Prednisone is a corticosteroid, which prevents the release of substances in the body that lead to inflammation. It can also suppress the immune system. Prednisone can be used as an immunosuppressant or an anti-inflammatory drug. A number of conditions can be treated with prednisone. They include ulcerative colitis, allergic diseases, lupus, psoriasis, arthritis, and breathing disorders, among others. Prednisone mimics the action of cortisol and is used for its potent anti-inflammatory effects.
Prednisone is inactive in the body, so it is first converted in the liver to make it effective. For this reason, prednisone may not effectively work in people who have liver disease due to impaired liver function to convert prednisone to prednisolone.
Prednisone was approved by the FDA in the year 1955. The side effects of prednisone are similar to other corticosteroids, and can also range from mild to serious ones. The chronic and prolonged treatment of prednisone in high doses can cause irreversible organ damage.
Prednisone is available in the form of tablets, oral solution or syrup, and extended-release tablets. The following conditions can be treated using prednisone:
- Neurological Inflammation - Prednisone reduces inflammation in the brain and nervous tissue. Brain swelling caused by altitude sickness can also be reduced by prednisone. It can also prevent brain swelling caused by brain trauma. When prednisone is used to calm down acute inflammation of the blood vessels in the head, it can also prevent blindness.
- Asthma - Prednisone can improve breathing in the case of acute asthma flare-ups, wherein other inhaled steroids or bronchodilators cannot control the condition. Airway inflammation can also be reduced by prednisone, and in an emergency, it can be very helpful. However, for standard asthma treatment, prednisone is not considered appropriate.
- Autoimmune Diseases - Pain and inflammation can be caused by autoimmune diseases, such as lupus, inflammatory bowel disease, rheumatoid arthritis, and polymyalgia rheumatica (PMR). The hyperactive immune response is calmed by corticosteroids along with inflammation. They are not a solution, but they can help in managing flare-ups.
- Addison’s Disease - In this condition, the adrenal cortex fails to produce the hormones called cortisol and aldosterone. The cause of this condition is a frequent autoimmune attack. This condition can also be triggered by an infection. One of the prednisone side effects is secondary adrenal insufficiency, which occurs when prednisone is used for a long period of time to treat another condition. To replace the missing cortisol, doctors prescribe prednisone, and to replace aldosterone, doctors prescribe fludrocortisone.
- Cancer - Prednisone and other corticosteroids can be useful when it comes to treating cancer, such as multiple myeloma, leukemia, and lymphoma. These drugs can help reduce inflammation caused by cancer as well as lessen the likelihood of chemotherapy side effects. One common side effect of chemotherapy is severe nausea.
The Side Effects of Prednisone
Common Side Effects
Prednisone causes a number of side effects. The most common are:
- Increased white blood cell (WBC) count
- Increased appetite and weight gain
- Increased growth of facial hair
- Increased blood sugar level
- Changes in the level of electrolytes
- Increased risk of infections, such as herpes zoster (shingles) and fungal infections
- Slow wound healing
- Increased blood pressure
- Swelling of the legs, ankle, and feet
- Mood changes (depression)
- Muscle weakness
- Vision problems
- Mental confusion
- Nervousness, irritability, and restlessness
- Sleep problems
- Aggression and agitation
- Decreased urine output
- Noisy or rattly breathing
- Pounding in the ears
- Breathlessness or shortness of breath
- Trouble thinking, walking, or speaking
- Trouble breathing at rest
Less Common Side Effects
- Bloody, black, or tarry stools
- Skin reactions (facial redness, rash, acne, shiny skin, or reddish-purple lines on the skin)
- Burning abdominal pain
- Leg cramps
- Vomiting or mild nausea
Adverse Side Effects
- General - The most common side effects are the alteration of glucose metabolism, fluid retention, mood changes, behavioral changes, increased appetite, weight gain, and high blood pressure. The drug also has long-term side effects, which include cataracts, Cushingoid appearance, osteoporosis, increased intraocular pressure or glaucoma, vertebral compression fractures, and HPA suppression.
