Prednisolone Side Effects – Introduction
When facing acute asthma exacerbation, systemic corticosteroid therapy is the treatment choice for immediate results and life-saving conditions. For patients with organ transplantation, corticosteroids will help the transplanted organ to be accepted. Prednisolone is a corticosteroid used in these or other medical conditions. (1)
Some of the common side effects of prolonged prednisolone use include: increased blood pressure or blood sugar, slow or stunted growth in children, osteoporosis, or Cushing’s syndrome. (1)
This article explains the most common side effects of prednisolone use. Keep reading to learn about prednisolone side effects and when you need to act immediately.
What Is Prednisolone Used For?
Prednisolone is a corticosteroid, a chemical substance very similar to cortisol (a hormone our bodies produce). When bacteria or virus infects our body, the immune system is activated, producing white blood cells and chemicals (interleukins) to defend itself from the infection. (1-3)
In some conditions, this system can over-respond, causing uncontrolled inflammation (redness, warmth, swelling, or pain) harmful to our body. Corticosteroids, such as prednisolone, suppress the immune system and reduce the production of chemicals that cause inflammation. This leads to inflammation relief in the affected area.” (2, 3)
Prednisolone helps in the treatment of inflammatory conditions such as severe allergy, asthma, rheumatoid arthritis (RA), blood or bone marrow problems, ulcerative colitis (UC), skin problems (eczema, psoriasis), eye or kidney problems, or endocrine conditions. (1, 4)
In certain neoplastic conditions (types of cancer), prednisolone is used as palliative therapy. (1)
Common Prednisolone Side Effects
Aside from the positive effects, prednisolone, like other corticosteroids, has the following common side effects:
Prednisolone can make sodium stay in the body, resulting in water retention. Swelling of the face is a common sign, but swelling in the lower legs may also happen. (1, 5) Therefore, monitor the swollen areas, such as your legs, ankles, and face, and tell your doctor if you notice swelling; sometimes it might be necessary to give you drugs to eliminate the fluids.
Alteration In Glucose Tolerance
Prednisolone may cause an increase in blood sugar levels in people with or without diabetes. Those with diabetes should regularly monitor blood sugar and practice healthy habits to reduce sugar/glucose levels. High blood sugar can be serious, with early signs of blurred vision, increased thirst or hunger, headache, and frequent urination. (1, 6)
Inform your doctor of any changes or symptoms that occur while you may be on this medication.
Blood Pressure Elevation
Prednisolone can increase your risk of developing high blood pressure. (1)
Although only a few people will experience symptoms of hypertension, such as headache, shortness of breath, or nosebleeds, if their blood pressure is very high, most will not experience any symptoms at all. Even though high blood pressure can be serious and lead to life-threatening conditions, it is important to have your blood pressure checked regularly while taking prednisolone. (7)
Behavioral And Mood Changes
Prednisolone may cause changes in your mood or behavior. You might feel energized, or you might feel down. Be aware that mood changes might happen, and talk to your doctor if you notice changes that bother you and cannot manage by yourself. (1, 8)
Increased Appetite And Weight Gain
Corticosteroids affect metabolism, so increased appetite may happen when prednisolone is used for a few weeks or longer. You may feel hungry, leading to eating more and retaining water. While on therapy, try to eat as usual and have regular exercise. Increased appetite will disappear when you stop using prednisolone, and you can regulate your weight again. (1, 8)
What Are The Serious Prednisolone Side Effects?
The other reported side effects that are associated with prednisolone affect the skin, cardiovascular, endocrine, gastrointestinal, musculoskeletal, nervous, and reproduction systems. Despite the low frequency, some side effects can be serious and require medical help. Here are some of them.
Long-term use of corticosteroids increases the risk of osteoporosis. Osteoporosis happens when the old bone tissue is not replaced with new bone. As a result, bones become weakened and can easily break. (1, 9) Keep in mind to take calcium and vitamin D with your diet, or if insufficient, take supplements after the doctor’s advice.
