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Prednisone Migraine Side Effects: Comprehensive Guide to Short-Term and Serious Reactions

What are the common short-term side effects of prednisone for migraines. How do serious side effects of prednisone manifest. What precautions should patients take when using prednisone for migraine treatment. How does prednisone affect different body systems in migraine patients.

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Understanding Prednisone: A Double-Edged Sword for Migraine Treatment

Prednisone, a powerful corticosteroid, is often prescribed to manage severe migraine attacks. While it can provide relief, it’s crucial to understand its potential side effects. This comprehensive guide delves into both short-term and serious side effects associated with prednisone use in migraine treatment.

Common Short-Term Side Effects of Prednisone in Migraine Patients

When prescribed for migraines, prednisone can cause several short-term side effects. These typically occur within the first few days or weeks of treatment and may vary in severity depending on dosage and individual factors.

  • Nausea and vomiting
  • Increased appetite and weight gain
  • Headaches (ironically, in some cases)
  • Mood changes and irritability
  • Insomnia or fatigue
  • Blurred vision
  • Dizziness
  • Fluid retention and swelling

It’s worth noting that women may be more susceptible to experiencing these side effects. The severity and type can also be influenced by factors such as age, overall health, and concurrent medications.

Serious Side Effects: When Prednisone Poses Greater Risks

While less common, serious side effects can occur with prednisone use, especially with higher doses or long-term therapy. These warrant immediate medical attention and may include:

Allergic Reactions

In rare cases, patients may experience severe allergic reactions to prednisone. Symptoms can include:

  • Hives or skin rashes
  • Difficulty breathing
  • Swelling of the face, lips, or tongue

If any of these symptoms occur, it’s crucial to seek emergency medical care immediately.

Bone Health Concerns

Long-term prednisone use can significantly impact bone health. How does prednisone affect bone density? Studies have shown that up to 40% of patients on prolonged prednisone treatment experience bone loss severe enough to increase fracture risk. Additionally, some patients may develop osteonecrosis, a condition characterized by reduced blood flow to joints, leading to bone tissue death.

Cardiovascular Complications

Prednisone can disrupt electrolyte balance, potentially leading to high blood pressure and heart rhythm irregularities. In some cases, particularly with medium to high doses, patients may develop premature atherosclerosis, a condition where cholesterol builds up in the arteries.

Metabolic and Endocrine Effects of Prednisone in Migraine Treatment

Prednisone’s impact on the body’s metabolic and endocrine systems can be significant, even when used for migraine management.

Cushing Syndrome

Excessive cortisol levels induced by prednisone can trigger Cushing syndrome. This condition manifests as:

  • Redistribution of body fat, particularly around the midsection and face
  • Development of a “buffalo hump” between the shoulder blades
  • Impaired growth in children

Blood Sugar Fluctuations

Prednisone can cause an increase in fasting blood sugar levels, which is particularly concerning for patients with Type 2 diabetes or those at risk for developing diabetes. Regular blood sugar monitoring is essential during prednisone treatment.

Gastrointestinal and Hepatic Concerns with Prednisone Use

The gastrointestinal system is not immune to prednisone’s effects. Patients using this medication for migraine management should be aware of potential GI issues.

Increased Risk of Ulcers and Bleeding

Prednisone use is associated with a higher risk of developing gastric ulcers, gastritis, and gastrointestinal bleeding. This risk is further amplified when prednisone is combined with NSAIDs, a common scenario in migraine treatment. How much does the risk increase? Studies indicate that the risk of GI complications is four times higher when prednisone and NSAIDs are used together.

Liver Impact

In some cases, prednisone can lead to fatty liver disease or contribute to the development of pancreatitis. Regular liver function tests may be necessary for patients on long-term prednisone therapy.

Immunosuppressive Effects and Infection Risk

One of prednisone’s primary mechanisms of action is immunosuppression, which can be a double-edged sword in migraine treatment.

While this effect can help reduce inflammation associated with migraines, it also increases the risk of infections. The risk is particularly high with larger doses used for immunosuppression. Older patients and those taking other immunosuppressive medications are at even greater risk.

What dose of prednisone poses the least infection risk? Generally, doses of 10 mg or lower are associated with the lowest risk of infection. However, even at lower doses, patients should be vigilant about potential signs of infection and report them promptly to their healthcare provider.

Musculoskeletal and Dermatological Side Effects

Prednisone’s impact extends to the muscles and skin, which can be particularly troublesome for migraine patients who may already be dealing with physical discomfort.

Muscle Weakness

Prednisone and other corticosteroids can cause muscle weakness, particularly in the legs and arms. In severe cases, this weakness may necessitate hospitalization. The good news is that this side effect is usually reversible upon discontinuation of the medication and implementation of appropriate exercises.

Skin Changes

Even at low doses, prednisone can cause various skin issues. These may include:

  • Skin thinning
  • Acne outbreaks
  • Excessive hair growth
  • Increased sensitivity to sunlight
  • Slow wound healing

Patients using prednisone for migraine management should be mindful of these potential skin changes and take appropriate precautions, such as using sunscreen and avoiding prolonged sun exposure.

