Prednisone (Deltasone) — Clinical FAQs

Question 1

What is Prednisone FDA-approved to treat?

Accepted Answer

Prednisone is FDA-approved for the following oncology indications: 1. Non-Hodgkin lymphoma — CHOP regimen (cyclophosphamide/doxorubicin/vincristine/prednisone; standard frontline DLBCL therapy) and CVP regimen 2. Acute lymphoblastic leukemia — induction chemotherapy regimens 3. Chronic lymphocytic leukemia — component of combination regimens 4. Multiple myeloma — combined with abiraterone acetate (Zytiga) to prevent mineralocorticoid excess/adrenal insufficiency in castration-resistant prostate cancer (FDA approval for prednisone 5 mg BID in this indication, 2011) 5. Hodgkin lymphoma — MOPP and other historical regimens; supportive role in modern protocols.

Question 2

How does Prednisone work (mechanism of action)?

Accepted Answer

Prednisone is an inactive synthetic glucocorticoid prodrug that is rapidly converted by hepatic 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) to its active metabolite prednisolone. Prednisolone binds cytoplasmic glucocorticoid receptors (GR-α), and the activated receptor complex translocates to the nucleus to regulate transcription of glucocorticoid-responsive genes. In lymphoid malignancies, it induces apoptosis via upregulation of pro-apoptotic BIM and downregulation of anti-apoptotic BCL-2 and BCL-XL, while suppressing NF-κB-mediated pro-survival signaling. Immunosuppressive effects result from inhibition of cytokine synthesis (IL-1, IL-2, IL-6, TNF-α) and lymphocyte proliferation.

Question 3

How is Prednisone administered?

Accepted Answer

Prednisone is administered Oral (PO). CHOP regimen: 100 mg PO once daily on days 1–5 every 21 days.

Question 4

What are the most common side effects of Prednisone?

Accepted Answer

The most commonly reported side effects of Prednisone (≥10% incidence) include: Hyperglycemia and glucose intolerance, Increased appetite and weight gain, Insomnia and sleep disturbances, Mood changes (irritability, euphoria, anxiety), GI upset, dyspepsia, nausea and others (10 total). Consult your oncologist for complete prescribing information.

Question 5

Is Prednisone safe during pregnancy?

Accepted Answer

Prednisone pregnancy safety: Category C — some evidence of cleft palate in animal models; short courses in oncologic indications may be necessary. Neonates born to mothers receiving substantial corticosteroid doses near delivery should be monitored for adrenal insufficiency. Benefits generally outweigh risks in acute oncologic settings.. Oncologists should review the complete prescribing information and discuss reproductive risks with patients before initiating therapy.

Prednisone — Drug Monograph

Mechanism of Action

FDA Indications

Common Side Effects

Clinical Pearl

Related Therapies & Mechanisms