Too much prednisolone: Short-Term & Serious Side 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:
Changes in behavior or mood
Elevated blood pressure levels
Elevated blood sugar levels
Insomnia or fatigue
Restlessness and inability to stay still (akathisia)
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.
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
Headache in the morning
Poor growth and weight gain in children
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.
- 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.
- Before relying on sleeping pills, develop a bedtime routine that includes relaxation techniques, such as guided meditation or deep breathing.
- 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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Side effects of prednisolone tablets and liquid
The higher the dose of prednisolone that you take and the longer you take it for, the greater the chance of side effects. You’re less likely to get side effects if you take a relatively low dose of prednisolone daily.
If you have been taking prednisolone for more than a few weeks, check with your doctor before stopping it suddenly to reduce your chances of withdrawal side effects.
Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months.
Common side effects
These common side effects of prednisolone happen in more than 1 in 100 people. There are things you can do to help cope with them:
If you have to take prednisolone for more than a few weeks, it’s likely that you’ll put on weight. Prednisolone can make you hungrier and also can make you retain more water in your body.
Try to eat well without increasing your portion sizes. Regular exercise will also help to keep your weight stable.
Once you stop taking prednisolone, your appetite and the way your body retains water should return to normal.
Take prednisolone with food to reduce the chances of stomach problems. It may also help if you avoid rich or spicy food while you’re taking this medicine.
If symptoms carry on, ask your doctor if you may benefit from taking an additional medicine to protect your stomach.
Problems sleeping (insomnia)
Take prednisolone in the morning so the levels are the lowest at bedtime.
If you’re feeling restless when you’re trying to sleep, take prednisolone in the morning so the levels are the lowest at bedtime.
Sweating a lot
Try wearing loose clothing and use a strong anti-perspirant. If this does not help, talk to your doctor as you may be able to try a different medicine.
Mild mood changes
Prednisolone can affect your mood in different ways. Talk to your doctor if you are finding it hard to cope.
Speak to a doctor or pharmacist if the advice on how to cope does not help and any of these side effects bother you or last more than a few days.
Serious side effects
You are more likely to have a serious side effect if you take a higher dose of prednisolone or if you have been taking it for more than a few weeks.
Call a doctor or call 111 straight away if you get:
- a high temperature, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva (yellowish and possibly with streaks of blood), pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- sleepy or confused, feeling very thirsty or hungry, peeing more often, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar
- weight gain in your upper back or belly, “moon face” (a puffy, rounded face), very bad headaches and slow wound healing – these can be signs of Cushing’s syndrome
- a very upset stomach or you’re being sick (vomiting), very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
- muscle pain or weakness, muscle cramps, or changes in your heart rate – these can be signs of low potassium levels
- severe stomach pain, severe back pain, severe upset stomach or you’re being sick – these can be signs of pancreas problems
- swelling in your arms or legs
- changes in your eyesight
- any bruising or bleeding that is not normal
- red or black poo
Immediate action required: Call 999 or go to A&E if:
You may notice mood changes and mental health problems while taking prednisolone.
Talk to your doctor or contact 111 if you have any mood changes including:
- feeling depressed
- feeling high, or moods that go up and down
- feeling anxious, having problems sleeping, difficulty in thinking, or being confused and losing your memory
- feeling, seeing or hearing things that do not exist (hallucinations)
- having strange and frightening thoughts, changing how you act, or having feelings of being alone
The higher the dose, the more intense the mood changes can be.
Go to 111.nhs.uk or call 111.
Immediate action required: Call 999 or go to A&E if:
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to prednisolone.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
- your throat feels tight or you’re struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Long-term side effects
Taking prednisolone for a long time can lead to side effects such as:
- thinner bones (osteoporosis)
- poorly controlled diabetes
- eyesight problems
- high blood pressure (hypertension)
Children and teenagers
Taking prednisolone at higher doses for a long time can slow down the normal growth of children and teenagers.
Your child’s doctor will monitor their height and weight carefully for as long as they’re taking this medicine. This will help them spot any slowing down of your child’s growth and change their treatment if needed.
Even if your child’s growth slows down, it does not seem to have much effect on their eventual adult height.
Talk to your doctor if you’re worried. They’ll be able to explain the benefits and risks of giving your child prednisolone.
Other side effects
These are not all the side effects of prednisolone. For a full list, see the leaflet inside your medicine packet.
You can report any suspected side effect using the Yellow Card safety scheme.
Visit Yellow Card for further information.
Page last reviewed: 24 February 2022
Next review due: 24 February 2025
Why Gaining Weight Rapidly Diet Menu Recipes
Weight changes are easy to explain if you start eating more (eat more calories) or if you reduce your physical activity (spend fewer calories) – you adjust your diet and / or increase physical activity, and your weight returns.
But what if nothing changes in your life, and the weight grows slowly and inevitably?
Lack of sleep
First, if you stay up late, you are more likely to eat more calories with supposedly small snacks or a glass of wine. For example, 1 chocolate candy = about 60 calories.
