Prednisone

Sounds like 'PRED-ni-sone'

Prednisone is a steroid used to treat and prevent a variety of conditions that involve inflammation. Find out how to take it safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines known as corticosteroids
  • Apo-Prednisone®
  • Prednisone®

What is prednisone?

Prednisone is used to treat many illnesses associated with inflammation, such as asthma, COPD, rheumatoid arthritisgoutulcerative colitisCrohn's disease and other autoimmune conditions. 

Prednisone works by calming or suppressing your body's immune system and is especially effective for treating flare-ups of these conditions. Prednisone helps to reduce the symptoms associated with these conditions – it does not cure them.

Prednisone is in a class of medicines known as corticosteroids, which is similar to the steroid hormones your body naturally makes. 

Dose

In New Zealand prednisone is available as tablets in 4 different strengths: 1 mg, 2.5 mg, 5 mg and 20 mg.  

  • The dose of prednisone is different for different people, depending on your condition.
  • Doses usually range from 5 mg to 60 mg daily.
  • Some people may need a short course of prednisone (such as 5 days), while others may need to take it for longer (weeks to months).   
  • Prednisone tablets come in different strengths. Check the strength of your tablets and the dose you are prescribed. You may need to take more than 1 tablet. If you are unsure about your dose or the number of tablets to take, ask your pharmacist. 
  • Always take your prednisone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much prednisone to take, how often to take it and any special instructions.

How to take prednisone

  • Timing: Take your prednisone tablets with food and with a full glass of water. If you take it once a day or every second day, it is best taken at breakfast time. If it needs to be taken more than once a day, space your doses out during the day. Try not to take it too close to bedtime because it may keep you awake.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Stopping prednisone: If you have been taking prednisone regularly for more than 3 weeks, or taking high doses of prednisone (40 mg or more) for longer than 1 week, do not stop it suddenly. Stopping suddenly can cause withdrawal symptoms, which can be serious or even life-threatening. Instead, you will be given a tapering dose. This means your dose of prednisone will be gradually reduced over a few days or weeks. Read more about a steroid withdrawal plan.
My prednisone dose
I am taking prednisone for:

_________________________________________________________________________
My dose is:

___________________________

___________________________

 For how long:

___________________

___________________
How to reduce my prednisone dose gradually over a few weeks
Date:   Dose:
Date: Dose:
Date: Dose:
Date: Dose:
Date: Dose:
Notes:





While taking prednisone

  • Tell all your healthcare providers: It's important to tell all your healthcare providers that you are taking prednisone. 
  • Increased risk of infections: Taking prednisone for a long time can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness such as chickenpox or measles, or if you feel unwell.  
  • Vaccines: It is safe to have most vaccines, including the flu vaccine, while you are taking prednisone. Protecting yourself against infection is important because prednisone suppresses your immune system. However, vaccination with ‘live vaccines’, such MMR (measles, mumps, rubella) or shingles vaccine, should be postponed. Ask your doctor for advice before you have any vaccines while you are taking prednisone.  

Side effects

Like all medicines, prednisone can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking prednisone for. Read more about taking steroids long term.

Changes in behaviour and mood

Prednisone, especially in high doses, can cause changes in personality, behaviour and mood, such as:

  • irritability, agitation and restlessness
  • sleep problems (insomnia) and nightmares
  • mood swings and aggression
  • low mood, depression and even suicidal thoughts.

These symptoms typically develop within a few days of starting prednisone, but they can occur at any time, including after stopping treatment. 

While these symptoms often go away when your dose is reduced or prednisone is stopped, stopping prednisone must be done under the guidance of your doctor. Stopping too quickly can make these symptoms worse. You are at higher risk of mood and behaviour changes if you have previously had similar reactions to steroids (corticosteroid-induced psychosis), or if you have a personal or family history of psychiatric disorders.  

If you have changes in mood and behaviour, especially depression and suicidal thoughts, tell your doctor immediately or phone Healthline 0800 611 116. 

Other side effects

Side effects What should I do?
  • Difficulty sleeping
  • Take prednisone in the morning or at least 3 hours before bedtime.
  • Headache
  • Muscle weakness, feeling tired
  • These are quite common when you first start taking prednisone and usually go away with time.
  • Tell your doctor if troublesome.
  • Increased appetite 
  • Prednisone increases your appetite.
  • Follow a healthy, balanced diet to maintain your weight.
  • Develop an eating schedule and stick to it. 
  • Fluid retention causing swollen ankles and feet
  • Whenever possible, sit with your feet raised.
  • Avoid foods with high salt content.
  • Tell your doctor if this happens.
  • Raised blood glucose
  • Prednisone can cause an increase in blood glucose.
  • If you have diabetes, you may need to increase the dose of your diabetes medicine to control your blood glucose. Talk to your doctor about this.
  • Prednisone can also cause the onset of diabetes in people who are at risk of diabetes. Your doctor will monitor your blood glucose levels regularly.  
  • Eye pain and changes to your vision
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Problems with your stomach such as pain, blood in your stool (poo) or dark coloured stool (poo)
  • Tell your doctor immediately or phone Healthline 0800 611 116.

Interactions

Prednisone interacts with a number of medications and herbal supplements so check with your doctor or pharmacist before starting prednisone or before starting any new medicines. 

Learn more

The following links have more information on prednisone.

Prednisone RheumInfo
Prednisone
(Māori) NZ Formulary Patient Information

References

  1. Prednisone NZ Formulary
  2. Glucocorticoid therapy NZ Formulary
  3. Prednisone treatment – follow dosing recommendations Medsafe, NZ, 2021 
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 18 Jun 2021