Low-dose methotrexate therapy can be used to treat rheumatoid arthritis, asthma, psoriasis, and other inflammatory diseases. When the drug is used for these conditions, the dose is administered weekly or twice a week. Unfortunately, it is not uncommon for the Institute for Safe Medication Practices (ISMP) to receive reports of oral methotrexate overdoses, and even fatalities, due to accidental daily instead of weekly dosing. In one case, a physician decided to add methotrexate 10 mg weekly to a psoriasis patient's daily prednisone regimen. Methotrexate 2.5 mg tablets were prescribed with instructions to "take 2 tablets on Monday morning and 2 tablets Monday at bedtime."For some reason, the pharmacy label was unclear to the patient. Because her doctor described the methotrexate as "supplemental therapy to her prednisone," the patient assumed that it was to be taken every day with her prednisone. She took 4 tablets (10 mg) daily for 1 week before being admitted to the hospital due to intolerable nausea, vomiting, and diarrhea. buy levitra with mastercard In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated. Corticosteroids may mask some signs of infection, and new infections may appear during their use. Infections with any pathogen including viral, bacterial, fungal, protozoan or helminthic infections, in any location of the body, may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function.1 These infections may be mild, but can be severe and at times fatal. With increasing doses of corticosteroids, the rate of occurrence of infectious complications increases.2 There may be decreased resistance and inability to localize infection when corticosteroids are used. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses. Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. 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Prednisone delayed-release tablet is available as a generic drug and as the brand-name drug Rayos. The immediate-release tablet is only available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug. It’s approved to treat: Prednisone works by weakening your immune system. This action blocks chemicals that normally cause inflammation as part of your body’s immune response, and can help decrease inflammation in many parts of your body. If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist. Oral steroids, or corticosteroids taken by mouth, are prescription anti-inflammatory medications that have been commonly prescribed for various orthopaedic conditions, including low back and neck pain. While these drugs can reduce pain and inflammation, they also have potential serious side effects that you should discuss with your doctor. Corticosteroids can be administered in numerous ways, though injection and oral forms are the two most commonly used for spine pain. This article describes the basics of How Oral Steroids Work Oral steroids are designed to work in the same way as the hormones produced by your adrenal glands in response to stress and injury. When the corticosteroids you take raise your body’s natural adrenal hormones above their normal levels, this reduces inflammation. Corticosteroids also suppress your immune system, which helps people who suffer from autoimmune conditions (such as rheumatoid arthritis) but can also decrease your ability to fight infection. Oral steroids are generally prescribed for a limited time—typically 1 or 2 weeks. 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