Prednisolone: 7 things you should know - (2023)

Medically reviewed by Carmen Fookes, BPharm. Last updated on Aug 29, 2022.

1. How it works

  • Prednisolone is a corticosteroid that may be used to reduce inflammation and calm down an overactive immune system. It has predominantly glucocorticoid activity and low mineralocorticoid activity, which means it affects the immune response and inflammation rather than affecting the body's balance of electrolytes and water.
  • Prednisolone mimics the effect of cortisol, a hormone released by the adrenal glands (located on top of the kidneys) that regulatesmetabolism andstress.
  • Prednisolone belongs to the class of medicines known as corticosteroids. Specifically, it is a glucocorticoid.

2. Upsides

  • Prednisolone can help dampen down an over-reactive immune system and reduce inflammation.
  • May be used in the treatment of allergies, arthritis, certain blood disorders, cancer, endocrine disorders, inflammatory bowel diseases, swelling, and skin conditions.
  • Typically only taken as a short course.
  • Prednisolone also helps to control moderate-to-severe asthma attacks by controlling inflammation.
  • Prednisolone is the active form of prednisone (prednisone is metabolized in the liver first to become prednisolone).
  • Has five times the glucocorticoid activity of hydrocortisone and less than 10% of hydrocortisone's mineralocorticoid activity.
  • Available as an oral tablet, orally disintegrating tablet, oral suspension, and ophthalmic solution.
  • Generic prednisolone is available.

3. 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:

  • Acne, dizziness, facial flushing, general aches and pains, headache, an increased appetite that may result in weight gain, increased sweating, indigestion, and insomnia are the most common side effects reported.
  • May also cause facial hair growth (especially in women), high blood pressure, slow skin healing and skin thinning, osteoporosis (brittle bones), the onset of diabetes, sodium and water retention, and stomach ulcers with long-term use.
  • Side effects are more likely to be experiencedat higher dosages.
  • Limit or avoid alcohol use while taking prednisolone to help prevent stomach ulcers.
  • With high doses of corticosteroids, ‘live vaccines’ should be delayed until several months after corticosteroid treatment has stopped.
  • Children may be especially sensitive to the effects of prednisolone. Prolonged prednisolone use may affect growth and development in children.
  • All corticosteroids, including prednisolone, can cause salt and fluid retention, which may lead to blood pressure elevation and increased potassium excretion. Calcium excretion is also increased.
  • Cataracts, glaucoma, eye infections, an increase in new episodes of optic neuritis, and corneal perforation associated with herpes simplex of the eye, have all been reported with prednisolone use.
  • Prednisolone may cause low potassium levels (hypokalemia), which may be potentiated by other drugs that also cause hypokalemia (such as diuretics, amphotericin B).
  • Prednisolone is considerably more expensive than prednisone, but its effectiveness is similar.
  • May cause withdrawal symptoms if stopped suddenly after long-term or high-dose therapy. Symptoms include fever, vomiting, loss of appetite, diarrhea, weight loss, general aches, and pains.
  • May not be suitable for some people including those with fungal infections, thyroid disorders, herpes infection of the eyes, mental health issues, stomach ulcers, liver disease, high blood pressure, osteoporosis, myasthenia gravis, or multiple sclerosis.
  • Prednisolone may interact with several other medications including anticholinesterase agents, antidiabetic agents, anticoagulants, digoxin, estrogens, NSAIDs, and vaccinations (including both live and inactivated vaccines). It may also suppress the reaction to some skin tests.
  • Should not be used during pregnancy unless the benefits outweigh the risks. Corticosteroids, such as prednisolone can cause fetal harm when administered to a pregnant woman; an increased risk of orofacial clefts is associated with use during the first trimester. Intrauterine growth restriction and decreased birth weight have also been reported. Animal studies have found prednisolone to be teratogenic. Prednisolone is present in human milk at doses less than 1% of the maternal daily dose. Use the lowest possible dose during breastfeeding because high doses could potentially produce problems in the breastfed infant such as growth and developmental delays and interfere with endogenous corticosteroid production.

Note: 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. View complete list of side effects

(Video) Prednisone: Dosing and Side Effects

4. Bottom Line

  • Prednisolone 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 an increased risk of infection. Prednisolone should always be used at the lowest effective dose for the shortest possible time.

