Skip to Content

Flo-Pred Side Effects

Generic Name: prednisolone

Note: This page contains information about the side effects of prednisolone. Some of the dosage forms included on this document may not apply to the brand name Flo-Pred.

For the Consumer

Applies to prednisolone: oral liquid, oral solution, oral suspension, oral syrup, oral tablet, oral tablet disintegrating

In addition to its needed effects, some unwanted effects may be caused by prednisolone (the active ingredient contained in Flo-Pred). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking prednisolone:

More common:
  • Aggression
  • agitation
  • anxiety
  • blurred vision
  • decrease in the amount of urine
  • dizziness
  • fast, slow, pounding, or irregular heartbeat or pulse
  • headache
  • irritability
  • mental depression
  • mood changes
  • nervousness
  • noisy, rattling breathing
  • numbness or tingling in the arms or legs
  • pounding in the ears
  • shortness of breath
  • swelling of the fingers, hands, feet, or lower legs
  • trouble thinking, speaking, or walking
  • troubled breathing at rest
  • weight gain
Incidence not known:
  • Abdominal cramping and/or burning (severe)
  • abdominal pain
  • backache
  • bloody, black, or tarry stools
  • cough or hoarseness
  • darkening of skin
  • decrease in height
  • decreased vision
  • diarrhea
  • dry mouth
  • eye pain
  • eye tearing
  • facial hair growth in females
  • fainting
  • fatigue
  • fever or chills
  • flushed, dry skin
  • fractures
  • fruit-like breath odor
  • full or round face, neck, or trunk
  • heartburn and/or indigestion (severe and continuous)
  • increased hunger
  • increased thirst
  • increased urination
  • loss of appetite
  • loss of sexual desire or ability
  • lower back or side pain
  • menstrual irregularities
  • muscle pain or tenderness
  • muscle wasting or weakness
  • nausea
  • pain in back, ribs, arms, or legs
  • painful or difficult urination
  • skin rash
  • sleeplessness
  • sweating
  • trouble healing
  • trouble sleeping
  • unexplained weight loss
  • unusual tiredness or weakness
  • vision changes
  • vomiting
  • vomiting of material that looks like coffee grounds

Minor Side Effects

Some of the side effects that can occur with prednisolone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Increased appetite
Incidence not known:
  • Abnormal fat deposits on the face, neck, and trunk
  • acne
  • dry scalp
  • lightening of normal skin color
  • red face
  • reddish purple lines on the arms, face, legs, trunk, or groin
  • swelling of the stomach area
  • thinning of the scalp hair

For Healthcare Professionals

Applies to prednisolone: compounding powder, injectable solution, injectable suspension, oral liquid, oral suspension, oral syrup, oral tablet, oral tablet disintegrating


Patients treated with an average of 10 mg per day over several months have developed 50% fewer infections compared to those treated with an average of 20 mg per day. Significantly fewer episodes of aseptic necrosis and a trend toward fewer complications in general have been reported with lower dosages.[Ref]

Side effects have occurred less frequently when minimum dosages were employed. Dosages greater than 10 mg per day have been associated with an increased incidence of adverse events.

The side effects of prednisolone may be subdivided into those associated with short-term therapy (to three weeks) and those of long-term therapy (> three weeks).

Short-term effects have included sodium retention-related weight gain and fluid accumulation, hyperglycemia and glucose intolerance, hypokalemia, gastrointestinal upset and ulceration, reversible depression of the hypothalamic-pituitary-adrenal (HPA) axis, and mood changes ranging from mild euphoria and insomnia to nervousness, restlessness, mania, catatonia, depression, delusions, hallucinations, and violent behavior.

Long-term effects have included HPA suppression, Cushingoid appearance, hirsutism or virilism, impotence, and menstrual irregularities, peptic ulcer disease, cataracts and increased intraocular pressure/glaucoma, myopathy, osteoporosis, and vertebral compression fractures.[Ref]


Metabolic side effects of prednisolone (the active ingredient contained in Flo-Pred) have included hypernatremia, hypokalemia, fluid retention, negative nitrogen balance and increased blood urea nitrogen concentration. Glucocorticoids have been reported to decrease the secretion of thyrotropin (TSH).[Ref]


Cardiovascular side effects have included hypertension and congestive heart failure due to long-term fluid retention and direct vascular effects.[Ref]

