Use of Prednisone

Hi,
I, like many it seems has COPD.  I did but don’t smoke anymore, (10 years free).  My Doctor indicated that tests show a 30 percent lung capacity remaining.  To make a long story short the mucus (very thick) builds so quickly in my airway that I need Albuterol treatment 5 times per day and I take 25 mm of prednisone daily.  I’ve been on the prednisone for almost 10 months and my question is how long can I safely take this medication?

[National Jewish Health]

Prednisone 25 mg daily, cannot be taken safely for any sustained period and 10 months is a very sustained period.  Safely would mean without side effects and, in truth, side effects are almost inevitable at that dosage.  An alternative would be the use of a combined inhaled steroid and long-acting inhaled bronchodilator, such as Advair™ Diskus® (fluticasone propionate and salmeterol) Inhalation Powder or Symbicort Turbuhaler® (budesonide and formoterol).  Mucolytic medicines are generally not very effective, but Pulmozyme® (dornase alfa), approved for the treatment of cystic fibrosis, might help thin and clear your mucus secretions.

You might want to see a pulmonary specialist to make sure that the mucus is not due to another, non-smoking related lung disease or to gastroesophageal reflux (GERD).

Also at this dose, the function of your adrenal glands is almost certainly totally suppressed.  That means that you will have to work with your doctor to reduce the prednisone dose very slowly to allow adrenal gland function to return.