Typically, if a healthcare provider prescribes prednisone, it’s because the benefits outweigh the risks. They will try to prescribe the lowest dose for the shortest amount of time possible to mitigate side effects, but some people may need higher doses or longer use for the medication to be effective.
This article discusses the potential side effects of prednisone and when you should call your doctor. It also explains which prednisone side effects are likely to resolve and which ones may not.
Why Dosage and Length of Treatment Matter
A short course of 10 milligrams (mg) of prednisone a day may not cause side effects. (In fact, the body naturally produces a substance equivalent to about 5 mg of prednisone.) However, a dosage of 10 to 20 mg a day for a month or more—or a dosage of more than 20 mg a day for any length of time—could.
Once prednisone is discontinued, many side effects go away. How long it will take to get the dose low and finally down to nothing depends on the length of time that prednisone was used and how much you take.
The longer the prednisone was taken and the higher the dose, the longer it will take you to taper off the medication, and the longer you may have certain side effects.
Tapering off of prednisone too quickly can cause its own side effects, including a return of your symptoms, headaches, dizziness, weakness, mood swings, and more. It can also lead to adrenal crisis, a life-threatening condition in which your levels of the hormone cortisol are too low.
Short- vs. Long-Term Use
Prednisone is used to treat respiratory illnesses such as upper respiratory tract infections, asthma, chronic obstructive pulmonary disease (COPD), emphysema, and pulmonary fibrosis.
It is also used to treat inflammatory bowel disease, rheumatoid diseases, neurological conditions such as myasthenia gravis, muscular dystrophy, and certain diseases of the kidney such as glomerulosclerosis.
In some cases, such as for acute inflammation like an upper respiratory tract infection, the course of prednisone might be short; it’s only used for a few days or weeks.
However, people with IBD or other inflammatory conditions may find their healthcare providers have prescribed them prednisone for months or even years.
The goal of IBD treatment is typically to wean a patient off the steroids, but sometimes it can be difficult. Some people can taper their drug dosage down to a certain point, but then symptoms return, and they must bump it back up again.
Types of Prednisone Side Effects
While prednisone is very effective, the list of potential side effects of prednisone is extensive.
These range from facial “mooning” (the face taking on a moon-like swollen shape), acne, and increased hair growth (hirsutism) to increased appetite, mood swings, difficulty sleeping, and more.
Any time healthcare providers start patients on steroids, the short- and long-term adverse effects of prednisone should be discussed.
Common Side Effects
Some common side effects of prednisone include:
AcneBulging eyesChanges in personalityChanges in the way fat is distributed around the bodyDecreased sexual desireDifficulty falling asleep or staying asleepDizzinessExtreme changes in moodExtreme tirednessFragile skinHeartburnHeadacheInappropriate happinessIncreased hair growthIncreased sweatingIrregular or absent menstrual periodsRed or purple blotches or lines under the skinSlowed healing of cuts and bruisesWeak muscles
Tell your doctor if any of these side effects are severe or do not go away.
Serious Side Effects
Call your doctor immediately if you experience any of the following serious side effects:
Confusion Depression Difficulty breathing or swallowing Dry, hacking cough Eye pain, redness, or tearing Hives Irregular heartbeat Itching Lightheadedness Loss of contact with reality Muscle twitching or tightening Numbness, burning, or tingling in the face, arms, legs, feet, or hands Rash Seizures Shaking of the hands that you cannot control Shortness of breath, especially during the night Sore throat, fever, chills, cough, or other signs of infection Sudden weight gain Swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs Swelling or pain in the stomach Upset stomach Vision problems Vomiting
Permanent Side Effects
As the prednisone dosage is tapered down below 10 mg a day and eventually discontinued, the temporary side effects will lessen and reverse.
It should be noted, however, that some potential adverse effects of prednisone are permanent, and discontinuing the drug will not reverse them. These include:
GlaucomaCataractsOsteoporosis (bone weakness)Osteonecrosis (bone death)
A Word From Verywell
No one wants to be put on prednisone but there’s no denying that, for many people, it gets results and calms inflammation quickly. Anyone with concerns about prednisone side effects should discuss them with a healthcare provider.
There may be ways to avoid certain side effects, such as by taking doses earlier in the day to lessen the effect on sleep. It’s also important to discuss how long the prednisone will be needed and what the plan is to stop the prednisone altogether.
Knowing the answers to these questions can help in getting through a course of prednisone without quite so many struggles with side effects.
