Reducing Prednisone Side Effects

Precautions can help minimize adverse effects

Prednisone is a drug that is commonly used to treat many inflammatory conditions. It is often prescribed to treat the two major forms of inflammatory bowel disease (IBD)Crohn's disease and ulcerative colitis. The chief barrier to use of prednisone is its long list of potential side effects, many of which are visible or especially bothersome.

Some of these characteristic side effects of prednisone include insomnia, mood swings, increased hair growth, facial swelling ("mooning"), increased appetite, night sweats, acne, headaches, and weight gain.

The long-term effects of prednisone can often be severe and irreversible, leading to an increased risk of osteoporosis (bone loss), cataracts (clouding of the eyes), and the development of diabetes.

Benefits of Prednisone

Despite the risk of side effects, prednisone has its appropriate use in the treatment of many conditions, including IBD.

Prednisone is part of a class of drugs known as corticosteroids and is similar to cortisol, a type of steroid the body produces in the adrenal gland. It reduces inflammation in the body, which is why it is helpful in treating IBD, a condition that causes inflammation in the digestive tract.

The good news is that prednisone often works quickly to reduce the inflammation and other symptoms of IBD including diarrhea and bleeding.

Reducing Side Effects

Prednisone has been proven to be effective in reducing inflammation, and patients who choose to take it should be aware of a few ways to combat the side effects.

How to reduce the side effects of prednisone.

Britney Willson / Verywell

Preventing Bone Density Loss

To reduce bone density loss and the risk of osteoporosis and fracture, maintain a healthy diet with plenty of calcium throughout the course of prednisone treatment. Ask your healthcare providers regarding the type and amount of calcium that's needed every day to combat bone loss.

Avoiding Weight Gain

Reducing salt intake can prevent side effects associated with fluid retention, including the effects of facial mooning. Watching fat and calorie intake can help to prevent weight gain associated with steroids. Having a consultation with a nutritionist will be helpful in planning a diet to follow while taking prednisone.

preventing prednisone weight gain
Illustration by Emily Roberts, Verywell

Dosage Adjustment

Talking to a gastroenterologist about the best time of day to take prednisone for maximum effectiveness and minimal discomfort could make a big difference. Taking all of your doses of prednisone earlier in the day could reduce side effects such as insomnia or night sweats while taking it with meals could prevent stomach upset.

However, you need do so only under the direction of your doctor. Never experiment with prednisone dosing on your own.

Overcoming Mood Symptoms

Beyond the management of medication and symptoms, letting family and friends know about the side effects of prednisone can be beneficial to coping with emotional side effects. It may help people to understand that it's the drug that's causing mood swings or irritability and that getting the disease under control and stopping the drug is going to help with these issues.

Even if the side effects become intolerable, never stop treatment abruptly or without your doctor's instructions. Doing so can lead to severe withdrawal symptoms, including fatigue, nausea, loss of appetite, mouth sores, and weakness.

How to Discontinue Prednisone

Care must be taken when lessening the dosage of prednisone—a patient should not stop taking it suddenly. The body stops or decreases its own production of cortisol, and slowly tapering the amount of prednisone taken daily allows the body to begin producing it again on its own.

Tapering the dose of prednisone means lowering the dose by a certain amount every few days or every week. The length of time to taper will depend on the starting dosage, and the amount of time the prednisone has been taken. At higher dosages taken for a long period of time, it may take months to taper down. A short course can be tapered down relatively quickly.

Prednisone Use in Children

Children taking prednisone are of special concern and require careful consideration. A child's growth rate may be impaired, ultimately resulting in the delay of puberty. Children taking prednisone for any length of time should be monitored closely for any signs of long-term side effects such as impaired growth.

To avoid growth impairment in children, smaller prednisone dosages (less than 0.5 milligrams per kilogram per day) are often recommended. Dosing every other day may also help.

Frequently Asked Questions

How can I avoid weight gain when taking steroids?

Typically, most weight gain from steroids is related to fluid retention. Discuss the benefits of water pills (diuretics) with your doctor and follow a diet that’s rich in potassium and low in sodium to avoid too much water weight. Also, be aware that your appetite might increase with steroids, but your calorie needs won’t, so exercise regularly and eat a well-balanced diet, avoiding excess calories and fat.

How do I stop night sweats caused by prednisone?

Review your dosage with your doctor to see if adjusting your medication or taking it at a different time of day could help with night sweats. Otherwise, your best approach is to control your circumstances:

  • Adjust your bedroom temperature; use fans to keep air circulating
  • Wear sweat-wicking pajamas
  • Use quick-drying bedding instead of cotton
  • Avoid spicy food, smoking, and alcohol before bed
  • Reduce night-time stress with relaxation exercise or routines

Will I have mood swings if I take prednisone?

Mood swings are a possible side effect of prednisone. Women under 40 may be more likely to experience changes in mood. It’s important to discuss these feelings with your doctor and to avoid suddenly stopping the medication.

A Word From Verywell

Some patients feel that the negative side effects of prednisone far outweigh the benefits that can be derived. It may quickly stop a flare-up of IBD in its tracks but at the price of altered physical appearance, mental instability, and other health risks.

It's not an easy choice, but every person with IBD must make the decision to use prednisone based on their own needs in conjunction with input from a gastroenterologist.

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Article Sources
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