Prednisone is a type of steroid medicine that is used to treat many diseases and conditions, especially those associated with inflammation . These include asthma , Crohn 's disease, leukemia , lupus , lymphoma , multiple sclerosis , psoriasis , rheumatoid arthritis , ulcerative colitis , and many other conditions.
Prednisone reduces inflammation by reducing the activity of the immune system . As beneficial as this effect is, prednisone can also cause side effects, sometimes serious. These include acne , insomnia , mood swings , abnormal hair growth , facial swelling , night sweats , and weight gain .
Using high doses of prednisone for a long time can lead to serious and irreversible complications, such as osteoporosis (weak, porous bones), cataracts (blurry eyes), glaucoma (damage to the optic nerve), and type 2 diabetes .
This article looks at strategies you can use to reduce the risk of prednisone side effects. This includes how to safely stop taking prednisone to avoid stopping the drug.
Why dosage is important
The risk and severity of prednisone side effects increase with the dose and duration of the drug. The higher the dose, the greater the risk of side effects. The longer the treatment takes, the greater the risk of complications.
Prednisone is generally intended for short-term use to slow inflammation and control disease. When this is achieved, the dose is gradually reduced until treatment is finally discontinued. For some conditions, such as autoimmune diseases , other medications, such as biologics , may be prescribed to maintain control of the condition.
Prednisolone is also prescribed in the lowest possible dose to control the disease. However, in some cases this is not possible and higher doses are required. If so, your doctor will weigh the benefits and risks of treatment.
If, for example, you are at risk for osteoporosis , your doctor will need to monitor your condition and may prescribe supplements to protect your bones. If you have certain conditions, such as wide-angle glaucoma , you should avoid taking prednisone simply because the risk is too high.
You are involved in the decision-making process. If you experience any intolerable side effects, tell your doctor. In some cases, the dose can be reduced. In other cases, you may need to stop treatment and study other medications.
The risk of side effects from prednisone increases with the dose and duration of treatment. In general, the lowest possible dose should be used for the shortest possible time to achieve the desired effect. If the side effects are unbearable, your doctor may lower the dose to help relieve them.
Prednisone mimics the hormone cortisol . It is a hormone that the body secretes in times of stress. Cortisone levels are highest in the morning and gradually decrease throughout the day.
To reduce some side effects like insomnia, it should be taken once a day in the morning with breakfast. Taking a dose of prednisone too late at night can affect your sleep.
Preventing side effects
There are ways to reduce the risk or severity of some of the side effects of prednisone. Once you've identified your risk for these side effects, you can take steps to avoid or reduce them.
Anyone who takes prednisone for a long time may experience a decrease in bone density. However, there are certain conditions that increase the risk of osteoporosis, including:
- Family history of osteoporosis
- Advanced age
- Thyroid disease
- Slim frame
- Of smoking
- Drinking strong alcohol
- I do little or no physical activity
If any of this applies to you, talk to your doctor about ways to prevent or delay the loss of bone minerals. This includes a healthy diet rich in calcium , vitamin D , or calcium supplements. and regular exercise, including strength training .
Exercise can also help reduce the risk of prednisone gaining weight. Even with short-term use, prednisone can increase appetite and cause swelling of the face (the so-called "facial effect"). With long-term use, prednisolone can also cause changes in body fat, resulting in fat deposits on the back of the neck or around the abdomen.
Average weight gain with prednisone
Research shows that one in five people who take high doses of prednisone throughout the year gains 22 pounds or more (although the weight tends to stabilize after the first six months). In general, after one year, users gain an average of 4% in weight.
Reducing your salt intake can prevent water retention, which contributes to the appearance of the moon on the face. Controlling your fat and calorie intake can help prevent weight gain. To cope with your increased appetite, keep plenty of low-calorie snacks on hand, including vegetables and fruits. A nutritionist can help.
Exercise and diet can also help reduce the risk of a redistribution of body fat known as lipodystrophy . However, it can be difficult to avoid it if you have been taking prednisone for a long time. Talk to your doctor if you start to notice symptoms of lipodystrophy.
As with other prednisone side effects, the risk of mood symptoms increases with the dose and duration of treatment. Even after two weeks, prednisone can cause irritability in half of all users. Anxiety and depression are also common.
Help prepare for these side effects by letting your family and friends know what to expect and how they can help you. This relieves some of the stress. It can help you recognize mood swings.
Exercise can help burn off some of the stress. It can also help improve mood by triggering the release of feel-good hormones called endorphins . You can also try stress reduction strategies like yoga, meditation, guided imagery, and progressive muscle relaxation.
Getting enough rest is also important. This can be difficult because prednisone can interfere with sleep. One way to deal with this is to improve your sleep hygiene . This includes avoiding food and electronic devices before bed and sleeping in a cool, dark room. Some people also benefit from over-the-counter melatonin supplements .
Safe stopping of prednisone
It is a bad idea to stop taking prednisone abruptly. When you take prednisone, your body doesn't need to make its own natural cortisol. When you stop taking cortisol into the body, it stops working normally. This can lead to withdrawal symptoms such as:
- Joint pain
- Muscle pains
- Nausea or vomiting
To avoid this, doctors will gradually reduce or reduce the dose so that the body can resume its own cortisol production. Depending on the dose and duration of treatment, the dose reduction can last from several weeks to several months.
Your doctor will provide you with a precise dose reduction schedule that will eventually allow you to stop using prednisone altogether.
You should never suddenly stop taking prednisone. This can lead to withdrawal symptoms. To reduce your risk of withdrawal, your doctor will gradually reduce your dose over weeks or months until you can stop taking it completely.
Prednisone is an important drug used to treat many inflammatory conditions. However, it can cause side effects, especially in high doses or with long-term use. To reduce your risk, your doctor will prescribe the lowest dose of prednisone as soon as possible.
You can reduce the risk of some side effects, such as insomnia, if you take the medicine early in the day. Other side effects, such as weight gain, mood swings, and osteoporosis, can be reduced by lifestyle changes, such as diet, exercise, and improved sleep.
You should never suddenly stop taking prednisone; This can lead to withdrawal symptoms. When prednisone is no longer needed, your doctor will prescribe a taper schedule, during which the dose will be gradually reduced until you can stop taking it completely.
Get the word of drug information
Some people feel that the side effects of prednisone outweigh the benefits of treatment. If side effects interfere with your ability to function properly or affect your quality of life, tell your doctor.
There may be other treatments that can help. In some cases, all that may be necessary is a dose reduction. However, it is important that you never adjust your dose or dosing schedule yourself without first talking to your doctor.
Frequently asked questions
Generally, most of the weight gain from steroids is associated with fluid retention. Discuss the benefits of water pills (diuretics) with your doctor and follow a low potassium diet to avoid excess water. Also, keep in mind that your appetite may increase on steroids, but your caloric needs may not, so exercise regularly and eat a balanced diet, avoiding excess calories and fat.
Check with your healthcare provider about dosage to see if changing your medicine or taking it at a different time of day can help with night sweats . Otherwise, your best approach is to control your circumstances:
- Adjust the temperature in the bedroom; use fans to keep air circulating.
- Wear sweat-wicking pajamas .
- Use quick-drying bedding instead of cotton.
- Avoid spicy foods, smoking, and alcohol before bed.
- Reduce your nighttime stress with exercise or a relaxing routine.
Mood swings are a possible side effect of prednisone. Women under the age of 40 are more likely to experience mood swings. It is important to discuss these feelings with your healthcare provider and to avoid suddenly stopping your medication.