5. Tips

  • Take with food and a full glass of water.
  • Single doses are preferred over split doses.
  • Take exactly as directed by your doctor. Sometimes dosing for prednisolone may seem complicated. Follow the prescription label and your doctor's instructions exactly. If you have any concerns, ask your doctor. Do not take more or less prednisolone than prescribed.
  • Take prednisolone in the morning preferably before 9 AM to more closely mimic your body's natural secretion of cortisol.
  • If you are taking prednisolone suspension or giving a dose to a child, shake the suspension well and ensure you use a properly calibrated dosing syringe, rather than a kitchen teaspoon, to accurately measure the dose.
  • Keep prednisolone disintegrating tablets unopened in their packet until it is time to take them. Use dry hands to open the packet, and peel back the foil from the tablet, rather than trying to push the tablet through. Place the tablet in your mouth and allow it to disintegrate, do not crush or chew.
  • Prednisolone ophthalmic solution is not compatible with contact lenses. Ask your doctor or health care professional when you can wear your lenses again.
  • Stopping prednisolone suddenly can be dangerous.Do not stop taking without a doctor's advice. People who have taken prednisolone long-term must slowly wean themselves off it over days or weeks, following their doctor's instructions.
  • Avoid alcohol while you are taking prednisolone.
  • Prednisolone may affect blood sugar readings in people with diabetes. Talk to your doctor about how you should manage this.
  • Talk to your doctor if you become unwell or stressed while taking prednisolone. Your dosage may need to be adjusted temporarily.
  • Avoid contact with anybody known to have, or recently exposed to, viral illnesses such as chickenpox or measles. If you inadvertently come into contact with somebody, contact your doctor immediately as immune globulin or antiviral treatment may be required.
  • Tell other health care professionals, including your dentist, that you are taking prednisolone. Talk to your doctor or pharmacist before taking any other medications with prednisolone, including those bought over-the-counter, because some may not be compatible with prednisolone.
  • Tell your doctor if you are breastfeeding, pregnant, or intending to become pregnant because prednisolone may not be suitable for you.

6. Response and effectiveness

  • 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.
  • Prednisolone is five times more potent at relieving inflammation than naturally occurring cortisol.

7. Interactions

Medicines that interact with prednisolone may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with prednisolone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with prednisolone include:

  • antibiotics, such as clarithromycin, erythromycin, rifabutin, rifampin, or troleandomycin
  • anticholinesterases, such as neostigmine, or pyridostigmine
  • anticoagulants (blood thinners) such as apixaban, dabigatran, fondaparinux, heparin, or warfarin
  • antidepressants, such as desipramine, fluoxetine, sertraline, or St. John's Wort
  • antifungal medications, such as itraconazole, ketoconazole, or voriconazole
  • antinausea medications, such as aprepitant
  • aspirin
  • epilepsy medications, such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, or primidone
  • estrogen-containing hormonal contraceptives (includes birth control pills, patches, rings, implants, and injections)
  • heart medications, such as amiodarone, diltiazem, or verapamil
  • HIV medications (eg, atazanavir, delavirdine, efavirenz, indinavir, etravirine, ritonavir, nevirapine, saquinavir, or tipranavir)
  • immunosuppressants, such a cyclosporine
  • nonsteroidal anti-inflammatories (NSAIDs), such as celecoxib, diclofenac, etodolac, ibuprofen, ketorolac, meloxicam, nabumetone, or naproxen
  • other corticosteroids, such as dexamethasone
  • potassium-depleting agents, such as amphotericin B Injection and diuretics (eg, furosemide, hydrochlorothiazide)
  • some asthma medications, such as zafirlukast
  • vaccines (may inhibit the immune response)
  • others, such as aminoglutethimide, bupropion, cholestyramine, cyclosporine, digoxin, isoniazid, quetiapine, or thalidomide.

Prednisolone may increase blood glucose concentrations in people with diabetes and dosage adjustments of antidiabetic agents (eg, insulin, glyburide) may be required. Use with fluoroquinolone antibiotics (such as ciprofloxacin, levofloxacin) may increase the risk of tendon rupture with fluoroquinolones.

(Video) Prednisone: Overview of Uses

In addition, alcohol can increase the likelihood of gastrointestinal side effects with prednisolone, and possibly liver and kidney damage. Prednisolone may suppress the inflammatory response to skin tests.