Second, if you don’t get enough sleep, your hormone levels can start to change, which in turn can increase hunger and appetite, and decrease satiety. Therefore, you can eat a little more – imperceptibly, but enough to gain weight.
When we feel stressed, our body releases cortisol (the stress hormone), which causes an increase in appetite. And, of course, high-calorie “snacks” at your fingertips. This combination is excellent ground for weight gain.
Some antidepressants have the unpleasant side effect of weight gain. Talk to your doctor about changing your treatment plan if you have reason to believe that an antidepressant you are taking is causing weight gain. But never change or stop taking medications prescribed by your doctor without first talking to your doctor. Some people gain weight after the start of treatment only because they feel better and, as a result, their appetite improves, i.e. the medicine works exactly as you need it, you just need to pay more attention to what and how much you eat. Depression itself can cause weight changes.
Anti-inflammatory steroids such as prednisone may cause weight gain. The main reasons for weight gain in this case are fluid retention and increased appetite. Some people may also experience temporary fat accumulation, such as on the face, abdomen, or buttocks, until they have taken it before. If you have been taking steroids for more than a week, do not stop taking them abruptly, as this can cause more serious problems than weight gain. Talk to your doctor first.
Medicines that can cause weight gain
In addition to steroids, some other prescription medicines can cause weight gain. For example, antipsychotics (used to treat disorders such as schizophrenia and bipolar disorder) and medicines to treat migraines, seizures, high blood pressure, and diabetes. Talk to your doctor to find medications that treat your symptoms and have no side effects for you.
Contrary to popular belief, COCs (estrogen and progestin) do not cause permanent weight gain. It is believed that some women taking COCs may experience weight gain due to fluid retention, but this is usually temporary. If you continue to gain weight, talk to your doctor.
If your thyroid gland does not produce enough of the vital hormones triiodothyronine (T3) and thyroxine (T4), you may gain weight. Possible additional symptoms in this case may be – unexplained fatigue, increased sensitivity to cold, dry skin, swelling of the face, hoarseness, change in voice, muscle weakness, muscle pain,
irregular menstruation, brittle hair, slow heart rate, memory impairment, cognitive impairment. When thyroid hormones are deficient, the metabolism slows down, which increases the chances of weight gain. Hypothyroidism medication treatment can stop weight gain.
Most women gain weight during menopause, but hormonal changes may not be the only cause. As you get older, your metabolism slows down, which means you need fewer calories, and if your eating habits don’t change, you end up with a calorie surplus. Your level of physical activity may also decrease. But if more fat accumulates around the waist than on the hips and thighs, it may indeed be menopause.
Long-term elevated levels of the hormone cortisol can lead to weight gain, a common symptom of Cushing’s syndrome. In this case, obesity is mainly observed on the face and waist. Possible additional symptoms may be – slight bruising on the cheeks, increased appetite, thin limbs, round face, dry skin, weak muscles and bones, acne, stretch marks. ..
Cushing’s syndrome can be acquired:
- You are taking steroids for asthma, arthritis, or lupus erythematosus.
- If your adrenal glands produce too much cortisol.
Polycystic Ovarian Syndrome (PCOS)
Also called Stein-Leventhal syndrome or hyperandrogenic chronic anovulation.
The exact causes of PCOS are unknown, but PCOS occurs due to hormonal or complex metabolic disorders and is mainly associated with insulin resistance.
PCOS is a common hormonal problem in women of childbearing age that affects a woman’s menstrual cycle and can cause extra body hair and acne. Women with this disease are resistant to insulin (the hormone that controls blood sugar), which in turn can lead to weight gain. Fat tends to accumulate around the abdomen, which also increases the risk of heart disease.
You can gain weight by quitting smoking. People who quit smoking gain an average of only 4. 5–5 kg in weight. After a few weeks, your hunger should decrease and your weight should decrease as you reduce your calorie intake.
Tips on how to lose weight
The main thing is not to stress, yes, it may take time, but everything can definitely be fixed. If you are gaining weight, never:
- Do not stop taking your medication without first talking to your doctor, as this can be critical to your health. Keep in mind that there may be other reasons for weight gain, and it is your doctor who can best help you figure them out.
- Do not compare yourself to other people taking the same medicine. Not all people experience the same side effects when taking the same medications. Even if a drug causes someone to lose or gain weight, it is highly likely that it will affect you differently.
- Remember that weight gain often comes from water retention alone – it’s not fat that’s hard to get rid of. When you stop taking the medicine, the swelling caused by fluid retention will decrease. Reduce your salt intake while taking your medication. drink more water – this will help reduce the amount of water retention.
- If you suspect that your weight gain is due to any medication, talk to your doctor. In most cases, your doctor can replace your existing medication with another medication that may not have the same side effects.
- Find out the cause of weight gain. There are only three of them – a slowdown in metabolism, changes in well-being or the effect of drugs. If the reason is a slowdown in metabolism – do not rush metabolic activity.
- Never Turn Someone On a Fast Diet Losing weight quickly will only make things worse and it will take you much more time and effort to regain your weight.
