Prednisone High Doses For Four Days And No Taper 1 Week Later - Help

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Derrick Says:


I had an allergic reaction to Bactrim and was given prednisone - I took 60 mg, 80 mg, 60 mg, and then 40 mg. On the third day of prednisone I went to the ER because I woke up shaking uncontrollably. The last dose was a week ago today. Even since stopping, I have been feeling very shaky, weak, easily out of breath, tense/anxious, not sleeping properly, extremely emotional, and many other uncomfortable symptoms. I went to a doctor a couple of days ago and she basically said to give it time. I'm happy to do that but I'm also concerned about the (stupidly) large doses of prednisone I was given, and quitting abruptly even though it was only four days. Is it likely the symptoms I'm experiencing are a result of prednisone? I just got bloodwork, U/A, EKG results and nothing seems to be wrong. Should I have tapered off of it? Do I need to go back on? Or just deal at this point and hope it corrects?



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Mason Says:

In my opinion, of which I am not a medical doctor, the lingering effects are more likely from the allergic reaction you had to Bactrim. It sounds to me like you may be in a state of shock.

I have taken 5 day regimens of prednisone several times, for gout attacks, without even titrating. It's never been an issue for me. We're all different though.

Only a doctor could properly advise you. Perhaps you should make an appointment or head to a medcheck or back to the ER. Not trying to worry you but you could be in danger due to issues with your adrenal glands or potentially serious cellular injury or inadequate tissue function (shock).

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Derrick Says:
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Re: Mason (# 1)

Thanks for your reply, Mason. I too have been trying to figure out if the symptoms are from the Bactrim, which I was on for 8 days before developing a rash, or the prednisone. The rash went away by the fourth (and last) day of taking prednisone. The ER doc thought my symptoms were from the prednisone. I saw another MD a couple of days ago who did a complete physical exam and ordered all the tests I mentioned. She found nothing obviously wrong and also thought the symptoms were from the prednisone. If I had cellular damage, inadequate tissue function, etc., wouldn’t that have shown up on a test? Or what kind of test would tell me if these symptoms are from the Bactrim or the prednisone? I remain open-minded and greatly appreciate the community’s thoughts at this point. I should mention I’m 35 years old and was healthy before all of this.

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Mason Says:

Re: Derrick (# 2)

Well it seems by your writing that you're quite coherent and eloquent which leads me to believe you're probably not in shock. It sounds like your condition has improved. If the doctors think it was the prednisone then it probably was/is. Prednisone can be hard on your adrenal glands and your heart but I would think at age 35 that wouldn't be an issue. Then again I'm no expert.

That's about how old I was when I first took prednisone and i'm 40 now. It is a steroid so it is a powerful medication. Perhaps they should have had you do a titration up and taper down. Was there nothing off at all on your tests? Glucose wasn't high? I only ask because that can be a common side effect of corticosteroids like prednisone.

Anyway, sounds like you'll probably be okay just giving it time. Maybe you're just sensitive to prednisone. Something to keep in mind for the future if you ever need it again.

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Derrick Says:

Re: Mason (# 3)

Another day, same story so far. I do appreciate your thoughtful replies.

Nothing stood out on the tests, really. A couple things were slightly high (sodium 149, calcium 10.6), but I doubt those are worth paying attention to. Potassium was a bit higher than the normal range (5.5), but this was also high when I went to the doctor before any of this started (same visit doc prescribed Bactrim it was 5.6), and it was relatively low in the ER (3.1) -- the day it was low it may have been causing issues, but I doubt it is now.

Otherwise, everything else was normal including thyroid tests, EKG, and urinalysis.

I was looking closely at my skin last night and it's still somewhat mottled in places, so I'm not discounting the possibility that the reaction hasn't fully worked its way out of my system yet. I've read about people for whom the Bactrim rash has even returned after initial steroid/antihistamine treatment. However, I've read about skin side effects of prednisone as well ("thin skin"), and indeed my skin felt this way - it still feels weird to me, but may be normalizing somewhat in this regard.

I had been thinking about the glucose connection before, but it's been fine every time it's been tested (I have a tester at home, too). I don't observe any connection between eating (e.g., sugar) and any of the shakiness. My appetite hasn't been great through this, but maybe that's not too surprising as I'm probably not burning nearly as many calories as I usually do. I've also had pretty frequent heartburn / stomaches.

The shaking is present if I get up to go to the bathroom at night, but settles back down once I get back to rest. It's bad when I first get up in the morning, and in general is not great from morning through afternoon. Evenings it seems to be noticeably better, though. The cyclic nature of this leads me to believe *maybe* it's some kind of hormonal/body regulation thing, although I'm really not sure. As far as a coincidental or opportunistic infection possibly causing this, I'm not ruling it out but I haven't had any fever or chills thus far. What I would really like is some data point or test that could point to a definitive cause, be it an effect of the sulfa allergic reaction, the prednisone, or whatever. So far it's mostly just been ruling things out. Attempting to stay positive although it's very difficult to not be seeing a noticeable improvement at this point, to be so shaky/weak/useless, etc. It sucks to not understand this.

