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What is prednisone?

Prednisone belongs to a class of drugs called corticoste­roids (often called “steroid” medications). It can be injected or inhaled, or it can be taken as a pill or liquid.

Prednisone is a prescription drug, meaning you can only take it if your doctor prescribes it to you.

In the US, prednisone is available as the brand-name drugs Rayos and Prednisone Intensol.

What is prednisone used to treat?

Prednisone is prescribed to treat many different conditions, including:

  • Asthma

  • Allergies

  • Rashes and other skin conditions 

  • Adrenal gland conditions

  • Certain types of arthritis

  • Auto-immune conditions (such as ulcerative colitis or multiple sclerosis)

Prednisone reduces swelling in the body and helps counter an overactive immune system.

The drug can also help prevent rejection in people who have had an organ transplant. The body recognizes a transplanted organ as a foreign mass and activates the immune system. Prednisone helps suppress the immune system’s response, which prevents rejection and complications.

How to take prednisone

Keep prednisone somewhere cool and dry.

Use the medication exactly as recommended by your doctor, and follow the instructions on the prescription label carefully. Your doctor will keep an eye on your progress and may adjust your dose to ensure you’re getting the best results.

Take prednisone with meals. A delayed-release pill should not be crushed, chewed, or broken — instead, you should consume it fully.

For prednisone in liquid form, use a dose-measuring spoon or medicine cup to measure it out. You can obtain these items from your doctor’s surgery or pharmacy if you don’t have them.

Don’t alter your dose or regimen or stop taking the medication unless instructed by your doctor. Your doctor may change your dose if you have a significant sickness, fever, or infection, or if you undergo surgery or have a medical emergency.

Wear a medical attention alert tag or carry an identification card that states you are taking prednisone. In an emergency, the medical team treating you should be aware that you are using steroid drugs. Keep in mind that certain medical tests may produce unexpected results when you are taking this medicine.

Your doctor may ask you to come in for frequent blood tests or blood pressure checkups while taking prednisone.

Seeing results 

Prednisone works by lowering inflammation and suppressing your immune system’s activity.

Inflammation is a natural defense mechanism caused by the body’s white blood cells. It releases chemicals to fight infection and foreign substances, such as bacteria and viruses. However, several disorders impair the body’s immune system, which may result in inflammation attacking the body’s own tissues.

Inflammation symptoms include:

  • Redness

  • Warmth

  • Swelling

  • Pain

Steroids lower the production of chemicals that lead to inflammation,¹ which helps limit tissue injury. They also decrease immune system activity by changing the way white blood cells function.

You may notice results fairly quickly or over days to weeks depending on your dose and health condition.

Potential side effects of prednisone

Prednisone can cause side effects,² including:

  • Headache

  • Change in mood

  • Slowed healing of cuts and bruises

  • Acne

  • Fatigue

  • Dizziness

  • Change in appetite

  • Weight gain

  • Swelling (in the face, back of neck, arms, hands, lower legs, or feet)

  • Inability to sleep

  • Psychosis or emotional dysregulation

  • Hot flushes or sweating

Long-term use of prednisone

Taking prednisone for a long period of time can cause complications, including:

  • Increased risk of infection

  • Brittle bones³ (osteoporosis)

  • Stomach ulcers and inflammation

  • High blood sugar

  • Muscle loss

  • Glaucoma and cataracts

Missed doses

Take a missed dose of prednisone as soon as possible. If it’s almost time for the next dose, skip the dose you missed and resume your normal schedule. Don’t take two doses at once.

Overdoses

Taking too much prednisone or taking it for a long time⁴ may cause agitation, psychosis, high blood pressure, high blood sugar levels, muscle and bone weakness, nausea, vomiting, increased swelling, weight gain, skin changes, or insomnia.

Get emergency medical help immediately if you think you or someone else has taken too much prednisone.

What to discuss with your doctor before taking prednisone

Steroids can weaken your immune system, so you may be at greater risk of getting an infection or worsening an existing infection while taking prednisone. Let your doctor know if you have recently been ill or had an infection.

