Prednisone with Alfalfa Interaction Details
Brand Names Associated with Prednisone
- Cortan®
- Deltasone®
- Orasone®
- Prednisone
- Prednisone Intensol
- Rayos®
- Sterapred®
- Sterapred® DS
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 05, 2023
Interaction Effect
Reduced predniSONE effectiveness
Interaction Summary
The beneficial effects of predniSONE may be overcome by alfalfa in SLE patients. Two case reports document activation of quiescent SLE in women who had been previously stabilized on predniSONE. Previously healthy patients have developed positive antinuclear antibody (ANA) titers following alfalfa ingestion . The nonprotein amino acid, L-canavanine, has been identified as the active ingredient in alfalfa responsible for inducing SLE .
Severity
Moderate
Onset
Delayed
Evidence
Established
How To Manage Interaction
Patients with SLE (systemic lupus erythematosus) should be advised to avoid use of alfalfa until the nature of this phenomenon (i.e., SLE activation) is known. Consumption of 8 to 15 tablets of alfalfa (dosage unspecified) daily has been associated with SLE activation overcoming the effect of established predniSONE therapy.
Mechanism Of Interaction
Exacerbation of systemic lupus erythematosus by alfalfa
Literature Reports
A) A 40-year-old Caucasian woman with a 26-year history of SLE had been serologically normal for a minimum of 4 years while maintained on predniSONE 15 mg every other day. She then took 15 alfalfa tablets (dosage unspecified) daily for 9 months. At the time of presentation, antinuclear antibodies, elevated cryoglobulins, hypocomplementemia, and proteinuria had recurred. The patient experienced lethargy, malaise, depression and arthralgias. The effects were attributed to alfalfa due to the temporal relationship and the absence of other precipitating factors. Similarly, a 50-year-old Caucasian woman with a 25-year history of clinically mild SLE associated with membranous glomerulonephritis had been maintained on predniSONE 10 mg daily. The patient began ingesting 2 alfalfa tablets (dosage unspecified) 4 times daily for the previous 2.5 years; after one year, her antinuclear antibodies, cryoglobulins, and progressive hypocomplementemia worsened. A renal biopsy demonstrated a transformation from membranous to diffuse proliferative glomerulonephritis. The strong temporal relationship suggested alfalfa tablets led to the patient's worsened condition .
B) In 4 subjects (2 men and 2 women) who consumed 12 to 24 alfalfa tablets for 12 weeks to 7 months, positive antinuclear antibody (ANA) titers accompanied arthralgias, myalgias, and a mild rash. Upon discontinuing alfalfa tablets, all four became asymptomatic and ANA became negative in two .
C) Five females in three generations of one family who had taken alfalfa tablets and vitamin E supplements for 7 years developed symptoms of autoimmune and immune diseases. One developed elevated ANA and was diagnosed with SLE, her mother and her two nieces possibly had immune arthritis, and her sister developed sarcoidosis. However, the tablets were analyzed and found to contain less than 3 to 5 parts per million L-canavanine .
Prednisone Overview
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Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.