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Little Bear Says:

Re: Derrick (# 4)

I'm surprised they didn't include cortisol or aldosterone testing. What about simple glucose? Yeah, you were jacked up on steroids, a pretty high dose and you probably had a crash. I had an allergic reaction to an Rx pill and went to the ER. They gave me 30mg of prednisone. That's it. All symptoms subsided and I went home. What they gave you sounds excessive. It's March 1. You should be well over this by now. Is that right? btw: Bactrim is a nasty a/b.

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Deborah Says:
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What is your pulse, Do you have any skipped heartbeats. I’m wondering if this could be Cardiac related? However, no doubt you had too much steroid and put Bacttrim on your medicine allergic reaction list.

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Shelly Says:
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Re: Little Bear (# 5)

Hi, my hubby is on Bactrim for a cyst that they had to lance. What's up with bactrim? I'm just asking why did you say it's a nasty antibiotic? Just curious what to expect I guess. Thank you.

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Kris Says:

This happened to me as well. The problems with the prednisone were from not being able to taper off as the doctor prescribed. It was giving me diabetes symptoms and the doctors never discussed this with me: it caused huge fluctuations in my blood sugar. This is something else people should be aware of.

After a few weeks all the symptoms disappeared. I was told you need to be on Prednisone much longer than a few days for lasting problems, which seems to be true. However, symptoms related to the bad reaction to Bactrim were around longer, including neuropathy, tinnitus (I was told this was my nervous system being out of whack from the shock) and extreme sun sensitivity. Bottom line, doctors do not know everything, and did not take the time to tell me everything. Research everything, especially meds you are given, on your own in addition to what they provide. If I had understood about the sun sensitivity side effects of Bactrim, even though they are rare, I would have asked for something else as I am a red head and it was August in Colorado. I hope this helps.

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Patch Says:

Derek,
I can't believe they didn't taper that more (i.e. 40 for a few days then 30 a few days, etc.). I would get a second opinion on this. No offense to your Doctor, and they shouldn't be offended either. If you are concerned about a health problem and your doctor isn't giving you adequate treatment, get a second opinion!!! Good luck.

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Derrick Says:

Hi all,

I appreciate the comments and feedback. For those who are curious, I've started to improve somewhat over the course of the last week or so, but am still dealing with some lingering symptoms, primarily the neuropathy that Kris mentioned (limbs falling asleep easily, still have shakiness when waking up, hands are strangely shaky much of the time, still having weird muscle pains, seem abnormally weak at times, etc.). I've been slowly trying to get back into shape by forcing myself to walk, start stressing my muscles again with light exercises, etc. Hopefully eventually I'll make a full recovery but it's still amazing and bizarre to me that the Bactrim/allergic reaction/prednisone combo screwed me up so much. About half the health care people I've seen have wanted to attribute my remaining symptoms to the prednisone, the other half moreso to the Bactrim/allergic reaction. I finally saw my PCP and he was one of the people in the latter camp, I guess. Anyway, he basically looked through my test results and only noticed that calcium was somewhat high and became concerned about possible parathyroid issues. He ordered tests rerun after one week of waiting, and my calcium levels came back down a little and the PTH levels were fine. He didn't think it was worth testing cortisol levels because in his opinion "if something were out of whack, it would have shown up elsewhere" (on the metabolic or CBC tests, presumably -- he never specified what exactly). Bottom line, they haven't found anything wrong given the tests they've done and pretty much everyone thus far as just said it will take time. Been very frustrating and difficult, wish there was a way to know more definitely what the issue was, and/or speed up this recovery process! Best wishes to all of you though!



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Shirley Says:

Derrick, I have been on prednisone a LOT (unfortunately). It ALWAYS makes me shaky with rapid pulse, blood pressure elevation and heart palpitations. The dosage you spoke of is very high not to have been tapered slowly and down to at least 10mg before stopping. When one is given higher doses the adrenal glands stop producing your body's natural supply of cortisone/cortisol. And I have never learned how long it takes the body to kick back in. Prednisone wreaks havoc on the endocrine system, male and female hormones, cholesterol, blood glucose and thyroid. Hopefully you will feel better soon and not have to be prescribed this drug again. I you are not tapered properly and your symptoms return it is referred to as "rebound". Wish you well.

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Derrick Says:

Hi all,

Just a quick note to let everyone know that I seem to have made a full recovery from this. Thanks for everyone's support and hopefully if some other unlucky person is in the same boat, this thread will help them.

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Kitty Says:
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Re: Derrick (# 4)

Hi, I don’t have answers to many of your questions, but I can tell you this: i’ve Been on prednisone 3 times. The 1st when I was 45 and it was prescribed for a year as a sight -saving measure. When I was 61 I was prescribed prednisone for 10 day when I was diagnosed w/COPD. It’s ironic that people commonly complain of shortness of breath yet it is very frequently prescribed for COPD. Thirdly, I was prescribed it for 30 days when I was prescribed it for pneumonia and was hospitalized for 11 days, 3 of which I was unconscious (mostly) in ICU. All 3 times I experience trembling, even violent shaking of my hand or hands, terrible mood fluctuations, out of control of my emotions and extreme reactions, very sudden flashes of anger, depression and mania, as well as terrific sleep deprivation. Nurses and a psychiatrist have told me these are common. Some have told me it mimics no-polar , some have told me it cause Parkinson’s also. Hoe this information is of use.

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