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

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.

Woman holding pill in hand

What is it used for?

Prednisone can be used for the treatment of:

  • Endocrine changes, such as adrenocortical insufficiency, congenital adrenal hyperplasia or non-suppurative thyroiditis;
  • Rheumatism, such as psoriatic or rheumatoid arthritis, ankylosing spondylitis, bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis, osteoarthritic synovitis and epicondylitis;
  • Collagenoses, in particular cases of systemic lupus erythematosus and acute rheumatic carditis;
  • Skin diseases, such as pemphigus, some dermatitis, mycoses and severe psoriasis;
  • Allergies, such as allergic rhinitis, contact and atopic dermatitis, serum sickness and drug hypersensitivity reactions;
  • Ophthalmic diseases, such as allergic marginal corneal ulcers, ophthalmic herpes zoster, anterior segment inflammation, choroiditis and diffuse posterior uveitis, sympathetic ophthalmia, allergic conjunctivitis, keratitis, chorioretinitis, optic neuritis, iritis and iridocyclitis;
  • Respiratory diseases, such as symptomatic sarcoidosis, Löefler syndrome, berylliosis, some cases of tuberculosis, aspiration pneumonitis and bronchial asthma;
  • Blood disorders such as idiopathic thrombocytopenic purpura and secondary thrombocytopenia in adults, acquired hemolytic anemia, erythrocytic anemia and erythroid anemia.

Furthermore, prednisone may be indicated for the palliative treatment of cancers like leukemia or lymphoma, or as an aid in the treatment of hypercalcemia associated with cancer.

The doctor may also prescribe prednisone to treat of acute exacerbations of multiple sclerosis, to reduce swelling in cases of idiopathic nephrotic syndrome and lupus erythematosus, for maintenance treatment in cases of ulcerative colitis or regional enteritis, or for some cases of tuberculosis. 

This medications is a potent anti-inflammatory and immunosuppressant and should only be used as directed by a doctor. 

How to take and dosage

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.

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

  • Adults: the normally recommended dose varies from 5 to 60 mg per day, starting with low doses that can be increased by the doctor, depending on the response to treatment. After achieving a therapeutic response, the doctor may reduce the dose.
  • Children: the normally recommended initial dose of prednisone can vary from 0.14 mg/kg to 2 mg/kg of body weight per day, or from 4 mg to 60 mg per square meter of body surface per day, as directed and calculated by the pediatrician.

The dosage of prednisolone should be reduced little by little by the doctor until reaching the maintenance dose, which is the lowest possible dose with therapeutic response.

Possible side effects

The most common side effects that may occur during treatment with prednisone are increased appetite, nausea, indigestion, stomach pain, peptic ulcer, pancreatitis, ulcerative esophagitis, acne, dry skin, bruising, skin discoloration, slow wound healing, nervousness, fatigue, insomnia, headache or dizziness.

In addition, prednisone can cause allergic reactions, eye disorders (such as cataracts, glaucoma, or exophthalmos), worsening of secondary viral or fungal eye infections, as well as reduced carbohydrate tolerance, and the development of latent diabetes mellitus with increased need for insulin or oral hypoglycemic agents.

Treatment with high doses of corticosteroids can also cause a sharp increase in triglycerides and cholesterol levels.

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.

Contraindications for use

Prednisone should not be used by people with systemic fungal infections or uncontrolled infections, nor by people who are allergic to prednisone or any of its components.

Furthermore, prednisone should not be used during pregnancy, especially in the first trimester, as it can cause birth defects or low birth weight. It is also not recommended during breastfeeding as it can pass to the baby through breast milk.

Prednisone can affect the growth of children, and its use should only be done with the recommendation and monitoring of a pediatrician.

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.

Also recommended: Prednisolone: What It’s For, Dosage & Side Effects

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.