Prednisolone Sodium Phosphate Risks, Warnings, and Complications

CHANGES IN ENDOCRINE FUNCTION: Chronic use of corticosteroids can lead to endocrine abnormalities, including hypothalamic-pituitary axis suppression, Cushing’s syndrome, and hyperglycemia (elevated blood glucose levels). Changes in thyroid status (overactive or underactive thyroid gland) can affect the metabolic clearance of steroids, requiring a dose adjustment. Salt and mineralocorticoid supplementation may be necessary in some patients. 

Take prednisolone phosphate exactly as prescribed. Keep all your medical and laboratory appointments during treatment, and see your doctor regularly. Your doctor may order certain lab tests and adjust your dose based on your response to this drug.

INCREASED RISK OF INFECTIONS: Prednisolone sodium phosphate and other steroids suppress the immune system and can affect the body’s ability to fight infections. This can increase your risk of getting infections caused by bacteria, viruses, fungi, protozoans, and helminths. The higher the dose of corticosteroids, the greater the risk of infection. The use of steroids for prolonged or repeated periods is also linked to an increased risk of infections. You may not show the usual signs of infections while on steroids. Your resistance to new infections may be reduced. Steroids can make current infections worse, increase the risk of serious, widespread infections, and reactivate latent infections.

Tell your provider if you have had a positive tuberculosis test in the past. Also, tell your doctor if you have a systemic (bodywide) fungal infection. Avoid contact with anyone who is sick with infections such as chicken pox, measles, or shingles. If you are exposed to such individuals, your provider may recommend preventive vaccination or antiviral drugs. Call your doctor without delay if you notice symptoms of infection while on prednisolone phosphate. 

CHANGES IN CARDIOVASCULAR AND KIDNEY FUNCTION: Corticosteroids can lead to an increase in blood pressure, salt and fluid retention, and increased elimination of calcium and potassium from the body. Large doses are more likely to cause these effects. People with hypertension (high blood pressure), congestive heart failure, and renal insufficiency (reduced kidney function) are at an increased risk of complications. Corticosteroids should be used with caution in people with a recent myocardial infarction (heart attack). 

 Give your doctor a complete medical history before starting prednisolone phosphate. Your provider may recommend restricting dietary salt and taking potassium supplementation. Follow these recommendations carefully. 

GASTROINTESTINAL COMPLICATION: People who have certain gastrointestinal disorders and are taking corticosteroid medications are at an increased risk of gastrointestinal perforation. Steroid medicines can mask some of the signs of GI perforation and peritoneal irritation.

Before starting treatment with prednisolone phosphate, tell your doctor if you have any stomach or intestinal problems, such as an abscess, infection, diverticulitis, stomach bleeding, or peptic ulcer. 

MENTAL SYMPTOMS: Corticosteroid use can affect the central nervous system and cause changes in behavior and mood, including euphoria (abnormal excitement), severe depression, trouble sleeping, mood swings, personality changes, and psychotic symptoms in severe cases. Tell your doctor if you notice any changes in mood or behavior while taking prednisolone sodium phosphate.

DECREASED BONE DENSITY: Corticosteroids have an effect on calcium metabolism and can lead to decreased bone formation and increased bone resorption. This can lead to slowed bone growth in children and adolescents and osteoporosis in people of any age, but especially in postmenopausal women. Your doctor will monitor you carefully if you are on long-term treatment with prednisolone phosphate.

EYE PROBLEMS: Prolonged use of steroid medications can lead to cataracts and glaucoma and increase the risk of viral and fungal eye infections. Tell your doctor if you have an ongoing viral infection in the eye, such as ocular herpes simplex. Call your doctor immediately if you develop eye pain, swelling, redness, or vision changes.

VACCINATION: People on corticosteroid therapy should not receive live or live attenuated vaccines. However, inactivated or killed vaccines can be given, although the response to these vaccines is unpredictable. Check with your doctor before getting any vaccine while you are on prednisolone phosphate. 

GROWTH AND DEVELOPMENT: Long-term corticosteroid use can negatively affect a child’s growth and development. Your child’s healthcare provider will monitor their growth carefully if long-term steroids are necessary. 

FETAL TOXICITY: Prednisolone can be harmful to the fetus (unborn baby) if taken during pregnancy, including an increased risk of cleft lip and cleft palate, intrauterine growth restriction, and decreased birth weight. Tell your doctor if you are pregnant before starting prednisolone sodium phosphate. Call your doctor right away if you become pregnant while taking this drug.

EFFECTS ON MUSCLES: Acute myopathy (muscle weakness) has been reported with high-dose corticosteroids in people with neuromuscular disorders such as myasthenia gravis or those taking neuromuscular blocking drugs such as pancuronium. This can be a generalized muscle weakness, or it may involve the eye and respiratory muscles. It can result in paralysis. There may also be an increase in creatinine kinase levels in the blood, indicating muscle injury. These symptoms typically improve after corticosteroids are stopped, but it can take weeks to months or even longer.

KAPOSI’S SARCOMA: Kaposi's sarcoma, a cancer of the skin, mucous membranes, lymph nodes, and lungs, has been reported in people on corticosteroid therapy, usually for chronic conditions. Discontinuing treatment with corticosteroids may result in improvement.