Prednisone and Asthma

Steroids (anti-inflammatory medications) such as prednisone can be used for asthma as well as other lung diseases. Prednisone and other steroids (inhaled, oral, injection) help calm airway inflammation in asthma.

 If you've ever had a serious asthma attack, you may have had high doses of steroids in the hospital administered intravenously.  When prednisone or other steroid medication is used in a severe asthma attack, no doubt the benefits of steroids far outweigh the risks.

What is prednisone?

Prednisone is an oral steroid medication. If you have serious worsening of asthma symptoms (asthma attack), your doctor may prescribe a brief course of oral steroids such as prednisone. Oral steroids may also be prescribed when your asthma symptoms worsen but you do not require hospitalization.

How does prednisone work to treat asthma?

Oral prednisone is a systemic steroid. That means that after taking prednisone by mouth (orally), it goes directly into the bloodstream, unlike inhaled steroids (anti-inflammatory asthma inhalers) that go straight to the lungs. 

Prednisone and other systemic steroids may be used to treat asthma attacks and help people gain better asthma control. Steroids are used with other asthma medications to either control sudden and severe asthma attacks or to treat long-term, hard-to-control asthma.

How long does it take for prednisone to treat asthma?

Sometimes systemic steroids like prednisone are taken in high doses for a few days. This is called a steroid burst. They may also be given in a low dose daily or every other day for long-term control.

Is prednisone the only systemic steroid for asthma?

Systemic steroids used in the treatment of asthma include:

• Medrol, Methylpred, Solu-Medrol (methylprednisolone)
• Deltasone (prednisone)
• Prelone, Pediapred, Orapred, (prednisolone)
• Decadron (dexamethasone)

Are prednisone and other oral steroids safe for asthma?

While a two-week course or “short burst” of oral steroids like prednisone is relatively safe, it’s important to avoid steroids on a long-term basis as there are serious side effects. Taking supplemental calcium at this time may help you to prevent osteoporosis or thinning of the bones, which is one serious side effect of long-term steroid use.

What if I need to take prednisone frequently for asthma?

If you need steroids frequently for “rescue” therapy, this can suggest poor control of airway inflammation or continued exposure to some unsuspected allergen. In this case, talk to your doctor about inhaled anti-inflammatory medications.

What are the side effects of prednisone and other steroids?

Steroids have many potential side effects, especially when given orally and for a long period of time. Side effects with short-term use include:

• Weight gain
• Fluid retention
• High blood pressure
• Elevated blood sugar

Side effects with long-term use include:

• Growth suppression
• Diabetes
• Cataracts of the eyes
• Bone-thinning osteoporosis
• Muscle weakness

When are inhaled steroids used for asthma?

In asthma, the anti-inflammatory asthma inhalers have proven to become the first line of treatment for asthma and may play a role in other lung diseases. In fact, recent studies support the use of anti-inflammatory asthma inhalers early in the course of disease. After introduction of inhaled steroids, the need for oral steroids such as prednisone may decrease.

Unlike the serious side effects of oral steroids, the most common side effects of anti-inflammatory asthma inhalers are hoarseness and thrush, especially in elderly adults. As with all asthma inhalers, you should rinse the mouth carefully. Gargle with water after inhalation to help reduce the risk of oral thrush. 

For more detail, see WebMD’s Asthma, Steroids & Other Anti-Inflammatory Drugs.