Up to 12% of patients may develop systolic hypertension. Hypertension has been associated with long-term therapy with corticosteroids and is thought to be due to fluid retention. One author has associated these changes in blood pressure with advancing age.[Ref]


Endocrine side effects have included glucose intolerance and hyperglycemia. Diabetes-like symptoms may develop in some individuals. Hypothalamic-pituitary-adrenal suppression may be prolonged to 12 months following long-term therapy with prednisolone (the active ingredient contained in Flo-Pred) Cushingoid appearance has commonly occurred with chronic therapy. In addition, hirsutism or virilism, impotence, and menstrual irregularities may occur with chronic therapy.[Ref]

Corticosteroid therapy may induce glucose intolerance by reducing the utilization of glucose in tissues and increasing hepatic glucose output. Patients on alternate day therapy may exhibit significantly higher serum glucose on the day prednisolone is taken. Diabetes mellitus requiring therapy with diet modifications and hypoglycemic agents has developed in some patients.

Adrenal suppression can persist up to twelve months after long-term corticosteroid therapy. Adrenal suppression may be reduced by giving corticosteroids once a day or once every other day. After corticosteroid therapy has been tapered, supplemental corticosteroid therapy during times of stress (illness, surgery, trauma) may be required.[Ref]


Gastrointestinal side effects have included gastrointestinal upset, nausea, vomiting, and peptic ulcer disease. Pancreatitis as well as gastrointestinal perforation and hemorrhage have also been reported.[Ref]

Gastrointestinal effects most commonly have included nausea, vomiting, dyspepsia, and anorexia. Peptic ulcer disease has been associated with long-term corticosteroid therapy, but is relatively uncommon. Routine prophylactic therapy is not warranted in all individuals. Aluminum/magnesium containing antacids may be used to manage GI complaints without significant drug interactions.[Ref]


Immunologic side effects have included impairment of cell-mediated immunity which increases patient susceptibility to bacterial, viral, fungal and parasitic infections. In addition, the immune response to skin tests may be suppressed.[Ref]


Corticosteroid myopathy presents as weakness and wasting of the proximal limb and girdle muscles and is generally reversible following cessation of therapy.

Corticosteroids inhibit intestinal calcium absorption and increase urinary calcium excretion leading to bone resorption and bone loss. Bone loss of 3% over one year has been demonstrated with prednisolone (the active ingredient contained in Flo-Pred) 10 mg per day. Postmenopausal females are particularly at risk for loss of bone density. Sixteen percent of elderly patients treated with corticosteroids for 5 years may experience vertebral compression fractures. One author reported measurable bone loss over two years in women on concomitant therapy with prednisolone 7.5 mg per day and tamoxifen.[Ref]

Musculoskeletal side effects have included myopathy, osteoporosis, vertebral compression fractures, and aseptic necrosis of bone. Aseptic necrosis has been reported to most often affect the femoral head.[Ref]


In renal transplant patients maintained on prednisolone (the active ingredient contained in Flo-Pred) 10 mg per day, 33% developed posterior subcapsular cataracts. Mean time to cataract development is 26 months. Increased intraocular pressure has occurred in 5% of patients.[Ref]

Ocular side effects have included increased intraocular pressure, glaucoma, and posterior subcapsular cataracts.[Ref]


Other side effects have included a glucocorticoid withdrawal syndrome, which resulted from abrupt discontinuation of prednisolone (the active ingredient contained in Flo-Pred) therapy and may not have been associated with adrenal suppression.[Ref]

Pseudorheumatism, or glucocorticoid-withdrawal syndrome, has occurred upon withdrawal of corticosteroids but was not related to adrenal insufficiency. Patients experienced anorexia, nausea, vomiting, lethargy, headache, fever, arthralgias, myalgias and postural hypotension. Symptoms resolved when corticosteroid therapy was reinstated.[Ref]


Psychiatric side effects have included psychoses, behavioral changes, and pseudotumor cerebri.[Ref]


Hematologic side effects have included thrombocytopenia, lymphopenia, and platelet alterations resulting in thrombolic events.[Ref]


Dermatologic side effects have included bruising, ecchymosis, petechiae striae, delayed wound healing, and acne.[Ref]


1. Thomas TP "The complications of systemic corticosteroid therapy in the elderly." Gerontology 30 (1984): 60-5

2. Ratnam KV, Phay KL, Tan CK "Pemphigus therapy with oral prednisolone regimens: a 5 year study." Int J Dermatol 29 (1990): 363-7

