Re: switch from hydrocortisone to prednisone after surgery? Any advice???

[Guest guest]

BUMPING - for those who can help with this question.

, below is a table showing Dr Hertoghe's recommended dosing of the different brands of cortisol. in case this might be of some help.

Luv - Sheila

MEN

DEFICIENCY

PRODUCT

7.8am

Noon

4.0pm

Before bed

Borderline

HYDROCORTISONE

15mg

5mg

Mild

20mg

10mg

Moderate

25mg

10mg

5mg

Severe to total

30mg

10mg

10mg

5mg

Bordeline

PREDNISOLONE

2.5mg

Mild

5mg

Moderate

6-7.5mg

Borderline

METYLPREDNISOLONE

2mg

Mild

4mg

Moderate

6-8mg

WOMEN

Borderline

HYDROCORTISONE

10mg

5mg

Mild

10mg

10mg

Moderate

15mg

10mg

5mg

Severe to total

20mg

10mg

5mg

5mg

Borderline

PREDNISOLONE

2.5mg

Mild

5mg

Moderate

7.5mg

Borderlione

METYLPREDNISOLONE

2mg

Mild

4mg

Moderate

6-8mg

Hirsutism

DEXAMETHASONE

0.1-0.5 mg

> In March I need to go for Surgery from the cervical vertebras; C4 to C6. My hormone doctor advised me to switch from hydrocortisone 25 mg to prednisone 5mg a day for one month right after surgery (without weaning off). She also suggested me at the very start of my treatment to take 5 mg prednisone each day, instead of the hydrocortisone, but I refused. > > Is it harmful to switch to prednisone just like that? > > Does anyone has advice how to dose during surgery, and the days and weeks after surgery. (either cortisone or prednisone) >

[Guest guest]

In March I need to go for Surgery from the cervical vertebras; C4 to C6. Myhormone doctor advised me to switch from hydrocortisone 25 mg to prednisone 5mga day for one month right after surgery (without weaning off). She alsosuggested me at the very start of my treatment to take 5 mg prednisone each day,instead of the hydrocortisone, but I refused.

Hello ,

If I were in your shoes, I would write to (or see) the hormone doctor and ask her to clarify her reasons for wanting to switch you from HC to prednisone. Personally I can't see any advantage (other than it is cheaper) to doing that – but then, I am not a doctor. Perhaps she knows something I don't. Furthermore, I do not understand why she would want you to use prednisone rather than prednisolone (again, other than it's cheaper).

The differences between HC, prednisone and prednisolone are –

Hydrocortisone is a cortisone which is biologically identical to the cortisone our own adrenals produce. If there is any disadvantage over steroids like prednisone or prednisolone, it is the fact that you need to multidose about 4 times a day to get the full benefit.

Prednisone and prednisolone are synthetic derivatives. Prednisone has the added disadvantage that it has to be converted by the liver into prednisolone, because prednisone cannot be used in its original formulation. So personally I do not understand why doctors use prednisone at all (but again, perhaps they know something I do not know) other than it is much cheaper than HC and even cheaper than prednisolone. The advantage of both, prednisone and prednisolone, is that it needs to be given only once a day, since it remains active in the system for about 24 hours. The disadvantage is that it can irritate the stomach lining, which is why it should always be taken with food. The same goes for HC btw., although, because HC is taken in smaller doses throughout the day, the risk of stomach irritation is less. Prednisone and prednisolone are about 4 times stronger than HC ..... 5 mg prednisolone equals 20 mg HC.

Is it harmful to switch to prednisone just like that?From a medical standpoint – no, it is not harmful to switch from HC to preds; they all are glucocorticoids (same steroid family) and there is no need for weaning. The body just utilizes the steroids differently – HC is used up straight away within a few hours, whilst preds remain active in the system for a period of 24 hours.

Does anyone has advice how to dose during surgery, and the days and weeks aftersurgery. (either cortisone or prednisone)Sorry, can't help with that, although I can't see any reason to change anything (other than I would imagine that you may need a little more HC because of the stress of the surgery for a couple of days or so). But the best person to address with that is your orthopaedic surgeon.

I honestly cannot see any reason to change, and I suspect money to be the reason for your doctor wanting to change your prescription. Preds are a lot cheaper than HC.... but I do say that tongue in cheek – perhaps there is a clinical reason that I do not know about, hence I would write to (or see) the hormone doctor and ask her to give you her reasons.

Hope this helps and best of luck with the ops,

[Guest guest]

Hi , I too took prednisone for years ( now thankfully weaned off) and the only advice I recieved was from my dentist- to take a double dose on the morning before a nasty extraction to cushoin me from shock. I had no problem with the singe double dose or the surgery. 5mg prednisone is double the dose I used to take and have never taken hydrocortisone so can't comment on that aspect. > thyroid treatment > From: sandra.deswaef@...> Date: Sun, 27 Feb 2011 18:56:40 +0000> Subject: switch from hydrocortisone to prednisone after surgery? Any advice???> > Dear Group members,> > In March I need to go for Surgery from the cervical vertebras; C4 to C6. My hormone doctor advised me to switch from hydrocortisone 25 mg to prednisone 5mg a day for one month right after surgery (without weaning off). She also suggested me at the very start of my treatment to take 5 mg prednisone each day, instead of the hydrocortisone, but I refused. > > Is it harmful to switch to prednisone just like that? > > Does anyone has advice how to dose during surgery, and the days and weeks after surgery. (either cortisone or prednisone) > Thanks for your help! Kind regards, > > > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >