The Basics

What is Prednisone?

Provides relief for inflamed areas of the body and is used to treat a number of conditions, such as inflammation, severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, endocrine problems, eye or vision problems, stomach or bowel problems, lupus, skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis.

Brand names for Prednisone

Deltasone

How Prednisone is classified

Corticosteroids – Systemic, Glucocorticoids, Anti-Inflammatory Agents

Prednisone During Pregnancy

Prednisone pregnancy category

Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Prednisone while pregnant

Usage in pregnancy: 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. Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. These effects are less likely to occur with the synthetic derivatives except when used in, large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids Increase calcium excretion. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered to patients receiving immunosuppressive doses of corticosteroids; however, the response to such vaccines may be diminished. Indicated immunization procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids.

Taking Prednisone While Breastfeeding

What are recommendations for lactation if you're taking Prednisone?

Amounts of prednisone in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With high maternal doses, the use of prednisolone instead of prednisone and avoiding breastfeeding for 4 hours after a dose theoretically should decrease the dose received by the infant. However, these maneuvers are not necessary with short-term use. High doses might occasionally cause temporary loss of milk supply.

Maternal / infant drug levels

Amounts of prednisone in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With high maternal doses, the use of prednisolone instead of prednisone and avoiding breastfeeding for 4 hours after a dose theoretically should decrease the dose received by the infant. However, these maneuvers are not necessary with short-term use. High doses might occasionally cause temporary loss of milk supply.

Possible effects of Prednisone on milk supply

Published information on the effects of prednisone on serum prolactin or on lactation in nursing mothers was not found as of the revision date. However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[11][12]

A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of another corticosteroid (betamethasone, 2 intramuscular injections of 11.4 mg of betamethasone 24 hours apart) given between 3 and 9 days before delivery resulted in delayed lactogenesis II and lower average milk volumes during the 10 days after delivery. Milk volume was not affected if the infant was delivered less than 3 days or more than 10 days after the mother received the corticosteroid.[13] An equivalent dosage regimen of prednisone might have the same effect.

A study of 87 pregnant women found that betamethasone given as above during pregnancy caused a premature stimulation of lactose secretion during pregnancy. Although the increase was statistically significant, the clinical importance appears to be minimal.[14] An equivalent dosage regimen of prednisone might have the same effect.

Possible alternatives to Prednisone

Methylprednisolone, Prednisolone.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Katz FH, Duncan BR. Entry of prednisone into human milk. N Engl J Med. 1975;293:1154. Letter. PMID: 1186783
2. Sagraves R, Kaiser D, Sharpe GL. Prednisone and prednisolone concentrations in the milk of a lactating mother. Drug Intell Clin Pharm. 1981;15:484. Abstract.
3. Berlin Jr CM, Kaiser DG, Demers L. Excretion of prednisone and prednisolone in human milk. Pharmacologist. 1979;21:264. Abstract.
4. Ryu RJ, Easterling TR, Caritis SN et al. Prednisone pharmacokinetics during pregnancy and lactation. J Clin Pharmacol. 2018;58:1223-32. PMID: 29733485
5. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
6. Moretti ME, Sgro M, Johnson DW et al. Cyclosporine excretion into breast milk. Transplantation. 2003;75:2144-6. PMID: 12829927
7. Munoz-Flores-Thiagarajan KD, Easterling T, Davis C et al. Breast-feeding by a cyclosporine-treated mother. Obstet Gynecol. 2001;97(5 pt 2):816-8. PMID: 11336764
8. Nyberg G, Haljamae U, Frisenette-Fich C et al. Breast-feeding during treatment with cyclosporine. Transplantation. 1998;65:253-5. PMID: 9458024
9. Correia LM, Bonilha DQ, Ramos JD et al. Inflammatory bowel disease and pregnancy: report of two cases treated with infliximab and a review of the literature. Eur J Gastroenterol Hepatol. 2010;22:1260-4. PMID: 20671559
10. Constantinescu S, Pai A, Coscia LA et al. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014;28:1163-73. PMID: 25271063
11. McGuire Ee. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012;20:32-4. PMID: 22724311
12. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013;19:248-50. PMID: 24261425
13. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis ii in women. Pediatrics. 2008;121:e92-100. PMID: 18166549
14. Henderson JJ, Newnham JP, Simmer K, Hartmann PE. Effects of antenatal corticosteroids on urinary markers of the initiation of lactation in pregnant women. Breastfeed Med. 2009;4:201-6. PMID: 19772378

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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