Note that this list is not all-inclusive and includes only common medications that may interact with prednisolone. You should refer to the prescribing information for prednisolone for a complete list of interactions.

More about prednisolone

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(Video) Prednisone: Review of Special Precautions


  • Prednisolone. Revised 02/2022. Prasco Laboratories.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use prednisolone only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

(Video) How and When to Use Prednisone? (Deltasone, Orasone, Adasone) - For patients

Copyright 1996-2023 Revision date: August 29, 2022.

Medical Disclaimer


What should I know about prednisolone? ›

Common short-term side effects include changes in appetite, mood, energy, and sleep. Long-term prednisone treatment can lead to weight gain, osteoporosis, and cataracts. Diarrhea is not a side effect of prednisone. But other gastrointestinal symptoms are possible, like increased appetite and indigestion.

What should I avoid while taking prednisone? ›

Prednisone has a tendency to raise the level of glucose, or sugar, in the blood, which can cause increased body fat or diabetes in some people. It is important to avoid "simple" carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, chips, breads, candy and other highly processed foods.

What does prednisolone do to your body? ›

Prednisolone is a medicine used to treat a wide range of health problems including allergies, blood disorders, skin diseases, inflammation, infections and certain cancers and to prevent organ rejection after a transplant. It helps by reducing swelling (inflammation) and can also calm down your immune system.

What are the most serious side effects of prednisone? ›

Serious allergic reaction
  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin.
  • you're wheezing.
  • you get tightness in the chest or throat.
  • you have trouble breathing or talking.
  • your mouth, face, lips, tongue or throat start swelling.

Should you drink a lot of water with prednisone? ›

Fluid retention can cause weight gain but as steroids are reduced, fluids will usually reduce as well, along with some of the weight gain. Drinking plenty of water and exercising can help with fluid retention.

Does prednisone raise your heart rate and blood pressure? ›

Prednisone raises blood pressure in many people who take it. One reason is that prednisone and other corticosteroids cause the body to retain fluid. Extra fluid in the circulation can cause an increase in blood pressure.

Can you have caffeine with prednisolone? ›

Prednisone can affect your sense of taste and make everything seem bland, but don't load up on salt to compensate. Avoid stimulants like caffeine and nicotine that can make sleep issues worse. Cutting these out can help ease insomnia, which is a common side effect of prednisone.

What food interacts with prednisolone? ›

Because prednisone may also increase blood sugar levels, you should avoid foods with simple carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, and candy.

Does your body go back to normal after prednisone? ›

A gradual reduction in prednisone dosage gives your adrenal glands time to resume their usual function. The amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take a week to several months.

Who should not take prednisolone? ›

have ever had an allergic reaction to prednisolone or any other medicine. have an infection (including eye infections) or any unhealed wounds. are trying to get pregnant, are already pregnant or you are breastfeeding. have recently been in contact with someone with shingles, chickenpox or measles.

How long can you take prednisolone for? ›

This depends on your health problem or condition. You may only need a short course of prednisolone for up to 1 week. You may need to take it for longer, even for many years or the rest of your life.

Why is prednisone so harmful? ›

Because prednisone suppresses the body's immune system, it can also increase the risk of infection. Therefore, some precautions need to be taken. Before taking prednisone, talk to your healthcare provider about the following: If you have a history of allergies to prednisone or other steroid drugs.

Can prednisone damage your brain? ›

31, 2022 (HealthDay News) -- Long-term steroid use can reshape the structure of the brain, causing some parts to shrink and others to grow, a major new study reports.

What drugs should not be taken with steroids? ›

Some key drugs that interact with steroids include anticoagulants (such as warfarin), drugs for blood pressure, antiepileptics, antidiabetic drugs, antifungal drugs, bronchodilators (such as salbutamol) and diuretics.

Does prednisone make you pee a lot? ›

Results: Low-dose prednisone significantly enhanced urine output. However, the effects of medium- and high-dose prednisone on urine output were less obvious. As for renal sodium excretion, high-dose prednisone induced a more potent natriuresis than low-dose prednisone.

What is similar to prednisone over the counter? ›

Other alternatives to prednisone

Common over-the-counter anti-inflammatory drugs for arthritis include ibuprofen, naproxen, and diclofenac gel.

