Prednisone is a prescription corticosteroid used to calm overactive immune responses and reduce inflammation in conditions like asthma flares, severe allergies, rheumatoid arthritis, lupus, inflammatory bowel disease, gout attacks, and certain skin disorders. It can be highly effective, but it also carries important risks, including adrenal suppression, infection risk, mood changes, blood sugar elevation, and bone loss—especially with higher doses or long-term use. Prednisone should be taken only under medical supervision, usually at the lowest effective dose for the shortest possible time and with a planned taper when needed. Always consult a licensed clinician before starting, stopping, or changing your dose.
Prednisone is a synthetic corticosteroid that suppresses inflammation and modulates immune activity. Clinicians prescribe it across a wide range of conditions where rapid control of inflammation is essential. Common indications include acute asthma or COPD exacerbations, severe allergic reactions (such as angioedema or poison ivy), autoimmune diseases (rheumatoid arthritis, lupus, polymyalgia rheumatica), inflammatory bowel disease (ulcerative colitis, Crohn’s disease) flares, gout attacks, and certain dermatologic conditions (eczema, contact dermatitis, psoriasis flares). It may also be used in some neurologic conditions (Bell’s palsy) and as part of cancer-related treatment regimens.
In short, Prednisone can be transformative when inflammation is driving symptoms or tissue damage. However, because it affects many body systems, it’s typically used at the lowest effective dose for the shortest duration possible and only when benefits outweigh risks. Many chronic conditions require a long-term steroid-sparing plan—adding non-steroid therapies to reduce or eliminate Prednisone exposure once the acute issue is controlled.
Prednisone converts in the liver to prednisolone, the active form. It binds glucocorticoid receptors, downregulating pro-inflammatory gene transcription and upregulating anti-inflammatory pathways. This reduces cytokines, stabilizes cell membranes, and decreases immune cell trafficking to inflamed tissues. The result is broad anti-inflammatory and immunosuppressive activity that can quickly improve pain, swelling, wheezing, and other inflammatory symptoms. That same power can mask signs of infection and suppress the body’s stress-response hormone (cortisol), which is why careful dosing, monitoring, and tapering are essential.
Dosing is individualized based on the condition, severity, and patient factors. Typical adult doses range from 5–60 mg daily. Short “bursts” are common for acute flares (for example, 40–60 mg daily for 3–5 days in some asthma exacerbations). Chronic diseases may use lower doses (5–20 mg/day) with plans to taper. For many conditions, a morning dose is preferred to align with the body’s natural cortisol rhythm and may reduce insomnia. Always take Prednisone with food or milk to minimize stomach irritation.
Tapering is critical if you’ve taken moderate-to-high doses or used Prednisone for more than about 2–3 weeks. A taper allows your adrenal glands to resume normal cortisol production and reduces the risk of withdrawal (fatigue, body aches, low blood pressure) and disease rebound. Never stop Prednisone abruptly without medical guidance.
Tablets come in multiple strengths and can often be split if scored; a liquid formulation exists for patients who have difficulty swallowing or need precise pediatric dosing. Your clinician will specify a schedule—daily, every other day, or a step-down plan—based on your clinical response and side-effect profile. If you are given a steroid “dose pack” with pre-set day-by-day instructions, follow it precisely and contact your prescriber if symptoms worsen or side effects become significant.
Because Prednisone affects metabolism, immunity, mood, and bone health, a baseline assessment is important. Tell your clinician if you have diabetes, high blood pressure, heart failure, glaucoma, cataracts, osteoporosis, peptic ulcer disease, kidney or liver disease, psychiatric conditions (depression, bipolar disorder), or a history of serious infections (tuberculosis, shingles, hepatitis B). Report recent exposures to chickenpox or measles if you’re not immune.
People on prolonged or repeated courses may need a bone-protection plan (adequate calcium and vitamin D, weight-bearing exercise, lifestyle changes; sometimes a bisphosphonate). Eye exams may be advised for extended therapy. Monitor blood pressure, weight, blood glucose (especially if you have or are at risk for diabetes), and electrolytes. Children may require growth monitoring during long-term use.
Vaccines: Avoid live vaccines while on high-dose or immunosuppressive courses. Inactivated vaccines are generally safe but may be less effective during steroid therapy. If possible, update needed immunizations before starting long-term Prednisone.