Navigating Different Formulations of Prednisone

Prednisone comes in various formulations, each with its own set of potential side effects. Understanding these differences is crucial for migraine patients and their healthcare providers when choosing the most appropriate treatment option.

Oral Prednisone

The most common form of prednisone is oral tablets. While this formulation is associated with the side effects discussed earlier, it offers flexibility in dosing and is often preferred for migraine treatment.

Liquid Prednisone

Liquid formulations of prednisone can cause specific local side effects, including:

  • Sore mouth
  • Sore throat
  • Stomach pain

These local effects are in addition to the systemic side effects associated with prednisone use.

Other Corticosteroid Formulations

While not prednisone specifically, other corticosteroids used in migraine management or related conditions include:

  • Fluticasone in asthma medications (e.g., Advair), delivered via inhaler
  • Hydrocortisone creams for topical application
  • Methylprednisolone, available in tablet form or as an intravenous formulation for conditions like multiple sclerosis

Each of these formulations has its own side effect profile, which should be considered when prescribing for migraine patients with comorbid conditions.

Strategies for Minimizing Prednisone Side Effects in Migraine Treatment

While prednisone can be an effective tool in managing severe migraines, its side effects can be challenging. Here are some strategies to minimize risks:

  1. Use the lowest effective dose for the shortest duration possible
  2. Take the medication with food to reduce gastrointestinal side effects
  3. Consider calcium and vitamin D supplements to support bone health
  4. Monitor blood pressure and blood sugar regularly
  5. Practice good sleep hygiene to combat insomnia
  6. Maintain a balanced diet to manage weight gain and fluid retention
  7. Engage in regular exercise, as approved by your healthcare provider
  8. Be vigilant about infection prevention, including hand hygiene and avoiding sick contacts
  9. Attend all follow-up appointments and report any new or worsening symptoms promptly

It’s crucial for patients to work closely with their healthcare providers to develop a personalized plan for managing potential side effects while maximizing the benefits of prednisone in migraine treatment.

The Role of Patient Education in Prednisone Use for Migraines

Effective management of prednisone side effects in migraine treatment begins with thorough patient education. Healthcare providers play a crucial role in this process.

Key Points for Patient Education

  • Explanation of expected benefits and potential risks
  • Instructions on proper dosing and administration
  • Signs and symptoms that warrant immediate medical attention
  • Importance of not abruptly discontinuing the medication
  • Potential drug interactions, including with over-the-counter medications
  • Lifestyle modifications to minimize side effects

By empowering patients with knowledge, healthcare providers can improve treatment adherence and outcomes while minimizing the risk of adverse effects.

Alternatives to Prednisone in Migraine Management

Given the potential for side effects, some patients and healthcare providers may explore alternatives to prednisone for migraine management. What are some options?

  • Triptans: Specific migraine medications that target serotonin receptors
  • Ergotamines: Another class of migraine-specific medications
  • Calcitonin gene-related peptide (CGRP) antagonists: A newer class of migraine preventive medications
  • Anticonvulsants: Medications like topiramate that can help prevent migraines
  • Beta-blockers: Originally developed for heart conditions, these can also help prevent migraines
  • Non-pharmacological approaches: Including acupuncture, biofeedback, and lifestyle modifications

The choice of treatment should be individualized based on the patient’s specific migraine pattern, overall health status, and personal preferences. A multidisciplinary approach, potentially involving neurologists, pain specialists, and other healthcare professionals, can help develop the most effective treatment plan while minimizing risks.

Long-Term Considerations for Prednisone Use in Migraine Patients

While prednisone can be effective for short-term management of severe migraines, long-term use requires careful consideration and monitoring.

Bone Health Monitoring

Given the potential for bone loss, patients on long-term prednisone therapy should undergo regular bone density scans. How often should these scans be performed? Generally, a baseline scan is recommended at the start of therapy, with follow-up scans every 1-2 years, depending on individual risk factors.

Adrenal Function

Long-term prednisone use can suppress the body’s natural production of cortisol. This can lead to adrenal insufficiency, especially if the medication is stopped abruptly. Patients should be educated about the importance of tapering off prednisone under medical supervision and the potential need for stress-dose steroids during periods of illness or surgery.

Ocular Health

Prolonged use of prednisone can increase the risk of cataracts and glaucoma. Regular eye exams are essential for patients on long-term therapy.

Cardiovascular Risk Assessment

Given the potential for prednisone to affect blood pressure, cholesterol levels, and overall cardiovascular health, patients should undergo regular cardiovascular risk assessments. This may include lipid panels, blood pressure monitoring, and discussions about lifestyle modifications to mitigate risk.

By carefully weighing the benefits and risks, and implementing appropriate monitoring strategies, healthcare providers can help migraine patients navigate the complex landscape of prednisone therapy. The goal is to maximize the medication’s benefits in managing severe migraines while minimizing the potential for long-term adverse effects.

Short-Term & Serious Side Effects

Common short-term prednisone side effects include nausea, weight gain and headaches. More serious side effects include fetal toxicity, allergic reactions and high blood pressure. Prednisone side effects are more likely to occur with larger doses or long-term therapy.

Common Short-Term Prednisone Side Effects

Common side effects of prednisone tend to be mild, especially with lower doses and short-term use. They may last a few days to a few weeks. If side effects persist or worsen, talk to your doctor or pharmacist.

