I've been on prednisone for the last month or so. I started at 40mg as well.
1. Make sure you are eating lots of potassium. Potassium deficiency is very common with prednisone and not something you get warned about very much. Potassium deficiency can be very bad for you as it spikes your blood pressure and can do long term damage. Monitor your blood pressure with an automatic machine at home or at the store or even better manually if you know someone who can do it.
Symptoms of potassium deficiency:
http://www.buzzle.com/articles/potassium-deficiency-effects-of-low-potassium.html
List of potassium rich foods:
http://www.weightlossforall.com/potassium-rich-food.htm (You can find other lists if you just do a search)
2. Prednisone tastes BAD, and it dissolves on contact with your saliva. Take it with pudding or yogurt (or mayonnaise if you hate sweet things). The trick is that you need a thick liquid that you can swallow without any sort of chewing. It both helps grab the pill so that it goes down ASAP, and it will coat the pill so that when it dissolves it has a barrier between your mouth and the pill.
3. Your immune system is weak. Especially to cuts and scraps. If a wound may have gotten infected before the prednisone, it WILL get infected now. It's also going to take you longer to get over illnesses. (For example I'm worried this bloody flu I got is going to need antibiotics to avoid pneumonia) Take care of yourself and avoid catching illnesses and infections.
4. Take a multivitamin. I could have included this in a couple of the other points but I want to give it special emphasis. Your absorption of various things is being countered by the prednisone and you'll need things like vitamin C to strengthen your immune system's other abilities to compensate for the lack of inflammation. You will not get a significant amount of potassium from an over-the-counter vitamin. It can't be put in pill form without making the pill taste so bad no one would buy it. You still need to eat potassium rich foods.
5. If you stay on this medication long-term you will get osteoporosis and much earlier than normal. Prednisone will cause your bones to hollow out like a bird's but, very sadly, it won't give you wings and feathers.
6. Ask your doctor about sleeping pill options if you're having trouble sleeping. Twice daily dosing is good for you in reducing side effects and helping to keep your adrenal gland healthy but it can cause some really nasty insomnia. Your doctor will not be surprised and sleeping pills of some sort (maybe even just a melatonin supplement) can help overcome the problem.
7.
DO NOT STOP TAKING THIS DRUG AHEAD OF SCHEDULE AND DO NOT MISS DOSES. Understand? Prednisone is produced naturally by your adrenal gland in much smaller amounts (0.5mg equivalent I think). Your adrenal gland works on a feedback loop with short-circuit protection. If there is more prednisone in your system than normal it will shut down. Adrenal gland no work. But, it requires some prednisone to get started again. So, if you stop taking this medication without following the proper dosing your adrenal gland will not start back up and your heart will run out of adrenaline and slow to a stop. The longer you're on it, higher the dose, and the older you are, the more difficulty your adrenal gland will have getting started again.
8. Prednisone is awesomely effective for most people. Just like any medication, if it has a strong positive effect of your body it's probably going to cause some collateral damage. For short-term use prednisone is a great option. Just try to find something else to take long-term if this doesn't put you into remission for a while.
