Deltasone is a brand name for prednisone, a corticosteroid that suppresses inflammation and calms an overactive immune system. The 20 mg tablet sits in the middle of the drug’s dosing range (5 mg to 60 mg per day), and it’s prescribed for a wide variety of conditions, from severe allergies and asthma flares to autoimmune diseases like lupus and rheumatoid arthritis.
How Deltasone Works
Prednisone is a synthetic version of cortisol, the hormone your adrenal glands produce naturally. Once you swallow it, your liver converts it into its active form, which enters cells and binds to receptors that control inflammation. The drug works by dialing down the signals that recruit immune cells to inflamed tissue. Specifically, it reduces the sticky molecules on blood vessel walls that allow white blood cells to latch on and swarm into joints, airways, skin, or wherever the inflammatory response is happening. It also suppresses the production of chemical messengers that drive swelling, redness, and pain.
This broad mechanism is why a single drug can treat such a long list of seemingly unrelated conditions. Anywhere inflammation is causing damage, prednisone can intervene.
Conditions Treated With Deltasone
The FDA-approved uses for Deltasone span more than a dozen medical categories. At the 20 mg dose, it’s commonly used for moderate flares of inflammatory or autoimmune disease. Here are the major groups:
- Autoimmune and rheumatic conditions: Rheumatoid arthritis, psoriatic arthritis, lupus, ankylosing spondylitis, and polymyositis. For many of these, prednisone is used short-term to get a flare under control while slower-acting medications take effect.
- Severe allergies and asthma: Allergic reactions that don’t respond to antihistamines, severe seasonal allergies, contact dermatitis, drug reactions, and acute asthma exacerbations.
- Inflammatory bowel disease: Ulcerative colitis and Crohn’s disease (called regional enteritis on the label), typically during a critical flare.
- Skin diseases: Severe psoriasis, pemphigus, Stevens-Johnson syndrome, and exfoliative dermatitis.
- Eye inflammation: Uveitis, optic neuritis, herpes zoster affecting the eye, and severe allergic conjunctivitis.
- Lung conditions: Sarcoidosis, aspiration pneumonia, and certain occupational lung diseases.
- Blood disorders: Autoimmune hemolytic anemia and immune-related low platelet counts.
- Multiple sclerosis: Acute relapses, where a short course of high-dose steroids helps speed recovery.
- Cancer care: Palliative management of leukemias and lymphomas, often alongside chemotherapy.
- Kidney disease: Nephrotic syndrome, where prednisone reduces the protein leaking into urine.
- Hormonal disorders: Adrenal insufficiency and congenital adrenal hyperplasia, where the body doesn’t produce enough cortisol on its own.
What 20 mg Means in Practice
Prednisone dosing ranges from 5 mg for mild maintenance therapy to 60 mg or more for severe flares. A 20 mg daily dose is a moderate dose, often used as a starting point for conditions like an inflammatory bowel disease flare, a lupus exacerbation, or a stubborn allergic reaction. In some cases it serves as a step-down dose for someone who started higher and is gradually reducing.
Your prescriber determines the dose based on the condition being treated, its severity, and how you respond. The goal is always to use the lowest effective dose for the shortest possible time.
Common Side Effects
Even at moderate doses, prednisone affects more than just the inflamed tissue. The most frequently reported side effects include increased appetite, weight gain, mood changes (irritability, agitation, or feeling “wired”), headache, dizziness, and blurred vision. Swelling in the hands, feet, or lower legs can occur because the drug causes your body to hold onto sodium and water.
Sleep disruption is extremely common. Many people find that taking their dose in the morning, rather than at night, helps reduce insomnia. Mood shifts can range from mild restlessness to significant anxiety or even euphoria, and they tend to be more pronounced at higher doses.
Long-Term Risks
Short courses of a few days to a couple of weeks carry relatively low risk. The concern grows when prednisone is used for months or longer. Among people on long-term oral corticosteroids, 30 to 50% develop osteoporosis or experience fractures. At doses of 7.5 mg per day or higher, the risk of spinal fractures is five times greater than in people not taking the drug, and hip fracture risk more than doubles.
Bone loss begins quickly. In the first year of treatment, the annual incidence of spinal fractures is roughly 5%, with non-spinal fractures around 2.5%. Other long-term risks include elevated blood sugar (which can tip into steroid-induced diabetes), increased blood pressure, thinning skin, cataracts, glaucoma, and a higher susceptibility to infections because the immune system is suppressed.
What Your Doctor Will Monitor
If you’re taking Deltasone for more than a few weeks, expect regular check-ins. Before starting, your doctor should assess your blood pressure, weight, blood sugar, potassium levels, and any pre-existing risk factors like diabetes, heart disease, or a history of mood disorders. If you’re expected to take 5 mg or more daily for over three months, a bone density scan is recommended at baseline.
After the first month, blood sugar and potassium are typically rechecked. Once you’re stable, monitoring continues on a regular schedule: blood sugar every three months if diabetes is a concern, an eye exam every six to twelve months to screen for cataracts and glaucoma, and bone density scans annually or every two to three years depending on your risk. Blood pressure and weight are checked at routine appointments throughout.
Why You Can’t Stop Suddenly
When you take prednisone for three to four weeks or longer, your adrenal glands slow down their own cortisol production because the drug is doing the job for them. If you stop abruptly, your body can’t ramp cortisol back up fast enough, potentially triggering adrenal insufficiency. Symptoms include severe fatigue, muscle weakness, joint pain, dizziness, and in serious cases, a dangerous drop in blood pressure.
Tapering is the standard approach. A general guideline is reducing the dose by 10 to 20% per week. As you get closer to low doses (around 4 to 6 mg per day), the taper slows down because that’s the range where your adrenal glands need to wake back up. Some people require reductions as gradual as 1 mg every four to eight weeks at the tail end. Your doctor will adjust the pace based on how long you were on the drug, what dose you started at, and whether symptoms of the underlying condition return during the taper.
Signs of withdrawal to watch for include sleep problems, mood changes, muscle aches, and fatigue. These overlap with adrenal insufficiency symptoms, so staying in close contact with your prescriber during a taper is important.
Who Should Not Take Deltasone
Deltasone is contraindicated in people with systemic fungal infections, because suppressing the immune system allows fungal organisms to spread unchecked. It’s also not appropriate for anyone with a known allergy to prednisone or any inactive ingredient in the tablet. People with active, untreated infections generally need the infection addressed before starting corticosteroid therapy, since the drug masks symptoms while allowing the infection to worsen.