Women are more likely to experience prednisone side effects, which can vary in severity and type, depending on a person’s overall health, age and other medications they take.


Common prednisone side effects include:

  • Acne

  • Blurred vision

  • Changes in behavior or mood

  • Dizziness

  • Elevated blood pressure levels

  • Elevated blood sugar levels

  • Fluid retention

  • Headache

  • Increased appetite

  • Insomnia or fatigue

  • Nausea

  • Restlessness and inability to stay still (akathisia)

  • Sleep problems

  • Swelling

  • Thinning skin

  • Vomiting

  • Weight gain

Many people take prednisone with only minor side effects — or none — but each method of taking corticosteroids can present its own unique side effects. In its liquid form, prednisone can cause a sore mouth, sore throat and stomach pain.

Other corticosteroids come as inhalers, as topical creams or as IV fluids. Fluticasone in asthma medications, such as Advair, comes in an inhaler. Hydrocortisone often comes as a cream. Methylprednisolone comes in tablet form, but medical providers can also deliver it intravenously for multiple sclerosis patients.

Serious Prednisone Side Effects

The most serious prednisone side effects usually include allergic reactions, infections, gastrointestinal issues and elevated blood sugar. These may occur when people take larger doses or take the medication for long-term treatment.


Some side effects and what to expect from them include:

Allergic Reactions:
The most prevalent reactions are hives, skin rashes, itching, difficulty breathing, and swelling of the lips, tongue or face. If you experience any of these symptoms, contact an urgent-care provider or your local emergency room.

Bone Loss:
One study showed that up to 40% on a long-term treatment of prednisone have enough bone loss to lead to a fracture. People can also experience osteonecrosis, which is death of bone tissue because of reduced blood flow to the joints. This often manifests as hip and knee pain, but it can become severe and may require surgery. Most people lose bone mass within the first six to 12 months of prednisone therapy.

Cardiovascular Issues:
Prednisone can cause irregularities in potassium, calcium and phosphate levels, potentially leading to high blood pressure and heartbeat irregularities. People who take medium-high doses may develop premature atherosclerosis, a buildup of cholesterol in the arteries.

Cushing Syndrome:
Too much cortisol can trigger Cushing syndrome, which redistributes fat within the body. Signs of Cushing syndrome include the distribution of fatty tissue around the midsection, between the shoulder blades and in the face. Children with Cushing syndrome have experienced impaired growth.

Gastrointestinal Problems:
People who take prednisone increase their risk of developing gastric ulcer formation, gastritis and GI bleeding. The risk is four times higher when someone takes prednisone and an NSAID (such as ibuprofen) together. Other side effects include fatty liver and pancreatitis.

High Blood Sugar:
Anyone who takes prednisone should get their blood sugar tested and monitored while taking it. The drug can cause an increase in fasting blood sugar, a side effect especially serious for people with Type 2 diabetes. Blood sugar metabolism usually returns to normal after the medication is stopped.

Infection Risk:
Taking prednisone can increase the chances of developing mild, serious or life-threatening infections. Larger doses increase the risk, especially doses for immunosuppression. Older age and taking other medications that also suppress the immune system increases the risks. Doses of 10 mg or lower pose the least risk.

Muscle Weakness:
Prednisone and other corticosteroids can cause muscle weakness in the legs and arms. Severe cases may require hospitalization. Stopping treatment and performing exercises usually reverses this side effect.

Skin Problems:
Even at low doses, prednisone can cause skin issues. These include skin thinning, acne, excess hair growth (hirsutism), hair thinning, face redness, stripe-like marks on the skin (stria) and impaired wound healing.

Vision Changes:
Blurry vision is the most common eye problem associated with prednisone, but it’s usually not serious. However, the risk of cataracts in both eyes increases for people who take more than 10 mg of prednisone daily for longer than a year. The drug also increases eye pressure, potentially leading to glaucoma or even permanent damage to the optic nerve.

Fetal toxicity is a valid concern for pregnant women who have a medical reason for taking prednisone. Autoimmune diseases, including lupus, rheumatoid arthritis and inflammatory bowel disease, are potentially more damaging to unborn babies than prednisone.

Researchers hint at a small increased risk of babies being born with a cleft lip or without a cleft palate when their mothers took corticosteroids in the first trimester of pregnancy. But medical providers need much more hard research to document fetal toxicity and other issues, such as a link to gestational diabetes, related to prednisone.

Adrenal Insufficiency

Increased cortisol from prednisone (and other corticosteroids) can cause adrenal glands to shut down, leading to adrenal atrophy (wasting away) and adrenal insufficiency. Adrenal insufficiency is when the adrenal glands don’t produce enough hormones.

The condition leads to Addison’s disease, a life-threatening episode characterized by low blood pressure, low levels of blood sugar and high levels of potassium.


Symptoms of adrenal insufficiency include:

  • Abdominal pain

  • Anorexia or weight loss

  • Body pains

  • Diarrhea

  • Fatigue

  • Fever

  • Headache in the morning

  • Nausea

  • Poor growth and weight gain in children

  • Psychiatric symptoms

Addison’s disease presents when damaged adrenal glands produce insufficient amounts of cortisol or aldosterone.

