Drug Interactions, Kratom Guides

Does Kratom Interact With Prednisone?

Prednisone is the generic name for a corticosteroid used to treat inflammation, joint pain, and a variety of other conditions. Prednisone is generally not recommended if you’re taking kratom because the two compounds are metabolized by the same enzymes.

Combining them could potentially lead to a buildup of prednisone in the bloodstream — leading to a higher risk of side effects.

In this article, you’ll learn about the interactions between prednisone and kratom and why they aren’t typically considered safe to take together.

Last updated 2 months ago by Wade Paul

Does Kratom Interact With Prednisone?

Does Kratom Interact With Prednisone?

Yes, kratom may counteract the immunosuppressive activities of prednisone and reduce its ability to do its job. 

Depending on what this medication was prescribed for, this could lead to severe consequences. 

Additionally, both substances will compete for metabolism in the liver. Metabolic competition means both substances will essentially need to “line up” before they can be metabolized. This can lead to buildups and a longer duration of effects for both substances. 

Since prednisone is generally taken every day for several weeks at a time, the competition with kratom can be severe and worsen throughout the prednisone protocol.

1. Kratom & Prednisone Antagonistic Interaction

An antagonistic interaction refers to drugs or substances that have opposite effects in one or more areas. 

Many of the alkaloids contained in kratom are considered immunomodulators or immunostimulants. This effect directly contradicts the immunosuppressant activities of prednisone and other corticosteroid medications. 

While it’s unclear whether this means kratom and prednisone will counteract each other’s effects, until more research is available, this theoretical effect needs to be considered.

Some of the conditions prednisone is prescribed for are life-threatening. Anything that might negate the effects of prednisone should be avoided — kratom included.  

2. Kratom & Prednisone Metabolic Competition

Most drugs are metabolized by CYP enzymes in the first phase of metabolism, and some move onto a second phase during which additional enzymes serve to break down the foreign substance. Prednisone is metabolized by CYP3A4 in phase I and then UDP-glucuronosyltransferase in phase II [1].

Similarly, UDP-glucuronosyltransferase plays a role in kratom metabolism [2], and CYP3A4 is one of the primary enzymes responsible for breaking down the alkaloids in Mitragyna speciosa [3].

Kratom & Corticosteroid Interactions

Prednisone is classified as a corticosteroid, which means it inhibits the body’s immune response by mimicking a stress hormone called cortisol. Drugs that do this are also referred to as immunosuppressants because they work by inhibiting one or more aspects of the immune system. 

Corticosteroids like prednisone are useful for treating joint pain, asthma, kidney issues, lupus, arthritis, colitis, multiple sclerosis, severe allergic reactions, and more. 

There are many other corticosteroids that have a similar level of risk when taken in conjunction with kratom.

Other related corticosteroids and immunosuppressants kratom will interact with include:

  • Cortisone (Cortone)
  • Prednisolone (Orapred & Prelone)
  • Methylprednisolone (Medrol, Solu-Medrol & Depo-Medrol)
  • Dexamethasone (Dexamethasone Intensol & DexPak)
  • Betamethasone (Celestone)
  • Hydrocortisone (Cortef)
  • Triamcinolone (Aristospan Intralesional, Aristospan Intra-Articular & Kenalog)
  • Fludrocortisone (Florinef)

Is It Safe to Take Kratom With Prednisone?

It’s not considered safe to mix kratom and prednisone because kratom may counteract the effects of prednisone — thus preventing it from doing its job. 

While the chances of severe interaction are low, the reduced effectiveness of prednisone could result in severe consequences — depending on what it was prescribed for. 

What is Prednisone?

Prednisone is one of the most prevalent corticosteroids used to treat inflammation, joint pain, and some immune system malfunctions.

Prednisone Details & Specifications:

Drug NamePrednisone
Trade NameDeltasone
Other Names (other generics)Liquid Pred, Meticorten, Prednicot, Prednisone Intensol, Rayos, Sterapred, Sterapred DS & Orasone
ClassificationCorticosteroid
CYP MetabolismCytochrome P450 and CYP3A4
Interaction With KratomMetabolic Competitor
Risk of InteractionModerate

What Is Prednisone Used For?

Just like most other corticosteroids, prednisone is prescribed most often to treat arthritis, joint pain, asthma, inflammation, colitis, and multiple sclerosis. 

Prednisone is also prescribed to treat severe allergies, lupus, blood problems, bone marrow issues, GI complications, and kidney issues.

Generic & Brand Name Versions of Prednisone

Prednisone is the generic name for this specific corticosteroid. In the United States, trade names or brand names include Liquid Pred, Meticorten, Orasone, Prednicot, Prednisone Intensol, Rayos, Sterapred, and Sterapred DS.

What Are the Side Effects of Prednisone?

