Prednisone: Uses, Doses, and Side Effects

It is a synthetic oral corticosteroid used to suppress the immune system and inflammation. It has similar effects to other corticosteroids such as:

  • Triamcinolona (Kenacort).
  • Metilprednisolona (Medrol).
  • Prednisone (Prelone).
  • Dexamethasone (Decadron).

These synthetic corticosteroids mimic the action of cortisol ( hydrocortisone ), the naturally-occurring corticosteroid produced in the body by the adrenal glands.

Corticosteroids have many effects on the body but are more often used for their potent anti-inflammatory effects, particularly in those diseases and conditions in which the immune system plays an important role, for example, arthritis, colitis, asthma, bronchitis, problems of skin and allergies.

Prednisone is inactive in the body, and to be effective, it must be converted to prednisolone by enzymes in the liver.

Therefore, prednisone may not work as effectively in people with liver disease whose ability to convert prednisone to prednisolone is affected. The FDA approved prednisone in 1955.

What diseases and conditions does prednisone (uses) treat?

Prednisone is used to treat inflammatory conditions or diseases in which the immune system plays an important role. Since this drug is used to treat and manage so many diseases and conditions, only the most common or FDA-approved uses are listed.

The treatment of:


  • Leukemia.
  • Lymphomas
  • Idiopathic thrombocytopenic purpura.
  • Autoimmune hemolytic anemia.
  • Bronchitis.

Corticosteroids, including prednisone, are commonly used to suppress the immune system and prevent the body from rejecting transplanted organs. Also, prednisone is used as replacement therapy in patients whose adrenal glands can not produce sufficient amounts of cortisol.

What is the dose of prednisone, and how should it be taken?

The initial prednisone dose varies depending on the disease being treated and the patient’s age. It is recommended that you take this medication with food.

The initial dose can be from 5 mg to 60 mg per day and is often based on the response of the disease or condition being treated.

Corticosteroids usually do not produce immediate effects and should be used for several days before the maximum results are seen. It can take much longer before conditions respond to treatment.

When prednisone is stopped after a prolonged period of therapy, the dose of prednisone should be gradually reduced (gradually decreased) to allow the adrenal glands to recover time.

How should prednisone be decreased, and what are the symptoms and signs of abstinence?

Patients should be withdrawn slowly from prednisone.

Withdrawal from prednisone after prolonged use causes side effects. The adrenal glands can not produce enough cortisol to compensate for departure, and symptoms of corticosteroid insufficiency ( suprarenal crisis ) may occur.

These symptoms include:

  • Nausea.
  • He retched.
  • Weakness.
  • Fatigue.
  • Decreased appetite.
  • Weightloss.
  • Diarrhea.
  • Abdominal pain.

Therefore, weaning from prednisone should occur gradually so that the adrenal glands have time to recover and resume cortisol production.

Until the glands recover entirely, it may be necessary to treat patients who have recently discontinued corticosteroids with a short course of corticosteroids during times of stress (infection, surgery, etc.), times when corticosteroids are particularly important for the body.

Is this medication available in generic form?

Yes, prednisone is available in generic form.

Do I need a prescription for this medication?

Yes, it would help if you had a prescription from your doctor or another medical professional to obtain this medication.

Side effects of prednisone and adverse events

The side effects of prednisone and other corticosteroids range from mild discomfort to severe and 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.
  • Muscular weakness.
  • Nausea.
  • He retched.
  • Acne.
  • Restlessness.
  • Problems to sleep.

Serious side effects include:

  • Swelling of the face
  • Facial hair growth.
  • Thinning and easy bruising of the skin.
  • Deterioration of wound healing.
  • Glaucoma.
  • Waterfalls.
  • Ulcers in the stomach and duodenum.
  • Worsening of diabetes
  • Irregular menstruation.
  • Rounding the upper part of the back (“buffalo hump”).
  • Obesity.
  • Delay of growth in children.
  • Convulsions
  • Anaphylaxis (severe allergic reactions such as hives, itching, rash, swollen lips/tongue/face).
  • Changes in vision
  • Congestive heart failure.
  • Heart attack.
  • Pulmonary edema.
  • Syncope.
  • Tachycardia.
  • Thrombophlebitis.
  • Vasculitis.
  • Allergic dermatitis.
  • Low blood pressure .
  • Amenorrhea (affects menstruation).
  • Diabetes of new beginning.
  • Hyperglycemia
  • Hypothyroidism .
  • Pancreatitis.
  • Anemia.
  • Amnesia.

 This medicine also causes psychiatric disorders, which include:

  • Depression.
  • Euphoria.
  • Insomnia.
  • Humor changes.
  • Changes of personality
  • Psychotic behavior

Other possible serious side effects of this medication include:

Prednisone and diabetes: Prednisone is associated with new manifestations or manifestations of latent diabetes and worsening diabetes. People with diabetes 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 inflammation of the airways (angioedema) that can cause shortness of breath or 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 can cause osteoporosis that causes broken bones. Patients who take prednisone in the long term often receive calcium and vitamin D supplements to counteract the effects on the bones. 

However, calcium and vitamin D are insufficient, and treatment with bisphosphonates such as alendronate (Fosamax) and risedronate (Actonel) may be necessary. Calcitonin (Miacalcin) is also effective. The development of osteoporosis and the need for treatment can be controlled using bone density scanners.

Adrenal insufficiency and weaning off prednisone: the prolonged use of prednisone and other corticosteroids causes the adrenal glands to atrophy (shrink) and stop producing natural corticosteroids of the body, 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 death and degeneration of the hip bone. It is a painful condition that can eventually lead to the need for a surgical hip replacement. 

Aseptic necrosis has also been reported in the knee joints. The estimated incidence of aseptic necrosis among long-term users of corticosteroids is 3% -4%. 

Patients who take corticosteroids who develop pain in the hips or knees should immediately report the pain to their doctors.