Prednisone Side Effects: Everything You Need to Know

Despite being an effective treatment for numerous inflammatory diseases, prednisone is linked to both short- and long-term side effects. Nonetheless, if a healthcare provider prescribes prednisone, it's because the benefits outweigh the risks.

Most short-term prednisone side effects, like headaches, nausea, and weight gain, go away once the dose is lowered or the steroid is stopped altogether. Other potential side effects—like vision problems and osteoporosis—may be permanent.

This article discusses the potential side effects of prednisone and when you should call your healthcare provider. It also explains which prednisone side effects are likely to resolve and which ones may not.

Prednisone side effects
Illustration by Brianna Gilmartin, Verywell

What Is Prednisone?

Prednisone is a corticosteroid immunosuppressant, meaning that it works by relieving inflammation and subduing immune system activity. In doing so, prednisone stops the immune system from damaging healthy tissues and cells.

Prednisone is used to treat numerous acute (short-term) and chronic (long-term) health conditions in both adults and children, including:

  • Respiratory illnesses, such as asthma and chronic obstructive pulmonary disease (COPD)
  • Chronic inflammatory diseases, such as inflammatory bowel disease (IBD) and rheumatoid arthritis
  • Neurological conditions, such as myasthenia gravis and muscular dystrophy
  • Certain kidney diseases, such as glomerulosclerosis
  • Organ transplants, in order to prevent or treat organ rejection

In some cases, such as for acute inflammation like an upper respiratory tract infection, the course of prednisone might be short, lasting a few days or weeks.

However, people with IBD or other chronic conditions may find their healthcare providers have prescribed them prednisone for months or even years.

Prednisone Side Effects

While prednisone is very effective, the list of potential prednisone side effects is extensive.

Some common side effects of prednisone include:

  • Acne
  • Bulging eyes
  • Changes in personality
  • Changes in the way fat is distributed around the body
  • Decreased sexual desire
  • Difficulty falling asleep or staying asleep
  • Dizziness
  • Extreme changes in mood
  • Extreme tiredness
  • "Face mooning," in which the face takes on a swollen, moon-like shape
  • Fragile skin
  • Heartburn
  • Headache
  • Inappropriate happiness
  • Increased hair growth, known as hirsutism
  • Increased sweating
  • Irregular or absent menstrual periods
  • Red or purple blotches or lines under the skin
  • Slowed healing of cuts and bruises
  • Weak muscles

A short course of 10 milligrams (mg) of prednisone a day may not cause side effects. In fact, the body naturally produces a substance equivalent to about 5 mg of prednisone.

However, a dosage of 10 to 20 mg a day for a month or more—or a dosage of more than 20 mg a day for any length of time—could. As the prednisone dosage is tapered down below 10 mg a day and eventually discontinued, the temporary side effects should lessen and reverse.

Tapering off of prednisone too quickly can cause its own side effects, including a return of your symptoms, headaches, dizziness, weakness, mood swings, and more.

Make sure to discuss the potential short- and long-term side effects with your healthcare provider. If you experience any prednisone side effects, or if you have side effects that do not go away, let your provider know.

Serious Prednisone Side Effects

Call your healthcare provider immediately or go to the emergency room if you experience any of the following:

  • Confusion
  • Depression
  • Difficulty breathing or swallowing
  • Dry, hacking cough
  • Eye pain, redness, or tearing
  • Hives
  • Irregular heartbeat
  • Itching
  • Lightheadedness
  • Loss of contact with reality
  • Muscle twitching or tightening
  • Numbness, burning, or tingling in the face, arms, legs, feet, or hands
  • Rash
  • Seizures
  • Shaking of the hands that you cannot control
  • Shortness of breath, especially during the night
  • Sore throat, fever, chills, cough, or other signs of infection
  • Sudden weight gain
  • Swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
  • Swelling or pain in the stomach
  • Upset stomach
  • Vision problems
  • Vomiting

Long-Term Prednisone Side Effects

It should be noted that some potential adverse effects of prednisone are permanent, and discontinuing the drug will not reverse them. These include:

  • Glaucoma
  • Cataracts
  • Osteoporosis (bone weakness)
  • Osteonecrosis (bone death)

The goal of treatment with prednisone is to only use it for as long as it takes to induce remission. Once you are in remission, prednisone can be discontinued and replaced with a "maintenance drug" that causes fewer side effects.

Side Effects in Children and Teens

Potential short-term prednisone side effects in children and teens include:

  • Upset stomach
  • Nausea and vomiting
  • High blood sugar (hyperglycemia)
  • Swelling of the face, feet, or hands
  • High blood pressure (hypertension)
  • Mood swings and depression
  • Insomnia (difficulty sleeping)
  • Increased risk of infections
  • Slowed wound healing
  • Bruises, rashes, and increased risk of sunburn
  • Blood in urine, stools, or vomit
  • Headache
  • Muscle weakness
  • Prolonged sore throat
  • Fever
  • Difficulty breathing

Potential long-term prednisone side effects in children and teens include:

  • Osteoporosis
  • Cataracts
  • Glaucoma
  • Steroid dependency

Although studies are conflicting, there is some evidence that long-term (five years) use of prednisone in children is linked to higher rates of obesity and stunted height, as well as metabolic issues like high blood pressure, high blood sugar, and high cholesterol.

In children and teens as well, sudden withdrawal from prednisone can be life-threatening. Do not take your child off prednisone unless advised by their healthcare provider.

What to Avoid When Taking Prednisone

To reduce your risk of side effects, there are some special precautions to consider when taking prednisone:

Avoid people who are sick. Prednisone may lower your immune system, making it harder for your body to fight off illness and infection. Avoid people who are sick and wash your hands often while taking prednisone. If you are exposed to someone who has chicken pox or measles, call your healthcare provider right away.

Avoid sugary and highly processed foods. Prednisone may raise your blood sugar, which can be dangerous if you have diabetes or are at risk for developing it. When taking prednisone, avoid foods including cakes, honey, chips, and breads.

Avoid salt. Since prednisone causes fluid retention and swelling, you should avoid eating too much salt, which can make the fluid retention worse. Sticking to a low-salt diet should help.

Avoid pregnancy and breastfeeding. Taking prednisone when pregnant can harm the unborn fetus and may travel to infants through breast milk in small amounts. If you become pregnant while taking prednisone, tell your healthcare provider.

Avoid live vaccinations. Prednisone may reduce your body's immune response, causing live-attenuated vaccines to be less effective. Talk to your doctor before taking any vaccinations.

Avoid taking prednisone late in the day. Prednisone may cause you to feel more alert and jittery and may disturb your sleep when taken late in the day. If possible, try to take your prednisone doses first thing in the morning.

Inform you provider if you are taking any medications, including oral birth control, antibiotics, antidepressants, pain relievers and (including over-the-counter drugs), which may interact with prednisone.

Summary

The corticosteroid immunosuppressant drug prednisone is used to treat conditions that cause inflammation and an overactive immune system. It is also linked to a long list of acute and irreversible side effects that can be distressing at best and occasionally life-threatening.

Contact a healthcare provider immediately if you or your child experience new side effects while using prednisone, or have side effects that do not go away.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • MedlinePlus. Prednisone. U.S. National Library of Medicine 1 Sept 2010.
  • UW Medicine. Corticosteroids for Arthritis. University of Washington–Seattle Dec 30 2004.
Amber J. Tresca

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.