Mental Health Side Effects

Early in treatment (within several days), prednisone may increase feelings of well-being, anxiety, hypomania or mild euphoria. With long-term therapy, however, people may develop depression. Psychosis, referred to as corticosteroid-induced psychosis, can occur at doses of 20 mg or more per day with long-term use.

Mental health issues start within 3 to 4 days after starting prednisone therapy, but they can occur at any time. Some people continue to have symptoms, including depression, even after therapy stops.

Children who get prednisone for acute lymphoblastic leukemia (ALL), may develop mood fluctuations, depression, manic behavior or euphoria. For most, symptoms go away when therapy concludes.

Prednisone Side Effects in Women and Men

Because corticosteroids, such as prednisone, impact hormones, they can affect men and women differently. Women are more likely to develop osteoporosis, a serious side effect from prednisone use. And women who are pregnant, who want to get pregnant or who are breastfeeding should not take prednisone.

For men, prednisone can cause erectile dysfunction and change testosterone levels. Some men reported reduced sperm counts and infertility.

Men and women experience similar side effects, including depression, mood swings and stomach pain. But overall, doctors need more research to understand the specific role of gender in reactions to corticosteroids.

How to Reduce Your Risk of Prednisone Side Effects

The best thing you can do to minimize side effects from taking prednisone is to maintain a healthy lifestyle. That means eating smart, exercising regularly and getting plenty of sleep.

While taking prednisone, you should avoid smoking and drinking alcohol, and add supplements to your diet.

Once you start on a course of prednisone, pay attention to signals your body sends. Weight gain, fluid retention, nausea, mood swings, sleeplessness and overall weakness are signs to watch. This is especially true for someone on a long-term treatment plan. Exercise helps with fluid retention, depression and high blood sugar.


Tips to help you manage, mitigate and reduce the risk of side effects include:

Fluid retention:
While it might seem counterintuitive, drinking more water helps maintain a proper fluid balance and reduce water retention. But if you notice ankle swelling, speak with your doctor.

Gastrointestinal symptoms:
Take your doses of prednisone with some food in your stomach. If the drugs irritate your stomach, mix in antacids for help.

Infection:
Prednisone and other corticosteroids suppress the immune system, which may need a boost. Stay updated on your vaccines, including an annual flu shot and for long-term vaccines and boosters for shingles, tetanus, pneumonia and COVID-19.

Insomnia:
Before relying on sleeping pills, develop a bedtime routine that includes relaxation techniques, such as guided meditation or deep breathing.

Osteoporosis:
Anyone who takes prednisone should increase their sources of calcium from supplements and food groups to offset bone loss. Peas, beans, lentils, almonds, sesame seeds, amaranth, dark leafy greens (such as collard greens and spinach), broccoli and Brussels sprouts are quality sources of calcium.

Weight gain:
Gaining weight while taking prednisone is a genuine concern, especially because one side effect from the medication is increased appetite. Monitor your food intake and develop a regular exercise routine.

Make time for other things you enjoy: reading, writing, fishing, hiking, dancing, crafting, painting, yoga, Pilates and tai chi can help people find balance. Community centers often have free or inexpensive classes several times a week.

How Prednisone Dosage Impacts Side Effects

Dosage and duration are two aspects of your prednisone prescription that affect the likelihood and severity of side effects.

The higher your dose of prednisone, the more likely you are to notice side effects. The same is true if you must take the medication for longer than 30 days. In fact, most side effects stem from long-term use.

Even if you experience negative side effects, don’t stop taking your prednisone. It is a strong medication, and doctors recommend a gradual step-down approach to end the prescription cycle.

Prednisone Side Effects

Please seek the advice of a medical professional before making health care decisions.

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Prednisone oral tablet side effects: Mild to serious

Prednisone (Rayos) is a generic prescription medication, and as with other drugs, it can cause side effects. Prednisone is used to treat certain conditions, including:

  • hormone conditions, such as adrenal insufficiency
  • autoimmune conditions, such as rheumatoid arthritis, lupus, and multiple sclerosis
  • skin conditions, such as Stevens-Johnson syndrome
  • allergic conditions, such as asthma or allergies
  • eye conditions, such as optic neuritis
  • breathing problems, such as pneumonitis
  • blood conditions, such as thrombocytopenia
  • leukemia and lymphoma
  • ulcerative colitis

Your doctor may prescribe prednisone short term or long term, depending on your condition.

Prednisone comes as an oral tablet. The drug also comes as an oral solution but this article does not cover that form. (For details, talk with your doctor.)

Read on to learn about potential common, mild, and serious side effects. For a general overview of this drug, including what prednisone tablets are used for, refer to this article. Your doctor can also tell you more about prednisone.

Prednisone can cause certain side effects (also called adverse effects), some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took the brand-name version of prednisone (Rayos) in clinical trials:

  • edema (swelling due to excess fluid)
  • muscle weakness
  • bloating (swelling due to excess fluid or gas, often in the abdomen)
  • thin skin
  • sweating*

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

Mild side effects can occur with prednisone. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to prednisone’s prescribing information.

