Reaction to switching prednisone to hydrocortisone

Posted by annelia @annelia, Apr 26 7:17am

My new endocrinologist and I, thought perhaps switching to hydrocortisone from years of prednisone might make a positive change. However ... I had three weeks of swollen ankles and feet (legs probably as well) but I didn't recognize the problem for a while because I was reeling from my last visit to ER.
I switched back to prednisone two days ago and the swelling has gone down remarkably. Has anyone else had something like this happen to them ?

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

daughterofmary | @daughterofmary | 2 days ago

It can go either way- Hydrocortisone to Prednisone or Prednisone to Hydrocortisone. Obviously, everyone responds to meds differently, but prednisone is a prodrug – meaning that it has to first synthesize in your body as prednisolone via the liver- before it starts working as such, taking longer to kick in than hydrocortisone. It is also longer-acting. When I tried switching from Hydrocortisone to Prednisone, it was horrific for me. I had to return quickly to my trusted Hydrocortisone treatment, as I went into bad withdrawal. I suppose my body was unable to convert the prodrug Prednisone into its active form effectively enough for me, but if that works for you, stay with it- under your Dr’s supervision, of course. So, yes- in short, one may work for one and one for another. Same category of medication, with some distinct differences between the two.!

swalex | @swalex | 2 days ago

Although I also have lupus and Adrenal insufficiency, hydrocortisone works best for me—even though I occasionally experience weight gain as a side effect.

Hydrocortisone for Adrenal insufficiency (like Addison’s disease)
Inflammation
Allergic reactions
Sometimes used topically (creams) for skin conditions
Mimics: The body’s natural cortisol closely

Prednisone: Intermediate-acting corticosteroid
Potency: About 4–5 times stronger than hydrocortisone
Uses:
Autoimmune diseases (e.g., lupus, rheumatoid arthritis)
Asthma
Severe allergic reactions
Inflammatory conditions