How Prednisone Works

Prednisone is a synthetic corticosteroid that is similar to cortisone, a natural corticosteroid hormone produced in the body’s adrenal glands. Prednisone suppresses the body’s immune system, and prevents the release of substances in the body that can cause inflammation (heat, redness, swelling, and pain).

Although corticosteroids like Prednisone are often called “steroids”, they are very different from the types of male-hormone-related steroids that some athletes might abuse for strength or performance gains in sports.

Despite Prednisone’s potential for side effects, the combined immunosuppressive and anti-inflammatory effects of the medication, as well as its relatively fast action compared to many other treatments, can make it a very useful tool to treat many forms of arthritis.

Side Effects of Prednisone

Not all people who take prednisone have side-effects. The side-effects are largely related to the dose and the length of time that the medication is taken. Higher doses taken for longer periods of time (over 3 months) would be more likely to cause side-effects than short courses of lower dose prednisone.

People taking prednisone should talk to their doctor if they are concerned about any side effects.

Short-term side effects – as the dose of prednisone is decreased and stopped the following side-effects will disappear:

  • Mood changes – Some patients feel full of energy (euphoric) which may result in difficulty sleeping, while others patients may feel depressed or irritable, or rarely, have hallucinations.
  • Increase in appetite – the medication can increase appetite and this can result in weight gain
  • Face and back swelling – prednisone can cause swelling of the face or the upper part of the back.
  • Stomach irritation – prednisone can sometimes upset the stomach with nausea or indigestion.
  • Blurry vision – prednisone can sometimes cause blurry vision.
  • Risk of infection – prednisone can decrease a person’s resistance to infection. Any infections or fevers should be taken seriously and reviewed by a doctor.
  • In women, Prednisone may cause alterations in the menstrual cycle.
  • Blood sugars – prednisone may cause a rise in blood sugars, sometimes resulting in diabetes.
  • Rise in blood pressure and fluid retention – prednisone may cause a rise in blood pressure or fluid retention (ankle swelling).

Long-term side-effects – the following side-effects might occur in patients who have taken prednisone for long periods of time. In many patients, these side-effects can be reduced with appropriate monitoring and prevention.

  • Skin changes – prednisone can affect the skin, such as: an increase in acne, hair growth, easy bruising, or wounds that take longer to heal.
  • Eye problems – with prolonged use of prednisone, cataracts or glaucoma may develop.
  • Bone loss – prednisone can cause loss of calcium from the bones in some people, resulting in fragile bones (osteoporosis).
  • Bone damage – a rare side-effect is damage to the bones called osteonecrosis. This can occur in any bone but the most common site is the hip, resulting in groin pain.
  • Muscle weakness – rarely muscles around the hips and shoulders become weak, causing difficulty climbing stairs or getting up from a chair.

How to minimize the side-effects of prednisone

  • Patients should take prednisone as prescribed and attend regular follow-up visits with their doctor.
  • People taking prednisone for a prolonged period (more than 3 months) can obtain a MEDIC-ALERT BRACELET.
  • Taking prednisone with food can help to reduce problems with nausea.
  • Following a diet can help maintain body weight.
  • Patients should remember to take any medications that they may be prescribed that reduce the risk of osteoporosis. Patients should ensure that they are taking appropriate amounts of calcium and vitamin D and discuss these supplements with their doctor.
  • If planning a trip or vacation, people taking prednisone should ensure they have an extra backup supply. Any medication should always taken on-board any flights or ships as carry-on and not stored with checked luggage.

Who Should NOT Take Prednisone

People who should NOT take prednisone include:

  • Patients who have had a previous serious allergic reaction to the medication

People who become pregnant or are planning to become pregnant should discuss their medications with their doctor. Prednisone is believed to be one of the safer medications and has been used safely and successfully to treat arthritis during pregnancy.

When to Call a Doctor

Patients taking prednisone should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.

Other reasons to call a doctor while taking prednisone include:

  • New severe groin pain
  • Fever or possible infection
  • Blurry vision
  • Pregnant or Planning Pregnancy
  • Planning surgery

Prednisone Video

Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Prednisone.