Mild side effects that have been reported with prednisone include:

  • edema (swelling due to excess fluid)
  • muscle weakness
  • bloating (swelling due to excess fluid or gas, often in the abdomen)
  • thin skin
  • excitement
  • changes in menstrual bleeding
  • confusion
  • restlessness
  • nausea or vomiting
  • acne
  • moon face*
  • weight gain*
  • headache*
  • sweating*
  • difficulty sleeping*
  • mild allergic reaction*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Prednisone and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

Prednisone may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to prednisone’s prescribing information.

If you develop serious side effects while taking prednisone, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • Heart problems, such as congestive heart failure. Symptoms may include:
    • difficulty breathing
    • swelling in the legs or feet
    • rapid heart rate
  • Mood changes, such as depression. Symptoms may include:
    • feeling sad or hopeless
    • insomnia or sleeping more than usual
    • loss of interest in activities that you typically enjoy
  • Low blood potassium level. Symptoms may include:
    • constipation
    • fatigue
    • heart palpitations
  • High blood pressure. Symptoms may include:
    • headache
    • shortness of breath
    • anxiety
  • Infection. Symptoms may include:
    • fever
    • sore throat
    • cough
  • Osteoporosis or bone fractures. Symptoms may include:
    • back pain
    • swelling or bruising
    • pain or numbness
  • Stomach ulcers. Symptoms may include:
    • abdominal pain
    • bloating
    • nausea
  • Pancreatitis (pancreas inflammation). Symptoms may include:
    • abdominal pain
    • fever
    • nausea or vomiting
  • High blood sugar or diabetes. Symptoms may include:
    • feeling more thirsty than usual
    • unexplained weight loss
    • blurry vision
  • Eye problems, such as cataracts or glaucoma. Symptoms may include:
    • cloudy vision
    • headache
    • blurry vision
  • Severe allergic reaction.*

* For more information about this side effect, see “Prednisone: Side effect specifics” below.

In most cases, side effects in children taking prednisone are similar to side effects in adults taking the drug.

However, prednisone may cause decreased growth in children who take the drug. This may mean that if your child is taking prednisone, especially if they take the drug for a long time, they may not grow as tall.

Due to this risk, your doctor may monitor your child’s growth while they’re taking prednisone. If you have additional concerns about side effects that may occur while your child is taking prednisone, talk with their doctor.

Prednisone may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Will stopping prednisone treatment cause withdrawal symptoms?

It’s possible that stopping prednisone treatment suddenly can cause withdrawal symptoms. These are symptoms that occur when your body becomes used to a medication and you suddenly stop taking it. Symptoms may include fatigue or changes in mood, such as depression.

To help prevent prednisone side effects of withdrawal, your doctor may taper your dosage. This means following a schedule that slowly reduces your dosage of the drug over time. The goal is to gradually help your body adjust to a lower level of prednisone, which may help reduce the risk of withdrawal symptoms.

It’s important that you do not stop taking prednisone without consulting your doctor. If you’re thinking about ending your treatment, be sure to talk with your doctor first. They can recommend the best way to stop treatment and reduce your risk of withdrawal symptoms.

I’m taking prednisone for an allergic reaction. What side effects can I expect?

If you’re taking prednisone to treat an allergic reaction, you’ll likely experience the same side effects as people taking the drug for other uses. Because treatment of allergic reactions is typically short term, you may be at a lower risk of side effects such as moon face or weight gain. (These tend to occur with long-term prednisone treatment.)

For more information on the possible side effects of prednisone, see the more common, mild, and serious side effect lists above. You can also talk with your doctor or pharmacist.

Do prednisone’s side effects vary depending on the dose I take, such as 10 mg or 20 mg?

Yes, it’s possible for the side effects of prednisone to vary based on your dose. If you take a higher dose of medication, your body is exposed to more of the drug. And when you have more prednisone in your body, side effects may be more likely to occur.

For example, the risk of side effects with a 20-milligram (mg) dose of prednisone is higher than with a 10-mg dose.

Before starting prednisone treatment, you may want to talk with your doctor about your risk of side effects and what dose is right for you.

Are there long-term side effects of prednisone?

Prednisone may cause long-term side effects. However, these weren’t common in clinical trials of the brand-name version of prednisone (Rayos). Examples of long-term side effects that may occur during your treatment with prednisone can include:

  • heart problems, such as congestive heart failure
  • high blood pressure
  • osteoporosis or bone fractures
  • stomach ulcers
  • eye problems, such as cataracts or glaucoma

For symptoms, see “Prednisone: Serious side effects” above. If you’re concerned about long-term side effects with prednisone, talk with your doctor before starting treatment.

Does prednisone cause constipation?

It’s not likely that you’ll experience constipation from taking prednisone. In clinical trials, constipation was not reported as a side effect of the drug.

However, constipation may be a symptom of a side effect of prednisone: a low level of potassium in the blood.

If you become constipated during your treatment with prednisone, talk with your doctor. They can help determine the cause. This may include ordering a blood test to measure the level of potassium in your blood. If it’s low, your doctor can recommend an appropriate treatment.

Most side effects of prednisone are similar in males and females.* However, this medication may cause changes in menstrual bleeding in females. For example, taking prednisone may cause irregular periods or periods that are heavier than usual.

