Prednisone Patient Tips

How it works

• Prednisone is corticosteroid that is used to reduce inflammation and calm down an overactive immune system. It has predominant glucocorticoid and low mineralocorticoid activity, which means it affects the immune response and inflammation rather than electrolytes and water.
• Prednisone mimics the effect of cortisol, a hormone released by the adrenal glands (located on top of the kidneys) that controls metabolism and stress.

Upsides

• Prednisone can help dampen down an over-reactive immune system and reduce inflammation. 
• Helps control conditions such as lupus, where your immune system mistakenly attacks its own tissue.
• Prednisone also helps to control moderate-to-severe asthma attacks by controlling inflammation.
• Available in cost-saving generic forms.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Indigestion, facial hair growth (especially in women), high blood pressure, increased appetite which may result in weight gain, slow skin healing and skin thinning, osteoporosis (brittle bones), onset of diabetes, sodium and water retention, and stomach ulcers.
• Side effects are more likely to be experienced at dosages greater than 7.5 mg/day and with long-term therapy.
• Limit or avoid alcohol use while taking prednisone to help prevent stomach ulcers.
• With high doses of corticosteroids, ‘live vaccines’ should be delayed until several months after corticosteroid treatment has stopped.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

• Prednisone effectively controls inflammation and an overactive immune system but may not be suitable for everybody.
• Long-term use is limited by potentially severe side effects such as adrenal suppression and increased risk of infection.

Tips

• Take with food and a full glass of water.
• Single doses are preferred over split doses.
• Take dosage in the morning, before 9 AM to more closely mimic your body's natural secretion of cortisol.
• Stopping prednisone suddenly can be dangerous. Do not stop taking without a doctor's advice. People who have taken prednisone long-term must slowly wean themselves off it over a period of days or weeks.
• Follow the prescription label exactly.

Response and Effectiveness

• Takes approximately 60 minutes to be metabolized in the liver to its active form, prednisolone. Liver disease does not appear to affect metabolism. Effects can last from 18-36 hours, meaning that alternate day dosing is possible.
• Temporary dosage increases may be necessary during disease flare-ups or during times of stress or infection.
• Prednisone is five times more potent at relieving inflammation than naturally occurring cortisol.