Unfortunately, prednisone can come with an extensive array of side effects, ranging from relatively insignificant to reasonably severe. Below are the most common side effects reported from taking prednisone:

  • Acne
  • Blotchiness
  • Changes in vision
  • Confusion
  • Difficulty breaching
  • Exhaustion
  • Eye pain or swelling
  • Headache
  • Heartburn
  • Involuntary shaking
  • Irregular heartbeat
  • Lightheadedness
  • Mood swings
  • Nausea
  • Nerve issues including burning or tingling of the skin
  • Poor sleep quality
  • Rapid weight gain
  • Reduced sleep
  • Seizures
  • Sore muscles
  • Thinning of the blood or reduced ability to clot
  • Vomiting

What is Kratom?

Kratom refers to the leaves of the Mitragyna speciosa tree, which mainly grows in Southeast Asia.

What’s Kratom Used For?

Kratom has a variety of uses, depending on the dose and strain. In small doses, most strains provide stimulating effects, similar to those you’d experience from several cups of coffee. It can improve focus and attention.

In larger doses, most strains have pain-killing capabilities [4] as well as sleep-supportive and anxiolytic effects (fights anxiety). 

What’s The Dose of Kratom?

Most users consume between 2 and 8 grams of kratom at a time. Doses over 8 grams are considered high and should only be used by experienced users. 

The best dose of kratom typically depends on the effects you’re looking to experience. For increased focus, attention, and wakefulness, doses between 2 grams and 4 grams are most common. 

For pain reduction, sedation, and decreased anxiety, most users take between 4 grams and 8 grams.

What are the Side Effects of Kratom?

Kratom can come with a number of side effects, most of which are made more severe or more noticeable with larger doses or if kratom is taken continuously without breaks.

Nausea, dizziness, lightheadedness, and constipation are the most commonly reported side effects of kratom. In most cases, reducing the dose or taking breaks once a week or so will help reduce the chances of these side effects.

For those taking kratom for sedative properties, lethargy and sluggishness are more common side effects.

A less common side effect reported most often from continued or excessive use is confusion, memory impairment, and the perception of slowed mental processes.

What are the Different Types of Kratom?

There are three primary strains of kratom and a fourth, less well-known variety. Each has its own effects and specific uses.

A) White-Vein Kratom

White-vein kratom is usually harvested early before the leaves of the Mitragyna speciosa tree develop the standard green color. White-vein kratom has a distinct set of alkaloids that are more stimulative and promote feelings of increased concentration, focus, and euphoria.

B) Red-Vein Kratom

Red-vein kratom is considered the opposite of white-vein varieties. It’s harvested late in the plant’s maturity after the green color of the leaves has begun to darken and turn red. Red-vein kratom is most famous for its pain-killing capabilities. It also tends to have more sedative properties.

C) Green-Vein Kratom

Green-vein kratom is harvested between when white-vein and red-vein are, so it has an alkaloid profile that sits somewhere in the middle. Some strains are more stimulative, while others are a bit more sedative. Green-strains tend to be good introductory options for beginners, given the more moderate effects.

D) Yellow-Vein Kratom

Yellow-vein kratom is not a primary kratom variety, and far less is known about yellow strains. There are several theories as to why the yellow color persists in some strains, including a fermenting process, a drying process, or the mixture of white and red strains.

While little is understood about why these strains are yellow, the effects are relatively well-known. They tend to produce a sense of euphoria and can have properties of both red and white strains, including pain reduction, sedation, relaxation, and boosted concentration.

Key Takeaways: Is it Safe to Mix Kratom & Prednisone?

It’s unwise to take kratom if you’ve been given a prescription for prednisone unless you’ve spoken with your doctor about it first. 

There’s a chance that kratom will counteract some of the effects of prednisone and make it less effective. 

Additionally, repeated kratom use alongside prednisone could interfere with metabolism and cause both substances to build up in the bloodstream — eventually leading to toxic levels. 

References

  1. Song, I. H., Borland, J., Chen, S., Savina, P., Peppercorn, A. F., & Piscitelli, S. (2013). Effect of prednisone on the pharmacokinetics of the integrase inhibitor dolutegravir. Antimicrobial agents and chemotherapy, 57(9), 4394-4397.
  2. Haron, M., & Ismail, S. (2015). Effects of mitragynine and 7-hydroxymitragynine (the alkaloids of Mitragyna speciosa Korth) on 4-methylumbelliferone glucuronidation in rat and human liver microsomes and recombinant human uridine 5′-diphospho-glucuronosyltransferase isoforms. Pharmacognosy Research, 7(4), 341.
  3. Kamble, S. H., Sharma, A., King, T. I., León, F., McCurdy, C. R., & Avery, B. A. (2019). Metabolite profiling and identification of enzymes responsible for the metabolism of mitragynine, the major alkaloid of Mitragyna speciosa (kratom). Xenobiotica, 49(11), 1279-1288.
  4. Eastlack, S. C., Cornett, E. M., & Kaye, A. D. (2020). Kratom—Pharmacology, clinical implications, and outlook: a comprehensive review. Pain and Therapy, 9(1), 55-69.

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