Prednisone is a corticosteroid that is prescribed for the treatment of inflammatory problems and conditions, like rheumatoid arthritis, systemic lupus erythematosus, infections, allergies and skin and eye problems. It can also be used as a part of the treatment of cancer.

This medication can be found in pharmacies in the form of 5 mg or 20 mg tablets, and is sold upon presentation of a prescription.

Prednisone should always be taken as prescribed, as prolonged or improper use of this medication can lead to side effects like increased cholesterol and triglyceride levels.

What it's used for

Prednisone is prescribed to treat a wide range of inflammatory, autoimmune, allergic, and cancer-related conditions. The table below organizes the primary uses of prednisone by medical specialty or affected body system.

Category	Conditions Treated with Prednisone
Endocrine disorders	Adrenocortical insufficiency, congenital adrenal hyperplasia, non-suppurative thyroiditis
Rheumatic and musculoskeletal diseases	Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis, osteoarthritic synovitis, epicondylitis
Autoimmune and collagen vascular diseases	Systemic lupus erythematosus, acute rheumatic carditis, vasculitis
Skin conditions	Pemphigus, severe psoriasis, contact dermatitis, atopic dermatitis, fungal skin infections
Allergic reactions	Allergic rhinitis, serum sickness, drug hypersensitivity
Eye disorders	Uveitis (anterior and posterior), optic neuritis, keratitis, chorioretinitis, allergic conjunctivitis, ophthalmic herpes zoster
Respiratory conditions	Asthma, symptomatic sarcoidosis, Löefler syndrome, aspiration pneumonitis, berylliosis, selected cases of tuberculosis
Hematologic diseases	Idiopathic thrombocytopenic purpura, secondary thrombocytopenia in adults, acquired hemolytic anemia, erythrocytic and erythroid anemia
Cancer-related uses	Leukemia, lymphoma, hypercalcemia associated with malignancy
Other indications	Acute exacerbations of multiple sclerosis, idiopathic nephrotic syndrome, ulcerative colitis, regional enteritis

Prednisone should only be used as directed by a healthcare professional, as its anti-inflammatory and immunosuppressive properties can cause serious side effects without proper monitoring.

How to take

Prednisone should be taken orally, with a glass of water, and preferably after a meal to avoid stomach irritation. Prednisone tablets should be swallowed whole, without breaking or chewing, and at the times established by the doctor.

Prednisone dosage

The dosage of prednisone varies depending on the patient's age and condition being treated.

Adult dosing by condition:

Condition	Typical daily dose
Rheumatoid arthritis	5–10 mg
Lupus, vasculitis	60–80 mg
Asthma (hospital)	40–80 mg
Asthma (outpatient)	40–60 mg
Multiple sclerosis (short-term)	1250 mg/day for 3–5 days
Multiple sclerosis (long-term)	200 mg for 1 week, then 80 mg every other day
Severe inflammation	Up to 100 mg

After achieving a therapeutic response, the doctor may reduce the dose.

Pediatric dosing by condition:

Condition	Typical dose
General use	0.05–2 mg/kg/day divided into 1–4 doses
Acute asthma	1–2 mg/kg/day for 3–5 days
Nephrotic syndrome	60 mg/m²/day or 2 mg/kg/day
Inflammatory conditions	0.1–2 mg/kg/day

The dosage of prednisone should be reduced little by little by the doctor until reaching the maintenance dose, which is the lowest possible dose with therapeutic response. Children receiving long-term treatment should have their growth monitored every 6 months.

Possible side effects

The side effects of prednisone depend on the dose and duration of treatment. Common short-term effects include increased appetite, mood changes, insomnia, nausea, indigestion, acne, and fatigue.

With prolonged use, prednisone may lead to weight gain, high blood sugar, elevated cholesterol and triglycerides, muscle weakness, increased risk of infections, osteoporosis, and eye problems such as cataracts or glaucoma. Children may also experience slower growth.

Although rare, serious side effects like avascular necrosis, psychiatric changes, and systemic infections may occur, especially with high doses or long-term therapy. Regular medical follow-up is recommended to monitor and manage potential complications.

Interactions and contraindications

Prednisone can interact with several medications, which may increase the risk of adverse effects or reduce treatment effectiveness. Caution is advised when used with the following:

Warfarin: may enhance anticoagulant effects and increase bleeding risk
NSAIDs: may increase the risk of gastrointestinal bleeding or ulcers
Live vaccines: contraindicated due to risk of infection from suppressed immune response
Cyclosporine: may cause additive immunosuppression
Diuretics: may lead to electrolyte imbalances, especially hypokalemia
Aspirin: may increase the risk of bleeding
Diabetes medications: may alter blood sugar control, requiring dose adjustments

Prednisone is contraindicated in people with systemic fungal infections, uncontrolled infections, or known hypersensitivity to prednisone or its components. It should be avoided during pregnancy, particularly in the first trimester, due to the risk of fetal harm, and is not recommended during breastfeeding, as it can pass into breast milk.

In children, long-term use may impair growth and should only be undertaken with careful medical supervision.

Difference between prednisone and prednisolone

Prednisone is the therapeutic compound in prednisolone. Prednisone is an inactive substance, and to become active, it needs to be transformed in the liver into prednisolone, to exert its action.

Thus, if a person ingests prednisone or prednisolone, the action exerted by the medication will be the same, as prednisone is transformed and activated, in the liver, into prednisolone. For this reason, prednisolone is more beneficial for people with liver problems, as it does not need to be transformed in the liver to exert its effect in the body.

FAQs

Some common questions that patients have about prednisone include:

1. Does prednisone cause weight gain?

One of the most common side effects of corticosteroids like prednisone is gradual weight gain or changes in the shape or location of body fat, such as the face, arms, legs, waist, abdomen or neck. This is particularly noted in cases of prolonged treatment.

2. How long can prednisone be taken safely?

Long-term use requires monitoring for bone loss, glucose control, and eye health. Use beyond 3 months should include bone protection strategies.

3. Can prednisone be stopped suddenly?

Abrupt discontinuation after prolonged use can lead to adrenal insufficiency. The dose must be tapered gradually under medical supervision.

Prednisone: Uses, How to Take, Dosage, & Side Effects