Tell your doctor if you have ever had:

  • Heart problems, high blood pressure, or a heart attack

  • Glaucoma or cataracts

  • Herpes infection of the eyes or eye pain

  • Tuberculosis

  • A parasite infection that causes diarrhea (such as threadworms)

  • Any illness that causes diarrhea

  • Underactive thyroid

  • Diabetes

  • Stomach ulcer

  • Diverticulitis

  • Colostomy or ileostomy

  • Osteoporosis or low bone mineral density

  • Low calcium or potassium levels

  • Cirrhosis or another type of liver disease

  • Mental illness or psychosis

  • A muscle disorder (such as myasthenia gravis)

Tell your doctor if you’re pregnant, breastfeeding, or planning to get pregnant while taking prednisone. Your doctor may advise against taking the drug, alter your dose, or prescribe a different medication.

Stopping prednisone

You might experience prednisone withdrawal symptoms if you abruptly stop taking your medication or taper it off too quickly.

Prednisone withdrawal symptoms include:

  • Severe fatigue

  • Weakness

  • Body aches

  • Joint pain

  • Nausea and vomiting

  • Loss of appetite

  • Lightheadedness

  • Fainting 

  • Low blood sugar

Prednisone is similar to cortisol, a hormone produced by the adrenal glands. Prednisone reduces cortisol production,⁵ so gradually reducing your dose gives your adrenal glands a chance to recover from the effects of long-term steroid use.

The length of time it takes to stop taking prednisone depends on the disease being treated, your dose, how long you have been taking prednisone, and other medical factors. It takes anywhere from one to several weeks to make a full recovery.

Contact your doctor right away if you experience any side effects when stopping prednisone.

Prednisone and pregnancy

Prednisone is categorized as pregnancy category C⁶ by the United States Food and Drug Administration (FDA), meaning animal studies have demonstrated harmful effects on a fetus.

It is not known whether prednisone increases the risk of birth defects or preterm delivery in humans, as insufficient research has been carried out. However, your doctor may prescribe prednisone during pregnancy if they believe the benefits outweigh the risks.

Consult your doctor if you wish to breastfeed while taking prednisone.

Interactions with other drugs

Some medications can affect the way prednisone works and increase your risk of side effects.

If you are considering getting a live vaccination (like yellow fever, rotavirus, or the varicella vaccine), tell your doctor you’re taking prednisone as it may not be safe.

Speak to your doctor about any medications you are currently taking to find out whether prednisone is suitable for you. You should also tell them about any supplements or herbal medicines you’re taking, as these could also interact with prednisone.

Allergy information

Prednisone may cause a severe allergic reaction (anaphylaxis), but this is rare.

Clinical trial history

Prednisone has been trialed for the treatment of rheumatoid arthritis and other conditions.

Rheumatoid arthritis

In 12 clinical studies,⁷ 10mg daily doses of prednisone (or less) have been shown to help improve function and/or slow disease progression in people with rheumatoid arthritis.

An early non-double-blind study⁷ in 1983 demonstrated the effectiveness of a 5mg daily dose of prednisone in a non-double-blind experiment.

Two further landmark studies⁸ conducted in the 1990s with 7.5mg per day, and the COBRA study⁹ which trialed a rapidly reduced step-down from 60mg to 5mg per day, created strong support for low-dose glucocorticoids to treat rheumatoid arthritis.

More recently, a 2002 study¹⁰ concluded that 10mg per day of prednisone slowed the progression of rheumatoid arthritis.

Asthma

A controlled trial¹¹ of oral prednisone for treating children with acute asthma in the emergency department found prednisone effectively lowered the need for hospitalization compared to placebo.

Tips and advice for taking prednisone

Your doctor will consider potential advantages and adverse side effects when prescribing prednisone. To maintain your health and give the treatment the best chance of success, follow these tips:

  • Take your medication as your doctor instructed.

  • Never take a larger dose than recommended.

  • Take a missed dose as soon as you can, or skip it and take the next dose as planned.

  • Do not stop taking the medication unless your doctor tells you to. If you stop taking prednisone suddenly, you may experience withdrawal symptoms.

  • Wear a medical attention alert tag or carry an ID card that tells medical professionals you are taking prednisone in the event of an emergency.

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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