If you have questions about side effects that prednisone may cause in males or females, talk with your doctor.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Learn more about some of the side effects that prednisone may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for prednisone.

Moon face

Prednisone may cause a condition called moon face, in which your face becomes rounder. It can happen when excess fluid or fat makes your face look round or puffy. The condition isn’t harmful. However, some people may not like the change in their appearance.

Moon face can occur with long-term use of steroid drugs such as prednisone. Clinical trials of the medication didn’t report how often this side effect occurred.

What you can do

To help prevent moon face, your doctor may prescribe prednisone for the shortest amount of time possible to treat your condition.

If you notice that your face looks round or puffy while taking prednisone, talk with your doctor. They can suggest treatment options, such as consuming less salt to help reduce puffiness. Or they may recommend a drug other than prednisone.

Weight gain

It’s possible for prednisone to cause weight gain. In fact, weight gain was one of the most common side effects reported in people taking a brand-name version of prednisone called Rayos.

Prednisone is a generic drug that comes as an immediate-release tablet. It starts working right away. Rayos comes as a delayed-release tablet. With this form, the release of the drug is delayed for a time, so its effects occur later.

What you can do

If you gain weight during your treatment with prednisone, talk with your doctor. They can help determine the cause. Weight gain can be due to conditions such as heart problems, which are a possible side effect of prednisone. Your doctor can also recommend ways to manage your weight.

Headache

Headaches may occur with prednisone. It wasn’t reported how often this side effect happened in clinical trials of people taking prednisone.

What you can do

If you have headaches while taking prednisone, talk with your doctor. They may be able to recommend a headache treatment. An example is the over-the-counter (OTC) medication acetaminophen (Tylenol). An OTC drug is one that you can purchase without a doctor’s prescription.

Sweating

Increased sweating is a possible side effect of prednisone treatment. Clinical trials of the drug didn’t report how frequently sweating occurred.

What you can do

If you’re sweating more than usual while taking prednisone, be sure to talk with your doctor. They may be able to suggest ways to manage this side effect, such as wearing clothing that keeps moisture away from the skin. You can find other tips in this article.

Difficulty sleeping

It’s possible for prednisone to cause trouble sleeping. It wasn’t reported how often difficulty sleeping occurred in clinical trials. Difficulty sleeping may also be called insomnia. This may be trouble falling asleep or trouble staying asleep throughout the night.

What you can do

If you’re not sleeping well while taking prednisone, talk with your doctor. If you take prednisone once daily, your doctor may recommend taking your dose early in the morning. This could make it less likely that the drug will keep you awake at night. Your doctor may also recommend an OTC medication to help with insomnia, such as melatonin.

Allergic reaction

As with most drugs, prednisone can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking prednisone. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take prednisone. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered to be drug-condition or drug-factor interactions. The conditions and factors to consider include:

Active infections. Before starting prednisone treatment, tell your doctor if you have an active infection (one that’s causing symptoms). This medication can weaken your immune system. If you have an untreated infection, taking prednisone may worsen it. Your doctor will likely treat your infection before prescribing prednisone.

Heart disease. If you have heart disease, tell your doctor before taking prednisone. This medication can cause certain heart problems, such as congestive heart failure. If you already have heart disease, taking prednisone may worsen it. So your doctor may monitor your heart more often than usual while you take prednisone. It’s also possible that they may recommend a different treatment option.

Kidney problems. Prednisone is removed from your body by your kidneys. If your kidneys aren’t working correctly, the drug can build up in your body. If you have a kidney problem, tell your doctor before starting prednisone treatment. Your doctor may monitor your kidneys while you take the medication.

Allergic reaction. If you’ve had an allergic reaction to prednisone or any of its ingredients, your doctor will likely not prescribe prednisone. Taking prednisone could cause you to have another allergic reaction. Ask your doctor what other medications may be better options for you.

Eye problems. Before starting prednisone treatment, tell your doctor if you have any eye conditions, such as glaucoma. This medication may increase your risk of certain eye conditions, including glaucoma and cataracts. If you already have such a condition, taking prednisone may worsen it. Because of this, your doctor may monitor your eyes more often than usual when you take prednisone. In some situations, they may recommend a different treatment.

Stomach or intestinal problems. It’s possible for prednisone to cause stomach or intestinal problems, such as ulcers. If you already have a condition that affects your stomach or intestines, tell your doctor before starting prednisone treatment. Taking the drug can worsen it. Your doctor can advise you on whether prednisone is safe for you.

Mood problems. If you have any mood conditions, such as depression, tell your doctor before taking prednisone. This medication may increase your risk of mood problems. If you already have a mood condition, taking prednisone can worsen it. Your doctor may monitor your mood more frequently than usual. In some situations, they may recommend a different treatment option.

Alcohol with prednisone

There aren’t any known interactions between alcohol and prednisone. However, it’s possible that drinking alcohol while taking prednisone could increase your risk of certain side effects. For example, both alcohol and prednisone can cause:

  • nausea
  • vomiting
  • headache
  • confusion
  • pancreatitis (pancreas inflammation)

If you drink alcohol during prednisone treatment, these side effects could be more likely to occur. Your doctor can help determine whether it’s safe for you to consume alcohol while taking prednisone.

