taking it.  NEVER.

Why You Have to Taper Prednisone

Prednisone is what they call a corticosteroid drug. Corticosteroids mimic your body's natural adrenal gland hormone, cortisol. Prednisone gives a boost to your body's usual adrenal gland hormone levels, thus suppressing the inflammation.

It is important to note that cortisol is also known as "The Stress Hormone."  It influences and/or regulates:
  • Blood sugar (glucose) levels
  • Fat, protein and carbohydrate metabolism to maintain blood glucose
  • Immune responses
  • Anti-inflammatory actions
  • Blood pressure
  • Heart and blood vessel tone and contraction
  • Central nervous system activation
See?  Important.  To learn more about cortisol and its functions, click HERE. For an article that explains it better in layperson's terms, click HERE.

If you take Prednisone often, your body will become used to having the higher levels of cortisol and it will get very lazy and stop making its natural hormones.  To prevent this, you MUST taper the Prednisone slowly to give your body time to start its hormone production factory again.  Otherwise you can become dependent on Prednisone and its side effects will increase until you become totally miserable.  Seriously miserable.  

Please take another look at these side effects by clicking: HERE.  You do NOT want this.  ALWAYS taper if you have to take this drug for more than three or so days.  Always. Always. Always.

DexPak 10-Day Taper Pack (Dexamethasone)

DexPak 10-Day Taper Pack is the drug I was recently given that has given me these terrible side effects.  I can take Prednisone, but I will NEVER take DexPak again.  Never.  My side effects from this drug have included:
  • severe insomnia
  • ravenous insatiable hunger
  • anger/aggression
  • severe sweating
  • shortness of breathe
  • bloating and stomach pain
  • explosive diarrhea
  • vision problems
  • acne
  • increased urination at night
  • acidic feeling throat and mouth
  • shaking hands and jittery feeling
All this and I was still afraid to stop taking the medication because of the knowledge I have about why I, personally, ALWAYS must taper steroids due to my having to use them so much and the damage they can cause to my body if I don't taper.

Today is my last day on this drug.  Thank goodness.  I know it will take at least five days to go out of my system and maybe longer, but I hope to start feeling better very soon.

I'll try to explain further.

DexPak (Dexamethasone) like Prednisone is used to treat many conditions. These include adrenal insufficiency, inflammation, allergic reactions, ulcerative colitis, certain cancers and other conditions that do not respond well to Prednisone.

Dexamethasone is a glucocorticoid.  It is NOT Prednisone.  It is in the same family, but much like your sibling, is somewhat the same AND entirely different. Please know that your body may react very differently to these two drugs.

KNOW THIS when your doctor mentions that you might want to try this "other steroid."  It can be used to TREAT some of the same things, but it is NOT the same thing.

DexPak is a glucocorticoid. Glucocorticoids are adrenocortical steroids that can be either naturally occurring or synthetic. They modify the body’s immune responses to fight inflammation by basically messing with your endoctrine glands:  the hypothalamus, the pituitary gland, and the adrenal glands in order to fight inflammation in your body.

These glands control your body's reaction to stress and regulate many body processes, including digestion, the immune system, mood and emotions, sex drive, energy storage, etc. etc. etc.  You do NOT want to mess with these glands for very long.  You NEED these glands to function.

This is a very powerful drug. 

It can certainly help what ails you, but you MUST be very careful to taper it if you have to take steroids of any kind very often.  Seriously.  I can NOT stress this enough.

Why You Have to Taper DexPak

There are three things that can happen if you do NOT taper this type of steroid.
  1. secondary adrenal insufficiency (suppression of the HPA axis)
  2. steroid withdrawal or deprivation syndrome
  3. relapse of the problem you are trying to treat
Yes.  All three things can happen at the same time.

The most feared complication that can happen if you don't taper is secondary adrenal insufficiency. This can be partial or total, and can do serious damage to your adrenal glands, AND the scariest part is:

It is not possible to predict with confidence which patients will be affected even when factors such as dose and duration of corticosteroid therapy are taken into account.

Read that again.

This means, its true prevalence remains unknown.

Some studies have considered it to be fairly infrequent due to the fact that physicians are taught to gradually reduce corticosteroid doses, thereby allowing your adrenal glands to recover their original function.

Thank God for physicians who tell you to taper these drugs.  NEVER suddenly stop taking them.  NEVER.

Now read this statement:

Recent reports have indicated that incorrect withdrawal of corticosteroids from patients who have been on them for prolonged periods is the primary cause of adrenal crises and secondary adrenal insufficiency.

Please read that again.

Symptoms of adrenal insufficiency include: anorexia, nausea, vomiting, abdominal pain, weakness, tiredness, lack of energy, emotional exhaustion, muscle pain, joint pain, weight loss, low blood pressure, sleep-walking, depression, and more.

In severe cases, an acute adrenal crisis may occur (vomiting, diarrhea, fever or hypothermia, acute dehydration, hypo-tension, hypoglycemia, shock and coma), which is a life-threatening situation.

In other words, if you suddenly stop taking oral steroids after taking them repeatedly for 15 years like me, then your body will not automatically produce the steroids you need to be your normal self.  You will not have any steroids in your system, and THAT IS BAD

BAD = YOU COULD DIE (in a MOST unpleasant way)

If anyone tells you to NOT TAPER your steroids without knowing your entire medical history, do NOT listen to them. 

GET ANOTHER OPINION FROM SOMEONE WHO IS AN EXPERT ON STEROIDS.

YOU NEED YOUR BODY.  Please education yourself and take care of your body as best you can.   

Research.  Listen.  Learn.  Ask questions.  Ask more questions.  Consult experts up to and including our National Library of Medicine whose databases are online.  Make your own decisions about your health based on educating yourself.  

Do ask your personal physician, but don't always stop there.  Your doctor is human and has not memorized the side effects of every single medication a drug rep slips in front of him/her.  No human has time to do all that research, so make it your mission to inform yourself about your own body, and do find yourself a physician who is caring, with good listening skills, to help you along your path.

This getting old stuff really is NOT for sissies.

I wish  you all well, and I hope you learned a little something from today's post.  Question it.  Always question everything.  Don't just take my word for it either.

One last thing:  This particular medical article is an oldie (2008) but a goodie.  It contains a lot of good information about steroids with citations.  You may want to read it.  If so, click HERE.

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