- Allergic Reactions - Anaphylactic reactions are rare but may happen in some patients. The signs of allergic reactions are swelling of the face, tongue, and throat, skin rash, difficulty breathing, fever, chills, itching, dizziness, and palpitations. Do not take another dose of this drug if you experience these symptoms. Seek immediate medical attention instead.
- Metabolic - Decreased tolerance for carbohydrates and glucose, protein catabolism causes negative nitrogen balance, abnormal lipid metabolism, hypokalemia, metabolic alkalosis, sodium retention, loss of potassium, anorexia, weight loss, hypertriglyceridemia, and hypercholesterolemia. (Frequency not reported)
- Cardiovascular - Cardiac arrest, cardiac enlargement, congestive heart failure, circulatory collapse, bradycardia, ECG changes in hypokalemia, fat embolism, edema, hypertension, hypotension, myocardial rupture after myocardial infarction, syncope, thromboembolism, tachycardia, vasculitis, thrombophlebitis, and necrotizing angiitis. (Frequency not reported)
- Endocrine - Arthralgias, amenorrhea, menstrual irregularities, hypothyroidism, hyperthyroidism, pituitary unresponsiveness, moon face, buffalo hump, postmenopausal bleeding, and motility (increased or decreased) and sperm count. (Frequency not reported)
- Ocular - Cataracts, blurred vision, secondary bacterial, viral, or fungal infection, central serous chorioretinopathy (CSCR), glaucoma, increased intraocular pressure, and exophthalmos. (Frequency not reported)
- Gastrointestinal - Abdominal pain, abdominal distention, diarrhea, constipation, gastric irritation, pancreatitis, perforated small and large intestines, vomiting, ulcerative esophagitis, hemorrhage, nausea, oropharyngeal irritation, and candidiasis. (Frequency not reported)
- Immunologic - Masking of infection, decreased resistance to infection, and immunosuppression. (Frequency not reported)
- Musculoskeletal - Aseptic necrosis of femoral and humeral head, the risk of fracture increases, arthralgia, loss of muscle mass, myalgia, osteopenia, osteoporosis, myasthenia, steroid myopathy, tendon rupture, growth suppression in children, and vertebral compression fractures. (Frequency not reported)
- Hypersensitivity - Allergic reactions, angioedema, and anaphylaxis. (Frequency not reported)
- Nervous System - Dementia, convulsions, dizziness, benign intracranial hypertension, impaired cognition, increased motor activity, weakness, neuritis, meningitis, paraplegia, ischemic neuropathy, and sensory disturbances. (Frequency not reported)
- Psychiatric - Hallucination, emotional instability, anxiety, amnesia, depression, long-term memory loss, insomnia, psychiatric symptoms, mania, personality changes, paresthesia, mood swings, restlessness, verbal memory loss, schizophrenia, and the worsening of pre-existing psychiatric conditions. (Frequency not reported)
- Hematologic - Febrile neutropenia, neutropenia, anemia, leukocytosis, lymphopenia, eosinopenia, and polycythemia. (Frequency not reported)
- Dermatologic - Allergic dermatitis, acneiform eruptions, acne, angioneurotic edema, thinning of the skin, dry scaly skin, angioedema, petechiae, hirsutism, erythema, increased sweating, perineal irritation, rash, subcutaneous fat atrophy, thin fragile skin, urticaria, and hypertrichosis. (Frequency not reported)
- Hepatic - Hepatomegaly and elevated alkaline phosphatase (reversible). (Frequency not reported)
- Oncologic - Kaposi’s sarcoma (Frequency not reported)
- Others - Abnormal fat deposits, malaise, vertigo, and pyrexia. (Frequency not reported)
Some side effects of prednisone do not need medical attention. During treatment, these side effects may go away while the body is able to adjust to the medicine. The doctor may also guide you on how to reduce or prevent the side effects. If any of these side effects continue or bother you, then immediately contact your doctor.
Not all mentioned side effects will affect those who take prednisone, and if it does, then maybe one or two side effects may be experienced. The dosage level in which these side effects happen cannot be determined. However, if a person is taking 10 mg of prednisone for a year or more, then doctors usually start looking for these side effects.