Pregnancy and breastfeeding while taking prednisone

Here’s some information about pregnancy, breastfeeding, and prednisone.

Pregnancy. Your doctor may recommend that you do not take prednisone while pregnant.

Prednisone may cause harm to a developing fetus if it’s taken during pregnancy. The drug can cause cleft palate and decreased birth weight. In addition, babies may have hormone problems, such as low levels of adrenal hormones, once they’re born. This could cause problems such as fatigue and trouble feeding. Your doctor may monitor your newborn for symptoms of low hormone levels if you took prednisone while pregnant.

If you’re pregnant or planning to become pregnant, talk with your doctor. They can help determine the right treatment option for you.

Breastfeeding. It’s unknown whether it’s safe to take prednisone while breastfeeding.

It’s not known whether prednisone (a type of steroid) passes into breast milk or what effects the drug may have on a breastfed child. However, another steroid drug called prednisolone does pass into breast milk. This means that a child who is breastfed would be exposed to the drug. Prednisolone did not cause negative effects in children.

If you’re breastfeeding or thinking about it, talk with your doctor. They can help determine whether prednisone is right for you. Your doctor can also advise you on ways to feed your child.

Prednisone may cause side effects. However, most of them are mild. It’s possible to develop serious side effects from this medication as well. If you do, be sure to talk with your doctor.

If you’d like to learn more about prednisone, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug. Referring to the following articles about prednisone can provide you with additional information:

  • More information about prednisone. For details about other aspects of prednisone, refer to this article.
  • Drug comparison. To learn how prednisone compares with methylprednisolone, read this article.
  • Cost. If you’d like to learn about prednisone and cost, see this article.
  • A look at your condition. For details about some of the conditions prednisone treats, you can see our:
    • rheumatoid arthritis hub
    • dermatology hub
    • asthma and allergies hub
    • eye health hub
    • leukemia and cancer hubs
    • inflammatory bowel disease hub for information about ulcerative colitis

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Migraine – a directory of diseases – HealthInfo

Migraine cannot be cured, but a doctor can help relieve your condition.

Many drugs have been developed specifically for the treatment of migraine. In addition, some drugs used for other purposes can also relieve or prevent migraine symptoms. Medicines used for migraine are divided into two large groups:

  • Painkillers. These are drugs for the rapid relief of developing symptoms – they are used during an attack of pain.
  • Medicines to prevent migraine attacks. These drugs are taken regularly, often daily, to reduce the severity and frequency of attacks.

The choice of treatment depends on the frequency and severity of headaches, how much the headache interferes with your daily activities, and your other medical conditions.

Some drugs are not recommended for pregnant and lactating women. Some drugs should not be given to children. Your doctor will help you find the most suitable medicine for you.


Painkillers

For maximum effect, take painkillers as soon as you notice the signs of a migraine. It is also helpful to rest or sleep in a dark room after taking these drugs. This group of drugs includes:

  • Ordinary painkillers. Aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may relieve the symptoms of mild migraine. Also helps some people with mild migraine paracetamol . Combinations with painkillers that are made specifically for the treatment of migraine, such as paracetamol + aspirin + caffeine , can also help with non-severe migraine, however, they do not help with severe migraine. The prescription drug indomethacin can relieve migraine headaches and is available as a rectal suppository, which is convenient if you experience nausea.
  • Triptans. Many people with migraine use triptans for treatment. They cause spasm of blood vessels and block the transmission of pain impulses in the brain. They effectively reduce pain and other migraine symptoms. This group includes Cermatipan , Risatricipatan , Alraotriptan, Naratriptan , Zolimitriptan , Froveitriptan and Eletripan . Some triptans are available as nasal sprays and injections in addition to the tablet form. Side effects of triptans include nausea, dizziness, drowsiness, and muscle weakness. They are not recommended for people at high risk of stroke and heart attack . The combination of sumatriptan and naproxen sodium in one tablet has been shown to be more effective in reducing migraine symptoms than sumatriptan alone.
  • Ergots. The combination of ergotamine and caffeine is less effective than triptans. Ergots seem to be more effective for those people whose headache lasts more than 48 hours. Ergotamine can increase the nausea and vomiting associated with migraines and has other side effects. In addition, it can cause headaches associated with the use of drugs. Dihydroergotamine is an ergotamine derivative that has fewer side effects. It is available as a nasal spray and injection. This drug causes fewer adverse reactions than ergotamine and is less likely to be complicated by medication-induced headaches.
  • Antiemetics. Because migraines are often accompanied by nausea, with or without vomiting, antiemetics may be used. They are often combined with other medicines. chlorpromazine , metoclopramide and prochlorperazine are often prescribed.
  • Opioids. Opioid preparations containing narcotic substances, in particular codeine , are sometimes used to treat migraine if the patient cannot take triptans and ergots. Narcotic drugs can be addictive, so they are used only as a last resort.
  • Glucocorticoids ( prednisone , dexamethasone ). Glucocorticoids can be used in combination with other drugs to enhance the analgesic effect. Because of the risk of side effects, glucocorticoids should not be used frequently.


Medicines to prevent migraine attacks

You may be offered medicines to prevent attacks if you have 4 or more debilitating migraine attacks per month, if the attack lasts more than 12 hours, if pain medication does not help, or if you have prolonged aura, numbness, or weakness.

