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Prednisone Side Effects

Prednisone Side Effects
Prednisone belongs to a class of drugs called corticosteroids. Though the use of this drug can help treat several ailments, certain side effects may also be experienced by the user. The following write-up provides information on prednisone side effects that are associated with its short-term and long-term use.
Arun Chitnis
Last Updated: Jan 24, 2018
Prednisone molecule isolated on white
Prednisone is a synthetic glucocorticoid that is used to treat a variety of medical conditions such as asthma, severe allergic reactions, inflammatory bowel disease, adrenocortical insufficiency, multiple sclerosis, rheumatic disorders, lupus, nephrotic syndrome, myasthenia gravis, etc. This drug has almost the same effect like that of the naturally-occurring corticosteroid hormones. Though it is a very potent glucocorticoid, its use has been associated with certain side effects. When it comes to the severity of the side effects, the dosage, frequency, and the duration for which this drug is taken are some of the determining factors.
Mechanism of Action
Prednisone is produced by dehydrogenation of cortisone. It is biologically inert. Once this synthetic corticosteroid is administered either orally or via an intramuscular/intravenous injection, the liver turns it into an active metabolite called prednisolone. Prednisolone binds to the glucocorticoid receptors, thereby suppressing the immune response. This makes it very useful in the treatment of autoimmune diseases and inflammatory conditions. It is also a fast-acting drug as it is rapidly absorbed. Its effects can be observed in a couple of hours. The usual adult dose at the beginning of treatment ranges from 5-80 mg per day. The initial dose and the maintenance dose would vary, depending on the medical condition for which the person is being treated. For children who are older than 18 months, the initial dosage may be within 0.5-2 mg per kilogram of body weight if the child is showing signs of inflammation or an immune response. The dosage may be higher for serious conditions such as asthma or nephrotic syndrome.
Side Effects of Prednisone
Though there have been reports of serious side effects owing to larger doses and long-term use of this drug, some of the users may experience adverse effects even on taking this drug for a period of less than three weeks. Side effects could also occur due to drug interactions. Here are some of the common side effects of prednisolone that are associated with short-term use:
► Insomnia
► Mood changes
► Headaches
► Upset stomach
The use of prednisone can affect many organ systems of the body. Here are some of the common side effects of prednisone that are associated with its long-term use:
Effects on the Skin
The long-term use of this drug could affect the skin. Here are the skin changes that could occur due to glucocorticoid therapy:
► Easy bruising
► Excessive sweating
► Slow healing of wounds
► Hirsutism (excessive hair growth)
► Stretch marks
► Acne
Effects on the Musculoskeletal System
The risk of the following conditions may increase with the prolonged use of prednisone:
► Osteoporosis
► Long bone fractures
► Myalgia
► Rupturing of the tendons
Effects on the Gastrointestinal Tract
Long-term use of this synthetic glucocorticoid hormone could also affect the process of digestion and may cause the following side effects:
► Nausea
► Indigestion
► Abdominal pain
► Increased appetite
► Weight gain
Effects on the Eyes
Temporary impairment of vision has been reported in case of people who have been taking this drug for some time. The risk of secondary infections caused by viruses or fungi may also increase with long-term glucocorticoid therapy. Other adverse effects include:
► Increased intraocular pressure
► Glaucoma
► Cataract
Effects on the Electrolyte Balance
Electrolyte balance is essential for proper functioning of the body. Steroid therapy could hamper this balance, thereby giving rise to the following:
► Elevated blood pressure
► Fluid retention
► Retention of sodium
► Loss of potassium
Effects on the Nervous System
It is believed that the prolonged use of steroids could induce mental changes. Some of the effects that are linked to the use of prednisone include:
► Mood swings
► Restlessness
► Confusion
► Depression
► Insomnia
Effects on the Endocrine System
Long-term use of prednisone can also affect the endocrine system. Here are some of the side effects:
► Cushing's syndrome
► High blood sugar
► Glucose intolerance
► Adrenal suppression
The user may become dependent on the drug owing to its prolonged use. This is the reason why doctors do not recommend suddenly stopping the dose, especially when the patient has taken it for more than a week. They reduce the dose gradually over a few days in the case of short-term use, and over weeks or months in case of long-term treatment. If the drug is stopped abruptly, symptoms such as fatigue, weakness, joint pain, and body aches might be experienced by the user. Prolonged use may lead to adrenal insufficiency, a condition in which the body no longer produces sufficient amounts of adrenal steroid hormones.
Adverse Drug Interactions
Certain drugs can interact with prednisone, therefore the patient must inform their doctor about pre-existing medical conditions, and the drugs he/she has been taking as a part of their treatment.
► Diuretics (carbonic anhydrase inhibitors, furosemide and thiazides)
► Antacids
► Non-steroidal anti-inflammatory drugs
► Anticonvulsant drugs
► Drugs for diabetes
► Estrogen
► Anticoagulants
► Antifungal medication
► Live-virus vaccines
If you are a prednisone user, do inform your doctor on experiencing any of the aforementioned side effects. Reducing the dosage gradually is the best way to prevent these adverse effects. Doctors could also follow a symptomatic approach. These are situations where doctors have to weigh the disadvantages of using a drug against the advantages and make an informed decision. One must remember that while prednisone definitely does give rise to many side effects, it is also a life-saving drug.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.