Pregnancy and breastfeeding: Use only if benefits outweigh risks. Short courses may be acceptable for specific indications; long-term or high-dose use requires specialist oversight. Small amounts of prednisolone enter breast milk; timing feeds several hours after a dose can reduce infant exposure—ask your clinician for individualized advice.
Do not use Prednisone if you have a known hypersensitivity to prednisone or any tablet components. Systemic fungal infections are a classic contraindication because immune suppression can worsen outcomes. Live vaccines should not be administered to patients on immunosuppressive doses. Caution or specialized management is required in untreated systemic infections, strongyloides infestation, active peptic ulcer disease, uncontrolled diabetes or hypertension, severe osteoporosis, and certain eye infections (e.g., herpes simplex keratitis).
Short-term side effects can include increased appetite, fluid retention or swelling, mood swings, anxiety, irritability, insomnia, stomach upset, and transient rises in blood sugar or blood pressure. Many of these improve as the dose is lowered or the course ends. Taking the dose in the morning with food, limiting dietary sodium, and practicing good sleep hygiene can help.
Longer-term or higher-dose therapy raises the risk of more serious effects: adrenal suppression (necessitating a taper), reduced infection resistance, slow wound healing, thin skin and easy bruising, muscle weakness, fat redistribution (face/neck/abdomen), glaucoma or cataracts, bone loss and fractures (osteoporosis), menstrual changes, acne, and persistent hyperglycemia. Rarely, severe mood changes or psychosis can occur—seek prompt medical attention for confusion, hallucinations, severe depression, or mania.
Call your clinician urgently for fever, severe or worsening infection, black or tarry stools, vomiting blood, severe abdominal pain, vision changes, confusion, severe swelling, shortness of breath, or signs of an adrenal crisis (profound fatigue, dizziness, low blood pressure), particularly during a taper or after missed doses.
Prednisone interacts with numerous medicines. Always provide your full medication and supplement list to your pharmacist and prescriber.
Gastrointestinal risk: Combining Prednisone with NSAIDs (ibuprofen, naproxen) increases the risk of stomach ulcers or bleeding; gastroprotection (e.g., a PPI) may be considered when risk is high. Prednisone can alter warfarin’s effect—INR monitoring and dose adjustments may be needed.
Blood sugar and blood pressure: Diabetes medications may require adjustments; antihypertensives may need tuning due to fluid retention and blood pressure changes.
Electrolytes and heart rhythm: Diuretics that lower potassium (like furosemide) combined with Prednisone raise the risk of hypokalemia; monitor potassium, especially if you take digoxin (risk of digoxin toxicity increases with low potassium).
Immunosuppressants and antivirals: Cyclosporine and Prednisone can raise each other’s levels and side-effect risks (including neurotoxicity). Potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir/cobicistat) may increase steroid exposure; inducers (e.g., rifampin, carbamazepine, phenytoin) may reduce efficacy—dosing changes or alternatives may be needed. Mifepristone antagonizes glucocorticoid effects. Combining systemic steroids with fluoroquinolones may raise tendon injury risk.
Vaccines: Avoid live vaccines during immunosuppressive dosing; responses to inactivated vaccines may be blunted.
If you take Prednisone once daily and miss a dose, take it when you remember the same day. If it is close to your next dose, skip the missed dose and resume your regular schedule—do not double up. For alternating-day or complex tapers, call your clinician or pharmacist for specific advice. If you have been on Prednisone for more than a couple of weeks and miss more than 24 hours of dosing, contact your prescriber to reduce the risk of withdrawal or disease flare.
Acute overdose may cause agitation, confusion, severe mood changes, high blood pressure, high blood sugar, fluid retention, or gastrointestinal bleeding. Chronic excessive dosing leads to Cushingoid features, muscle weakness, and significant infection risk. If an overdose is suspected, contact poison control or seek emergency care immediately. Do not abruptly stop long-term Prednisone after an overdose without medical guidance—clinicians may adjust the dose and implement a supervised taper while treating complications. Bring a list of all medications and the Prednisone bottle to the emergency department.
