Prednizone Side Effects - Should I Be Worried if I Take this Drug?

Prednizone- the correct spelling is prednisone- is a commonly used oral glucocorticoid medicine.

The adrenal glands manufacture a natural form of glucocorticoid. Glucocorticoids are responsible for many functions in the body including maintenance of blood pressure, proper use of sugar, protein, and fat metabolism, response to stress, and many other tasks.

Glucocorticoids manufactured by the body are referred to as endogenous steroids- meaning a persons own body makes these steroids.

When steroids are taken in from the outside either by mouth, intramuscularly or intravenously, they are referred to as exogenous steroids. Taking glucocorticoids orally or intravenously can reduce the ability of the persons own adrenal glands to continue to manufacture glucocorticoids.

Without the ability to increase steroid production in the face of stressors such as injury, infection, and surgery, a patient can go into shock.

The chances of the adrenal glands being suppressed increase as the dose of outside steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone, therapy continues for more than a few weeks or months, doses are given late in the day or in split doses, or long-acting corticosteroid preparations are used.

Patients who require high doses of prednisone (more than 20 mgs a day) for extended periods of time often will develop side-effects.

Taking steroids on an alternate day (every other day) schedule lessens the chance of adrenal insufficiency but does not do away with it altogether.

Other side-effects include:

Increased risk of bacterial or opportunistic infections such as fungi, tuberculosis, pneumocystis carinii
Elevated blood sugar
Fat distribution changes leading to moon face, buffalo hump
Elevated blood lipids
Aggravation of hypertension
Electrolyte abnormalities such as low blood potassium
Fluid retention leading to edema
Easy bruisibility
Increased body hair
Increased sweating
Purple stretch marks
Impaired wound healing
Glaucoma
Cataracts
Muscle wasting
Stomach ulcers
Pancreatitis
Accelerated hardening of the arteries
Osteonecrosis (bone death)
Psychiatric disturbance
Insomnia
Bowel perforation
Masking of infection

The use of prednisone for different diseases such as arthritis needs to be assessed with the potential benefits vs. the risks. These benefits and risks need to be discussed with your rheumatologist.

Dr. Wei (pronounced way) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: Prednizone Side Effects