What Is Prednisone?
Prednisone is a medication in a class of drugs called corticosteroids. You might hear your doctor call them glucocorticoids. Corticosteroids are manmade drugs that mimic a hormone your body makes naturally called cortisol.
Even though corticosteroids are sometimes called “steroids” for short, they’re different from anabolic steroids, the drugs athletes use to build bigger muscles.
Prednisone, which comes as a tablet or a liquid, treats many conditions, from allergies and asthma to inflammatory types of arthritis, like rheumatoid arthritis, and related diseases like gout, lupus, and vasculitis. It’s even used to treat cancer and multiple sclerosis symptoms.
What Does Prednisone Do?
Prednisone, like other corticosteroids, quickly lowers inflammation, which cuts down on pain, redness, and swelling. It also dials down your immune system. Under normal conditions, this system protects you against things like viruses and bacteria that cause infections and diseases.
Sometimes your immune system overreacts and attacks your body's tissues. Prednisone stops that attack. There’s also proof that low-dose prednisone may slow joint damage in people with rheumatoid arthritis, but not as much as other arthritis medications do. It can also cause unpleasant long-term side effects.
How Much Prednisone Will I Take?
The amount of prednisone your doctor prescribes will depend on your specific condition and the stage of your disease. You might get a high dose (in the range of 80 milligrams/day) for a short time if you’re having a flare-up. Or your doctor may put you on a lower dose for what they call bridge therapy while you’re waiting for another medication to take effect. Many people take a low maintenance dose (5-10 milligrams/day) for a long time to keep inflammation levels in check.
What Are the Side Effects of Prednisone?
Steroids come with a long list of side effects. They’re more common with oral medications like prednisone because it affects your entire body. You’re also more likely to get them if you’re taking a high dose over a long time. Some side effects are more serious and longer-lasting than others.
Common side effects of prednisone include:
- Bone thinning (osteoporosis)
- Eye problems like glaucoma and cataracts
- High blood pressure
- Worsening diabetes
- Higher risk of infection
- Increased appetite and weight gain
- Mood swings
- Nervousness, restlessness
- Skin problems like easy bruising and slower wound healing
- Sleep problems
- Stomach upset (especially if you take it with ibuprofen or naproxen)
- Swollen, puffy face
- Water retention, swelling in lower legs
How Do You Take Prednisone?
Take prednisone with food so it doesn’t upset your stomach. Don’t break, crush, or chew delayed-release tablets. Measure liquid prednisone carefully.
How Long Does It Take Prednisone to Work?
The medication usually works within 1 to 2 hours. Delayed-release tablets start working in about 6 hours. Once you stop taking it, the medication doesn’t stay in your system long.
How Do You Taper off Prednisone?
No matter the dose, if you’ve been taking prednisone for more than 2 weeks, you shouldn’t stop suddenly. Your doctor will help you decrease your dose (they’ll call it tapering off) slowly so your body has time to increase its own cortisol production. Follow your doctor’s instructions about tapering carefully. If you quit all of a sudden, you could have symptoms like:
- Fatigue
- Nausea
- Joint pain
- Lack of appetite
- Weakness
- Lightheadedness
- Body aches
Who Shouldn’t Take Prednisone?
Prednisone may not be good choice for people with certain health conditions. Tell your doctor if you have:
- Heart disease or if you’ve had a heart attack
- Liver disease
- Kidney disease
- High blood pressure
- Diabetes
- GI issues like peptic ulcer, diverticulitis, or ulcerative colitis
- Osteoporosis
- Eye diseases like glaucoma, cataracts, or ocular herpes simplex