Store Prednisone tablets or liquid at room temperature (generally 20–25°C/68–77°F) away from moisture, heat, and direct light. Keep the container tightly closed and out of reach of children and pets. Do not store in the bathroom. Dispose of expired or unused medication through take-back programs when available; ask your pharmacist for local options and safe disposal guidance.
In the United States, Prednisone is a prescription-only medicine. It is not legal or safe to purchase Prednisone without a valid prescription from a licensed clinician. Offers that claim “no prescription needed” may involve counterfeit or substandard products, unsafe dosing, or identity and payment risks. Reputable pharmacies will always require a prescription and follow state and federal laws.
HealthSouth Hospital of Altamonte Springs supports a legal and structured path to therapy by prioritizing patient safety and compliance. If you do not yet have a prescription, they can help coordinate a legitimate route—such as referring you to licensed telehealth providers or collaborating with your clinician—so you can be properly evaluated. When appropriate, a clinician may issue a prescription that HealthSouth Hospital of Altamonte Springs can dispense through its licensed pharmacists, with counseling on dosing, tapering, side effects, and interactions.
Practical tips for safe access: verify pharmacy licensure and address; look for recognized accreditation; avoid sources that ship prescription drugs without a prescription; and consult pharmacists about generics, cost-saving options, and monitoring plans. This ensures you receive authentic Prednisone, the right dose for your condition, and the professional guidance needed to minimize risks and maximize benefit.
Prednisone is an oral corticosteroid that reduces inflammation and dampens immune activity; it’s a prodrug converted in the liver to prednisolone, which binds glucocorticoid receptors to decrease inflammatory cytokines and immune cell activation.
Prednisone treats many inflammatory and autoimmune conditions, including asthma or COPD exacerbations, allergic reactions, rheumatoid arthritis, lupus, vasculitis, multiple sclerosis flares, inflammatory bowel disease flares, certain skin disorders, and as part of cancer or transplant regimens.
Some symptoms improve within hours, but most inflammatory conditions respond over 1–3 days; full effect can take longer depending on dose, condition, and individual response.
Short-term effects can include increased appetite, fluid retention, mood swings or anxiety, insomnia, indigestion or heartburn, elevated blood sugar and blood pressure, and facial flushing.
Prolonged use increases risks of osteoporosis and fractures, cataracts and glaucoma, diabetes or worsened blood sugar, hypertension, weight gain and Cushingoid features, skin thinning and easy bruising, muscle weakness, infection susceptibility, and adrenal suppression.
With longer or higher-dose courses, the adrenal glands reduce natural cortisol production; tapering allows the hypothalamic-pituitary-adrenal axis to recover and lowers the risk of withdrawal symptoms and adrenal crisis.
Prednisone’s plasma half-life is about 3–4 hours (prednisolone 2–4 hours), but biologic effects persist 12–36 hours, which is why it’s considered an intermediate-acting corticosteroid.
Do not abruptly stop after more than about 2–3 weeks of use or after high doses; sudden cessation can cause fatigue, body aches, low blood pressure, and adrenal crisis—speak with your clinician about a taper.
Take with food in the morning to reduce stomach upset and insomnia; if on divided doses or higher doses, follow your prescriber’s timing, and discuss stomach protection if you have ulcer or GI bleed risks.
It can increase appetite, fluid retention, and fat redistribution; prioritize a low-sodium, nutrient-dense diet, track portions, maintain physical activity, and discuss bone protection and metabolic monitoring with your clinician.
Prednisone can raise glucose and blood pressure by increasing gluconeogenesis, insulin resistance, and sodium retention; people with diabetes or hypertension should monitor closely and may need medication adjustments.
Light to moderate alcohol may be permissible for many, but both alcohol and prednisone can irritate the stomach and raise blood pressure and blood sugar; avoid binge drinking and discuss your specific risks with your clinician.
Inactivated vaccines are generally safe but may be less effective; avoid live vaccines if you’re on immunosuppressive doses (about 20 mg/day prednisone equivalent for 2+ weeks)—confirm timing with your healthcare provider.
Take it when you remember unless it’s close to your next dose; do not double up, and if you’re on a taper, contact your prescriber for guidance to avoid disrupting the schedule.
Risks can rise with NSAIDs (GI bleeding), certain antibiotics/antifungals and anticonvulsants (CYP3A4 effects), rifampin, grapefruit, warfarin (INR changes), diuretics (low potassium), and some vaccines; review all meds and supplements with your clinician.