3. Chan L, French ME, Oliver DO, Morris PJ "High- and low-dose prednisolone." Transplant Proc 13(1 Pt) (1981): 336-8

4. Yukosuka O, Omata M, Imazeki F, et al "Combination of short-term prednisolone and adenine arabinoside in the treatment of chronic hepatitis B: a controlled study." Gastroenterology 89 (1985): 246-51

5. McClements BM, Callender ME "D-penicillamine therapy in patients with HBsAG-negative chronic active hepatitis and major prednisolone-induced adverse effects." J Hepatol 11 (1990): 322-5

6. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42

7. Surks MI, Sievert R "Drugs and thyroid function." N Engl J Med 333 (1995): 1688-94

8. Morris GC, Egan JG, Jones MK "Hypokalaemic paralysis induced by bolus prednisolone in Graves' disease." Aust N Z J Med 22 (1992): 312

9. Swartz SL, Dluhy RG "Corticosteroids: clinical pharmacology and therapeutic use." Drugs 16 (1978): 238-55

10. Jackson SH, Beevers DG, Myers K "Does long-term low-dose corticosteroid therapy cause hypertension?" Clin Sci 61 (1981): s381-3

11. Klepikov PV, Kutyrina IM, Tareyeva IE "Steroid-induced hypertension in patients with nephrotic syndrome." Nephron 48 (1988): 286-90

12. Greenstone MA, Shaw AB "Alternate day corticosteroid causes alternate day hyperglycaemia." Postgrad Med J 63 (1987): 761-4

13. Lamberts SE, Bruining HA, De Jong FH "Corticosteroid therapy in severe illness." N Engl J Med 337 (1997): 1285-92

14. Messer J, Reitman D, Sacks HS, et al "Association of adrenocorticosteroid therapy and peptic-ulcer disease." N Engl J Med 309 (1983): 21-4

15. Cisneros JR, Murray KM "Corticosteroids in tuberculosis." Ann Pharmacother 30 (1996): 1298-303

16. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.

17. Ledford D, Apter A, Brenner AM, Rubin K, Prestwood K, Frieri M, Lukert B "Osteoporosis in the corticosteroid-treated patient with asthma." J Allergy Clin Immunol 102 (1998): 353-62

18. Mitchison HC, Bassendine MF, Malcolm AJ, et al "A pilot, double-blind, controlled 1-year trial of prednisolone treatment in primary biliary cirrhosis: hepatic improvement but greater bone loss." Hepatology 10 (1989): 420-9

19. Mizuta H, Kubota K, Shiraishi M, Kai K, Nakamura E, Takagi K "Steroid-related bilateral osteonecrosis of the patella." Arthroscopy 9 (1993): 114-6

20. de Jong DJ, Corstens FH, Mannaerts L, van Rossum LG, Naber AH "Corticosteroid-induced osteoporosis: does it occur in patients with Crohn's disease?" Am J Gastroenterol 97 (2002): 2011-5

21. Need AG, Philcox JC, Hartley TF, Nordin BE "Calcium metabolism and osteoporosis in cortiscosteroid-treated postmenopausal women." Aust N Z J Med 16 (1986): 341-6

22. Fentiman IS, Saad Z, Caleffi M, et al "Tamoxifen protects against steroid-induced bone loss." Eur J Cancer 28 (1992): 684-5

23. Body JJ "Low-dose prednisone and increased risk of development of bone metastases." Ann Oncol 7 (1996): 643

24. Fordyce MJ, Solomon L "Early detection of avascular necrosis of the femoral head by MRI." J Bone Joint Surg Br 75 (1993): 365-7

25. McDonnell PJ, Kerr Muir MG "Glaucoma associated with systemic corticosteroid therapy." Lancet 08/17/85 (1985): 386-7

26. Debnath SC, Abomelha MS, Jawdat M, et al "Ocular side effects of systemic steroid therapy in renal transplant patients." Ann Ophthalmol 19 (1987): 435-7

27. Klein JF "Adverse psychiatric effects of systemic glucocorticoid therapy." Am Fam Physician 46 (1992): 1469-74

28. "Multum Information Services, Inc. Expert Review Panel"

Not all side effects for Flo-Pred may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.