Does prednisone make you urinate a lot? ›

Prednisone & prednsolone have activity in the kidney leading to the conservation of salt. This creates the classical side effects of prednisone/prednisolone use: excessive thirst and excessive urination. If this occurs, another steroid can be selected or the predisone/prednisolone dose can be dropped.

How can I protect my heart from steroids? ›

Low sodium diet helps reduce fluid accumulation and may help control blood pressure. Have your blood pressure monitored regularly while you are on steroids, especially if you have a history of high blood pressure. Steroids can raise blood pressure in some patients.

Can I take prednisone with blood pressure medication? ›

If you already have hypertension (high blood pressure), taking prednisone may worsen blood pressure control. Your doctor may adjust your medication or recommend monitoring your blood pressure to assess your body's response to prednisone.

Which steroids cause heart attacks? ›

This study suggests that prednisolone increases the risk of a range of fatal and nonfatal cardiovascular diseases. It concludes that this risk increases with the dose and duration of steroid treatment. People on high doses develop a risk similar to those with diabetes.

Can prednisone be taken with sleep? ›

There are no known interactions between commonly prescribed sleep aids and prednisone. However, this does not mean that drug interactions do not exist. Please be sure to consult a healthcare provider before taking a sleep aid while on prednisone therapy.

Can you take Tylenol and prednisone together? ›

Generally speaking, it's safe to take prednisone with Tylenol because no known drug interactions or drug and food interactions have been found.

What is the best food to eat when taking steroids? ›

Eat a well-balanced diet including 2 rich sources of potassium daily, such as orange juice, apricots, banana, cantaloupe, baked potatoes and tomatoes. Do not take potassium supplements unless prescribed by your physician.

Can you have dairy with prednisolone? ›

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects. Take this medicine with food or milk to avoid stomach irritation.

How do you stay healthy while taking prednisone? ›

These healthy habits can affect your sugar levels, too: Use strategies (such as meditation) to cope with and reduce stress. Eat more fruits, vegetables, whole grains, and low-fat or skim milk and cheeses.

Why is it so hard to get off prednisone? ›

Your body needs cortisol to function. When you take prednisone for more than a few weeks, your adrenal glands make way less cortisol. If you stop prednisone or taper too quickly, your body won't have enough of the steroid it needs. Your withdrawal symptoms are due to that sudden steroid shortage.

Is it hard to get off prednisone? ›

Prescribed to treat many conditions, including autoimmune disorders, asthma, and organ transplants, prednisone is not something you would expect to cause withdrawals. Unfortunately, anyone that tapers off too quickly or abruptly quits taking their medication could experience seriously uncomfortable withdrawal symptoms.

How long does prednisolone take to work for inflammation? ›

Prednisone generally works very quickly — usually within one to four days — if the prescribed dose is adequate to reduce your particular level of inflammation. Some people notice the effects of prednisone hours after taking the first dose.

What should I know before taking prednisone? ›

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects. Take this medicine with food or milk to avoid stomach irritation.

What are some common side effects for prednisolone? ›

Nausea, heartburn, headache, dizziness, menstrual period changes, trouble sleeping, increased sweating, or acne may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Why would a doctor prescribe prednisolone? ›

Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders.

Is prednisolone a strong steroid? ›

Both prednisone and methylprednisolone are very strong medications. Doctors will try to use the lowest possible dosage that is effective, so they may increase or decrease the dosage during treatment.

Can you drink coffee while taking prednisone? ›

Prednisone can affect your sense of taste and make everything seem bland, but don't load up on salt to compensate. Avoid stimulants like caffeine and nicotine that can make sleep issues worse. Cutting these out can help ease insomnia, which is a common side effect of prednisone.

How does prednisone make you feel when you take it? ›

This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while taking this medicine.

How long can you be on prednisone? ›

This depends on your health problem or condition. You may only need a short course of prednisolone for up to 1 week. You may need to take it for longer, even for many years or the rest of your life.

Does prednisolone make you tired? ›

Official answer. Prednisone does not usually cause sleepiness but may make you feel dizzy, irritable with mood swings, or cause you to have trouble sleeping (insomnia). If your dose is stopped too quickly or if you take prednisone for a long period of time you may feel severely fatigued.


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