2. Depression And Insomnia
Depression is a serious side effect of prednisolone that can negatively affect your mood, thoughts, and behavior. It can cause you to feel sad, lose interest in activities you once enjoyed, and have difficulty functioning at work and home. (1, 10)
If you are experiencing any of the symptoms of depression while taking prednisolone, it is important to talk to your doctor. There are treatments available that can help you manage your depression and improve your quality of life. (1, 11)
3. Increased Risk For Infection
The suppressive effect of corticosteroids on the immune system raises the risk of infections. The results from the study performed in the UK suggest that: “Risk for infection was increased two- to almost six-fold, depending on the type of infection, age, diabetes, and corticosteroid dose.” (12) Therefore, corticosteroids should be used at the lowest effective dose and discontinued as soon as the treatment goal is achieved.
4. Suppression Of Growth In Children
Corticosteroids are approved for use in children to treat acute or chronic conditions, and possible side effects are well-known. Slow growth in children is a possible prednisolone side effect, especially in long-term therapy.
In 2017, three scientists performed a systematic review of studies evaluating adverse reactions in long-term corticosteroid treatment in patients under 18. Results showed a growth retardation incidence rate of 18.1%. In addition, 21.5% of the patients had decreased bone density and 0.8% osteoporosis. (13) When prescribing corticosteroids to children, the pediatrician evaluates if the treatment benefit is bigger than the possible side effects that might occur.
5. Severe Allergic Reaction
Anaphylaxis is an allergic reaction that occurs minutes after taking the medication or something you are allergic to. When the allergen triggers the immune system, it produces substances that cause decreasing blood pressure, narrowing of the airways, breathing difficulties, or even blockage. (1, 14)
Angioedema is a swelling of the deeper layers of the skin, most commonly affecting the face and lips. It can be life-threatening if the swelling occurs in the tongue or throat. If you notice any of the symptoms of angioedema, such as swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, call your doctor immediately. (1, 15)
6. Cushing’s Syndrome
Long-term use of corticosteroids may develop into a Cushingoid state, a disorder where there are excess corticosteroids in the body. Cortisol is a hormone that reduces inflammation but also helps the body when stressed and plays an important role in blood sugar regulation and blood pressure maintenance. (1, 16)
The signs of high corticosteroid levels for a long time are a round face, increased fat around the base of the neck, weight gain, thin arms and legs, easy bruising, and wide purple stretch marks on the stomach, breasts, hips, and under the arms. In children, Cushing’s syndrome causes obesity and slower growth. The most serious complications are heart attack and stroke, blood clots in the legs and lungs, bone loss and fractures, high blood pressure, and unhealthy cholesterol levels. (16) Be aware of any symptoms described and consult your doctor if they appear.
The list of side effects is present in the Medication Guide. However, ask your doctor about any concerns you may have. (1)
Your doctor will prescribe prednisolone based on your disease severity and how you respond to therapy. The initial dose is 10 to 60 mg, while the doctor will decide on the lowest dose with clinical effects as a maintenance dose. Treatment discontinuation of long-term or high-dose therapy should be initiated with a taper or gradual dose decrease. (1)
Take prednisolone as your doctor prescribed and follow the instructions on the label. Check with your doctor before you stop taking the medication; your doctor will tell you if you need to decrease the dose before discontinuing. (1)
Prednisolone is a medication that doctors prescribe using its anti-inflammatory, immunosuppressive, or antineoplastic effect. It has proven its clinical effect over 60 years of clinical practice and is yet used as first-line treatment in some diseases.
Its safety profile is already known, so learn about possible side effects and when to call a doctor. Call your doctor if you experience an adverse event, and you can also report it to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Tell your doctor if you have had recent or ongoing infections or recently received a vaccine. In addition, inform your doctor of any other prescription or over-the-counter medications, supplements, or herbal products due to possible interactions or dose adjustments.
Prednisolone is prescribed to help your medical condition; therefore, take the medication following medical instructions and practice healthy habits to manage some of the side effects.