Any fever other other sign of infection must be taken seriously and evaluated. Methods of minimizing or preventing side effects Careful evaluation of the patient before and during treatment is important. Patients should be seen at least monthly while on high doses of prednisone, depending on the underlying disease process. A diet low in calories, fat and sodium and high in potassium and calcium is best. Alcohol, coffee and nicotine aggravate osteoporosis, peptic ulcers and should be minimized.
Exercise is beneficial.
Calcium and vitamin D can decrease, but not prevent glucocorticoid-induced osteoporosis. Estrogen treatment can be helpful in postmenopausal women on prednisone in preventing bone loss. Newer medication such as bisphosphonate and calcitonin can prevent bone loss or increase bone density in patients on steroids. Patients with a family history of heart disease should be followed carefully. All patients should have monthly evaluation of blood pressure and serum glucose and periodic analysis of serum lipids.