These drugs reduce the frequency, severity, and duration of migraine attacks and may increase the effectiveness of symptomatic medications used during an attack.

Your doctor may recommend that you take these drugs every day or just before an event that triggers a seizure, such as your period.

In most cases, these medicines do not completely stop the seizures, and some of them have serious side effects. If you are responding well to these medications, your doctor may suggest reducing your intake to see if your migraine will return in their absence.

To prevent or reduce the frequency of migraines, take these drugs as directed by your doctor:

  • Cardiovascular drugs. Beta-blockers, which are widely used to treat high blood pressure and coronary atherosclerosis, may reduce the frequency and severity of migraine. The effectiveness of propranolol, metoprolol tartrate and timolol has been proven. Other beta-blockers are also sometimes used to treat migraines. During the first few weeks of taking it, you may not notice any improvement. If you are over 60, smoke, or have heart or vascular disease, your doctor may recommend taking other medications instead of beta-blockers. Another class of drugs (calcium channel blockers), which are used to treat high blood pressure and to control the degree of narrowing of the arteries, may also be useful in preventing migraines and relieving their symptoms. In this case, verapamil can help. In addition, lisinopril, an ACE inhibitor, may be helpful in reducing the duration and severity of migraines. Researchers don’t know why these particular drugs prevent migraine attacks.
  • Antidepressants. Some antidepressants help prevent some forms of headaches, including migraines. Tricyclic antidepressants have this effect. And you don’t have to be depressed to benefit from these drugs. Tricyclic antidepressants can reduce the frequency of migraine attacks by affecting levels of serotonin and other brain chemicals. The only tricyclic antidepressant that has been shown to be effective in preventing migraine is amitriptyline. Other tricyclic antidepressants may also be used as they have less side effects. These drugs can cause dry mouth, constipation, weight gain, and other side effects. Another class of antidepressants, serotonin reuptake inhibitors, have not been shown to be effective in preventing migraine attacks. However, researchers believe that one of the serotonin-norepinephrine reuptake inhibitors, venlafaxine, may prevent migraine attacks.
  • Anticonvulsants. Some anticonvulsants, such as sodium valproate and topiramate, seem to reduce the frequency of migraines. However, these drugs can cause side effects at high doses. Sodium valproate causes nausea, tremors, weight gain, hair loss, and drowsiness. Valproate compounds should not be taken by pregnant women. Topiramate can cause diarrhea, nausea, weight gain, impaired memory and concentration.
  • Botulinum toxin. Botulinum toxin (Botox) has been shown to be effective in the treatment of chronic migraine in adults. During this procedure, botulinum toxin (Botox) is injected into the muscles of the forehead and neck. If the treatment has been effective, then it should be repeated every 12 weeks.
  • Painkillers. Taking NSAIDs, especially naproxen, may prevent migraine attacks and reduce symptoms.

HEADACHE – Hadassah Medical Moscow

Traditional migraine therapy consists of behavioral therapy, relief of an already developed attack and preventive treatment aimed at preventing attacks. Behavioral therapy, a necessary step in effective patient management, is carried out during a conversation with the patient and includes: explaining the benign nature of migraine, dissuading the presence of an organic disease, discussing the role of attack triggers and the need to avoid them, risk factors for migraine chronicity (taking a large number of painkillers, stress, psycho-emotional states), as well as substantiating treatment tactics (mechanisms of action of prescribed drugs).

Treatment of a migraine attack is prescribed depending on its intensity and the degree of maladaptation of the patient. With infrequent attacks of mild or moderate intensity, simple or combined analgesics are indicated; with severe nausea and vomiting – antiemetics. With a high intensity of pain and significant maladaptation, triptans are prescribed.

New groups of drugs for the relief of migraine attacks are now approved in the world. This, in turn, enables doctors to treat their patients more effectively, and for patients to reduce the number of days with a headache, improve quality of life, sleep, mood and performance.

Lasmiditan is a selective serotonin 1F receptor agonist that does not have vasoconstrictive activity. The role of lasmiditan in clinical practice has not yet been determined, but it is probably best suited for patients with relative contraindications to triptans due to cardiovascular risk factors.

In October 2019, the US Food and Drug Administration (FDA) approved lasmiditan oral tablets for the treatment of acute migraine in adults. The drug is currently not registered in the Russian Federation.

CGRP antagonists (Rimegepant and Ubrogepant) Monoclonal antibodies directed against the CGRP receptor or ligand. These are oral options available for the acute treatment of migraine in patients with insufficient response or contraindications (eg coronary artery disease) to triptan treatment.

Ubrogepant received US Food and Drug Administration (FDA) approval for the treatment of acute migraine in adults in December 2019year, and rimegepant received a similar FDA approval in February 2020. This group of drugs is not registered in the territory of the Russian Federation.

Preventive therapy is aimed at reducing the frequency, duration, intensity of attacks, the number of doses of painkillers and improving the quality of life of patients.

The main indications for course treatment: the frequency of days with GB> 4 per month, the lack of effectiveness of drugs for the relief of migraine attacks, the presence of risk factors for chronic migraine (abuses, depression), prolonged aura (> 60 min).