Prednisone Side Effects and Adverse Effects

Prednisone is a drug that belongs to the corticosteroid drug class, and is an anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's disease and ulcerative colitis), lupus, asthma, cancers, and several types of arthritis.

Common side effects are weight gain, headache, fluid retention, and muscle weakness. Other effects and adverse events include glaucoma, cataracts, obesity, facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression, insomnia, mood swings, personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs, infections, and necrosis of the hips and joints.

Corticosteroids like prednisone, have many drug interactions; examples include: estrogens, phenytoin (Dilantin), diuretics, warfarin (Jantoven), alcohol, and diabetes drugs.

Prednisone is available as tablets of 1, 2.5, 10, 20, and 50 mg; extended release tablets of 1, 2, and 5mg; and oral solution of 5mg/5ml.

Its use during the first trimester of pregnancy may cause cleft palate. This medicine is secreted in breast milk and can cause side effects in infants who are nursing.

You should not stop taking prednisone abruptly because it can cause withdrawal symptoms and adrenal failure. Talk with your doctor, pharmacist, or other medical professional if you have questions about prednisone.

If you notice other effects not listed above, contact your doctor or pharmacist.

Side effects of prednisone and other corticosteroids range from mild annoyances to serious, irreversible organ damage, and they occur more frequently with higher doses and more prolonged treatment.

Common side effects include:

• Retention of sodium (salt) and fluid
• Weight gain
• High blood pressure
• Loss of potassium
• Headache
• Muscle weakness
• Nausea
• Vomiting
• Acne
• Thinning skin
• Restlessness
• Problems sleeping

• Hiccups
• Puffiness of the face (moon face)
• Growth of facial hair
• Thinning and easy bruising of the skin
• Impaired wound healing
• Glaucoma
• Cataracts
• Ulcers in the stomach and duodenum
• Worsening of diabetes
• Irregular menses
• Rounding of the upper back ("buffalo hump")
• Obesity
• Retardation of growth in children
• Convulsions
• Anaphylaxis (severe allergic reactions like hives, itching, skin rash, swollen lips/tongue/face)
• Vision changes
• Congestive heart failure
• Heart attack
• Pulmonary edema
• Syncope
• Tachycardia
• Thrombophlebitis
• Vasculitis
• Allergic dermatitis
• Low blood pressure
• Amenorrhea (lack of menstruation)
• Newly onset diabetes
• Hyperglycemia
• Hypothyroidism
• Pancreatitis
• Anemia
• Amnesia

This drug also causes psychiatric disturbances, which include:

• Depression
• Euphoria
• Insomnia
• Mood swings
• Personality changes
• Psychotic behavior

Possible serious side effects of prednisone include the following:

• Prednisone and diabetes: Prednisone is associated with new onset or manifestations of latent diabetes, and worsening of diabetes. Diabetics may require higher doses of diabetes medications while taking prednisone.
• Allergic reaction: Some people may develop a severe allergic reaction (anaphylaxis) to prednisone that includes swelling of the airways (angioedema) that may result in shortness of breath or airway blockage.
• Immune suppression: Prednisone suppresses the immune system and, therefore, increases the frequency or severity of infections and decreases the effectiveness of vaccines and antibiotics.
• Osteoporosis: Prednisone may cause osteoporosis that results in fractures of bones. Patients taking long-term prednisone often receive supplements of calcium and vitamin D to counteract the effects on bones. Calcium and vitamin D probably are not enough, however, and treatment with bisphosphonates such as alendronate (Fosamax) and risedronate (Actonel) may be necessary. Calcitonin (Miacalcin) also is effective. The development of osteoporosis and the need for treatment can be monitored using bone density scans.
• Adrenal insufficiency and weaning off prednisone: Prolonged use of prednisone and other corticosteroids causes the adrenal glands to atrophy (shrink) and stop producing the body's natural corticosteroid, cortisol.
• Necrosis of hips and joints: A serious complication of long-term use of corticosteroids is aseptic necrosis of the hip joints. Aseptic necrosis is a condition in which there is death and degeneration of the hip bone. It is a painful condition that ultimately can lead to the need for surgical replacement of the hip. Aseptic necrosis also has been reported in the knee joints. The estimated incidence of aseptic necrosis among long-term users of corticosteroids is 3%-4%. Patients taking corticosteroids who develop pain in the hips or knees should report the pain to their doctors promptly.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or Health Canada at 1-866-234-2345.

Side effects such as nausea, vomiting, loss of appetite, heartburn, trouble sleeping, increased sweating, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur:

• muscle pain/cramps,
• irregular heartbeat,
• weakness,
• swelling hands/ankles/feet,
• unusual weight gain,
• signs of infection (such as fever, persistent sore throat),
• vision problems (such as blurred vision),
• vomit that looks like coffee grounds,
• black/bloody stools,
• severe stomach/abdominal pain,
• mental/mood changes (such as depression, mood swings, agitation),
• slow wound healing,
• thinning skin,
• bone pain,
• menstrual period changes,
• puffy face,
• seizures,
• easy bruising/bleeding.

This medication may infrequently make your blood sugar level rise, which can cause or worsen diabetes. Tell your doctor right away if you develop symptoms of high blood sugar, such as increased thirst and urination. If you already have diabetes, be sure to check your blood sugars regularly. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

A very serious allergic reaction to this product is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash,
• itching/swelling (especially of the face/tongue/throat),
• severe dizziness,
• trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the U.S. — call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada — call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

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