Side effects of steroids
Side effects of steroids
Listed below are some of the most common long-term side effects of high-dose steroids in growing children. It is important to note that different patients may have different reactions to steroids. The key to successful steroid treatment is being aware of the potential side effects and working to prevent them. Reducing the dosage of steroids is necessary when the development of side effects is intolerable for the patient and inspires concern in the doctor. If the development of side effects cannot be corrected by reducing the dose or changing the regimen of taking the drug, then it is recommended to abandon the course of steroid treatment as a whole.
- Side effects of taking steroids
- Comments and recommended observation
- Issues to be resolved and discussed with your therapist
- General and external, Weight gain, Obesity
- Dietary advice should be given to all families before starting steroid therapy. It should be noted that steroids increase appetite.
- Nutrition must be balanced to prevent weight gain. Follow diet and nutrition recommendations for the whole family.
- Cushingoid features (moon face)
- The fullness of the face and cheeks becomes more noticeable over time.
- Careful adherence to a dietary regimen, limiting sugar and salt intake should help control weight gain and minimize Cushingoid symptoms.
- Increased hairiness (hirsutism)
- Clinical examination.
- The occurrence of this effect is not a sufficiently serious reason to refuse a course of steroid treatment.
- Acne, ringworm, papillomas
- More common in adolescents.
- Get a special treatment (temporary treatment) and do not rush to change your steroid regimen.
- Slow growth
- Monitor the patient’s growth at least every 6 months (usually patients with DMD have low stature, even those who are not on steroid therapy).
- Ask your son if he is worried about his short stature. If you are worried, discuss with your doctor the need for an examination by an endocrinologist.
- Delayed puberty
- Development monitoring. Find out about a family history of late puberty.
- Discuss the issue of puberty. Ask your son if he is worried about delayed puberty. If your son is concerned, discuss with the doctor the issue of examination by an endocrinologist.
- Adverse behavioral disorders (here you will find many recommendations on this topic)
- Determine initially: general mood, temperament, attention deficit hyperactivity disorder. Keep in mind that all of these parameters may experience deterioration temporarily for the first 6 weeks of steroid therapy.
- Consult a psychologist before starting steroid treatment if the child has behavioral problems. Changing your prednisolone regimen later in the day may help. Discuss this issue with your doctor.
- Immunosuppression / adrenocorticosteroid deficiency
- Be aware of the increased risk of infectious diseases and the need for timely treatment. Inform all medical personnel that the child is taking steroids and carry an individual patient record with you. Make sure you don’t stop taking steroids. It is very important that a patient on permanent steroid treatment does not allow pauses in taking the drug for a period of more than 24 hours.
- Get vaccinated against varicella before starting steroid therapy; If vaccination is not performed, in case of accidental contact of the patient with patients with chickenpox, you should immediately consult a doctor. If there is a threat of contracting tuberculosis, special monitoring may be necessary. Discuss with your doctor what to do if you have to stop taking steroids, such as replacing prednisone with an equivalent if deflazacort is temporarily unavailable, or whether you need an IV during an illness or nutritional deficiency. Discuss intravenous loading of methylprednisolone for surgery or underlying disease. Use droppers for parenteral nutrition.
- Increased blood pressure
- Blood pressure measurement at every clinic visit.
- If you have high blood pressure, limit your salt intake and aim for weight loss. If this does not lead to the desired result, then the doctor should prescribe ACE inhibitors or beta-blockers.
- Impaired glucose tolerance
- Urinalysis for glucose with rapid test with impregnated substrate. Consult a specialist for frequent urination or increased thirst.
- Blood tests may be needed if the level of glucose in the urine increases.
- Gastritis / gastroesophageal reflux
- Watch out for reflux symptoms (heartburn).
- Avoid non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, naproxen. To eliminate the symptoms, you can take specific medications and antacids.
- Peptic ulcer
- Abdominal pain may be due to damage to the gastric mucosa. Get a fecal occult blood test if you have anemia or a history of aggravation.
- Avoid NSAIDs (aspirin, ibuprofen, naproxen). Medications and antacids should be taken symptomatically. Seek advice from a gastroenterologist.
- Annual eye examination.
- If cataract develops and affects vision, consider switching from deflazacort to prednisolone. Seek advice from an ophthalmologist. Cataracts should only be treated if there is visual impairment.
- Osteoporosis (bone demineralization) and increased risk of fractures
- Note any history of fractures. An annual bone density test (DEXA) is recommended. Annual analysis of the level of vitamin D in the blood (ideally at the end of winter). With a decrease in its level, add vitamin D3. The doctor should assess the intake of calcium and vitamin D.
- Vitamin D supplements may be required depending on blood levels. After 3 months of treatment with vitamin D, recheck the level of vitamin D in the blood. Aerobic exercise may help. Make sure you get enough calcium in your diet, otherwise special supplements may be needed.
- Myoglobinuria (The color of the urine is brown, because it contains breakdown products of muscle proteins.