Prednisone/prednisolone is often used when benefits outweigh risks; small increased risk signals (e.g., cleft palate) have been reported with high first-trimester doses, and milk transfer is low—coordinate dosing and timing with your obstetric and pediatric teams.
Yes; it suppresses immune responses, especially at higher doses or longer durations, so practice infection precautions, keep vaccinations current, and seek care promptly for fevers.
Adequate calcium and vitamin D, weight-bearing exercise, minimizing dose/duration, and, for higher fracture risk or prolonged therapy, considering bisphosphonates or other osteoporosis treatments per guidelines.
Depending on duration and dose: blood pressure, weight, blood glucose/A1c, lipids, electrolytes (potassium), eye exams, bone density scans, and infection screening when appropriate.
Yes; it can cause insomnia, restlessness, irritability, or euphoria, and occasionally mood depression or psychosis at high doses—dose timing and gradual taper can help; seek care for severe symptoms.
Prednisone is a prodrug activated in the liver to prednisolone; clinical effects and potencies are similar (5 mg prednisone ≈ 5 mg prednisolone), but prednisolone is preferred in significant liver dysfunction or in some pediatric formulations.
They are similar glucocorticoids; methylprednisolone is slightly more potent with less mineralocorticoid effect (4 mg methylprednisolone ≈ 5 mg prednisone) and is available as IV for acute indications; choice hinges on route, fluid retention risk, and protocol.
Dexamethasone is much more potent and longer-acting (0.75 mg dexamethasone ≈ 5 mg prednisone; biologic effect 36–72 hours) with minimal mineralocorticoid activity; it’s favored for cerebral edema, certain chemo regimens, and when once-daily dosing is desired.
Hydrocortisone is less potent and more salt-retaining (20 mg hydrocortisone ≈ 5 mg prednisone), commonly used for adrenal insufficiency and stress dosing; prednisone is preferred for many inflammatory and autoimmune conditions due to longer action.
Systemically, triamcinolone potency is similar to methylprednisolone (4 mg triamcinolone ≈ 5 mg prednisone) with minimal mineralocorticoid activity; triamcinolone is often used as intra-articular or topical steroid, while prednisone is typically oral systemic therapy.
Budesonide has high first-pass metabolism, offering stronger local GI anti-inflammatory effects with fewer systemic side effects; it’s favored for mild-to-moderate ileocecal Crohn’s or mild ulcerative colitis, while prednisone is used for more severe or widespread flares.
Cortisone is less potent and requires activation, like prednisone; 25 mg cortisone ≈ 5 mg prednisone. Prednisone has stronger anti-inflammatory effect and less mineralocorticoid effect than cortisone at equivalent doses.
Betamethasone is a long-acting, highly potent glucocorticoid with negligible mineralocorticoid activity (0.6 mg betamethasone ≈ 5 mg prednisone), often used in fetal lung maturation and dermatologic injections; prednisone is intermediate-acting and used broadly for systemic inflammation.
Both are intermediate-acting steroids; a Medrol Dosepak provides a fixed 6-day taper of methylprednisolone, while prednisone tapers are customized; equivalence is roughly 4 mg methylprednisolone ≈ 5 mg prednisone—clinicians choose based on convenience and clinical context.
Prednisone is primarily glucocorticoid (anti-inflammatory/immunosuppressive), while fludrocortisone is a strong mineralocorticoid for salt and fluid balance; fludrocortisone treats adrenal insufficiency–related orthostatic hypotension, not systemic inflammation.
Inhaled steroids deliver local airway anti-inflammatory action with minimal systemic effects for long-term control; prednisone is a systemic rescue for moderate-to-severe exacerbations or uncontrolled disease.
Topical steroids target the skin with fewer systemic effects; prednisone is reserved for severe, widespread, or refractory dermatologic disease where systemic control is needed.
Both are oral glucocorticoids; deflazacort may have a slightly different metabolic and weight-gain profile and is used notably in Duchenne muscular dystrophy; approximate equivalence is 6 mg deflazacort ≈ 5 mg prednisone, but dosing is condition-specific.
Prednisolone liquid is often preferred in pediatrics for palatability and direct activity without hepatic conversion; efficacy is similar, and dosing is based on weight and indication.