Prednisone

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 29, 2022

Warnings

What are the risks of taking prednisone?

Prednisone can cause serious health problems, especially in certain high-risk patients. Please talk to your doctor or pharmacist about other treatment options if these complications are a concern for you.

Heart and Kidney Function: Prednisone can affect the heart and kidneys. The risk is higher in people who have recently had a heart attack or have a history of high blood pressure, heart failure, or kidney problems. If this is the case, discuss the risks and benefits of taking prednisone with your healthcare provider before taking this medicine.
Increased Risk of Fractures: Taking prednisone at high doses or for a long time can weaken your bones and increase your risk of fractures. The risk is higher in very young and very old people, women after menopause, and people who smoke or drink alcohol. Prednisone can also lead to slowed growth in infants and children.
Risks During Pregnancy: Prednisone can be harmful to the unborn baby. The risk is greater if prednisone is used during the first trimester of pregnancy. If you are pregnant, plan to become pregnant, or are breastfeeding, talk to your healthcare provider about whether prednisone is right for you.
Adrenal Suppression: The adrenal glands make certain hormones in the body. Long-term prednisone use can reduce the function of the adrenal glands, causing them to stop making natural hormones. If this happens, lowering the dose of prednisone or stopping the medication suddenly can be dangerous because the body depends on external prednisone to function normally. Never make changes in your prednisone dose without talking to your doctor or pharmacist first. Prednisone withdrawal symptoms can include fever, lethargy, joint pain, and muscle pain. The risk of adrenal suppression is higher in people who take high doses of prednisone for a long time. Stress from infection or injury can also increase the risk. Young children are at risk.
Increased Risk of Infections: Long-term prednisone use can mask certain infections and increase your risk of acquiring an infection. This is because prednisone affects how the immune system works. While on prednisone, be careful to avoid contact with people who have measles or chickenpox. If you have had TB (tuberculosis) before, your doctor will monitor you during prednisone treatment and may prescribe medicine to prevent or treat TB. Talk to your doctor about the safety of getting vaccines while taking prednisone. The risk of infection is higher in people taking prednisone and other drugs that weaken the immune system. Individuals who are not vaccinated against viral illnesses are also at increased risk of infections.
Eye Problems: Taking prednisone for a long time can increase the risk of developing eye problems such as cataracts, glaucoma, and certain eye infections. Tell your doctor if you experience eye symptoms such as pain, redness, blurred vision, or vision changes. Your doctor may advise regular eye exams if you are on long-term prednisone treatment.
Stomach Problems: Prednisone can damage the lining of the stomach. Drinking alcohol while on this medication can worsen stomach irritation. The risk is higher in people with a history of stomach bleeding, stomach ulcers, and ulcerative colitis. Risk factors also include taking medications that can damage the stomach, such as NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen and naproxen. Tell your doctor if you develop symptoms like stomach pain or dark or bloody stools. Your doctor may prescribe a medication to protect your stomach if you are on prednisone for a long time.
Psychiatric Changes: Corticosteroid medications like prednisone can cause changes in mood and behavior. The risk is higher in people with a history of psychiatric problems. Tell your doctor if you experience mood changes, depression, anxiety, trouble sleeping, or hallucinations while on prednisone. Do not lower your dose or stop taking prednisone without first talking to your doctor or pharmacist.

What should I tell my doctor before starting prednisone?

Please tell your doctor if you are allergic to prednisone or any ingredients in prednisone formulations. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, vitamins, and herbal products, especially St John’s Wort. This can help avoid serious drug interactions.

Tell your doctor about all your medical conditions. Prednisone may not be suitable for people with certain health conditions such as high blood pressure, diabetes, osteoporosis, mental illness, myasthenia gravis, seizures, tuberculosis, stomach ulcers, liver disease, kidney disease, or thyroid disease.

Prednisone can affect the development of the unborn baby. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What precautions should I take while on prednisone?

Please keep all your healthcare appointments while on prednisone treatment. Your doctor may adjust your prednisone dose during treatment to ensure you take the lowest dose that works for your condition. Doctors also need to adjust the prednisone dose in patients experiencing stress due to illness, infection, surgery, etc. Keep your doctor informed if you have worsening symptoms during treatment.

When prednisone is used to treat a chronic (long-lasting) disease, it may help to control your symptoms without curing the condition. You should continue taking prednisone as advised by your doctor, even if you feel well. Do not stop prednisone without talking to your doctor first. Suddenly stopping prednisone can lead to withdrawal symptoms because your body may not have enough natural steroids. Call your doctor immediately if you have symptoms like weakness, extreme fatigue, weight loss, upset stomach, slow movements, skin color changes, mouth sores, or salt cravings, especially after decreasing the dose of prednisone or stopping the medication.

Tell your healthcare providers that you are on prednisone before undergoing surgery, dental treatment, or emergency medical treatment.

Do not get vaccinations without talking to your doctor first.

Prednisone can increase your risk of getting an infection. Wash your hands often and stay away from people who are sick. Avoid people with chickenpox or measles. Call your doctor immediately if you have been exposed to someone with chickenpox or measles while taking prednisone.

Tell your doctor if you become pregnant while taking prednisone.

What are prednisone interactions?

Taking prednisone with certain medications can affect how the medicines work or increase the risk of severe side effects. Your physician may choose a different medication, change the dose or frequency of one or both medicines, and/or monitor you carefully for side effects if there are known drug interactions. There can be interactions between prednisone and medicines such as:

Anticoagulants or blood thinners like warfarin (Coumadin)
Heart medications like amiodarone (Pacerone)
Certain antifungals
Aspirin
Aprepitant (Emend)
Carbamazepine (Tegretol, Carbatrol, Epitol)
Cimetidine (Tagamet)
Cyclosporine (Neoral, Sandimmune)
Clarithromycin (Biaxin, in Prevpac)
Diuretics or water pills
Diltiazem (Cardizem, Dilacor, Tiazac)
Delavirdine (Rescriptor)
Dexamethasone (Decadron, Dexpak)
Efavirenz (Sustiva)
Fluvoxamine (Luvox)
Fluoxetine (Prozac, Sarafem)
Griseofulvin (Fulvicin, Grifulvin, Gris-PEG)
Certain HIV medications
Hormonal contraceptives (birth control pills, rings, patches, injections, implants)
Lovastatin (Altocor, Mevacor)
Medications used to treat diabetes
Nevirapine (Viramune)
Nefazodone
Phenobarbital
Phenytoin (Dilantin, Phenytek)
Rifampin (Rifadin, Rimactane, in Rifamate)
Rifabutin (Mycobutin)
Sertraline (Zoloft)
Troleandomycin (TAO)
Verapamil (Calan, Covera, Isoptin, Verelan)
Zafirlukast (Accolate)

This list does not describe all possible prednisone interactions. Give your healthcare provider a complete list of your medications, including prescription and non-prescription medications, dietary supplements, vitamins, and herbal remedies. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prednisone.

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