What Are Prednisone Side Effects?

Prednisone has several potential side effects that may be problematic

Prednisone is an inexpensive and effective corticosteroid drug that is frequently used to treat acute flare-ups of inflammatory bowel disease (IBD). While prednisone provides rapid relief, side effects are common and can occasionally be intolerable. These include insomnia, mood changes, abnormal hair growth, fatigue, thinning of the skin, and acne.

Girl with a bruised knee
Easy bruising is one of the many side effects associated with prednisone. Lea Paterson / Science Photo Library / Getty Images

What Is Prednisone?

Prednisone is a man-made version of a hormone called cortisol that is naturally secreted by the adrenal glands. By mimicking cortisol (a hormone that helps regulate the immune response), prednisone can temper inflammation associated with many conditions, including IBD.

Prednisone is a type of immunosuppressant. While the drug can be beneficial to people with autoimmune or immune-mediated diseases by blunting the exaggerated immune response, doing so can leave a person vulnerable to other infections.

Because the potential for side effects is high (and increases the longer you use the drug), prednisone should only be used on a short-term basis.

Prednisone is associated with a long list of potential side effects. Many are manageable, particularly during the early stages of treatment. However, more serious side effects can develop after months or years of use.

Common Side Effects

Because prednisone can alter the balance of hormones in the body, metabolic side effects can develop that affect everything from your skin texture to your brain and digestive function. Many of these side effects are reversible once the treatment is stopped; some (like the thinning of the skin) may not be.

Some of the more common side effects associated with prednisone use include:

  • Acne
  • Headache
  • Dizziness
  • Insomnia
  • Heartburn
  • Increased sweating (hyperhidrosis)
  • Irregular periods or no periods (amenorrhea)
  • Chronic fatigue
  • Bulging eyes (proptosis)
  • Facial puffiness ("moon face")
  • Thinning of skin (skin atrophy)
  • Spider veins (telangiectasia)
  • Easy bruising
  • Impaired healing
  • Abnormal hair growth (hirsutism)
  • Muscle weakness
  • Irregular or missed periods (amenorrhea)
  • Reduced sex drive (low libido)
  • Weight gain and obesity
  • Worsening of diabetes
  • Increased risk of infection

Severe Side Effects

The risk of severe side effects tends to increase the longer you take prednisone. The prolonged use (or overuse) of prednisone is associated with an increased risk of the following side effects:

  • Painful burning or tingling sensations in the hands or feet (peripheral neuropathy)
  • Severe depression
  • Changes in behavior
  • Uncontrollable muscle twitching or stiffening
  • Changes in body fat distribution (lipodystrophy)
  • Uncontrollable hand tremors
  • Vision problems (including glaucoma and cataracts)
  • Stunting of growth in children
  • Irregular heartbeat (arrhythmia)
  • Difficulty swallowing (dysphagia)
  • Stomach ulcers
  • Seizures

When to Call 911

Seek immediate emergency care if you experience symptoms of a severe, whole-body allergy known as anaphylaxis after taking prednisone, including:

  • Sudden rash or hives
  • Shortness of breath
  • Wheezing
  • Irregular heartbeat
  • Dizziness or fainting
  • Swelling of the face, lips, tongue, or throat
  • A feeling of impending doom

If left untreated, anaphylaxis can lead to anaphylactic shock and death.

Risk of Infection

Because of prednisone's immunosuppressant properties, people taking the drug are at increased risk of certain infections. These may be infections you acquire from others or the reactivation of infections that you were previously able to control.

The risk of infection increases with the dose or duration of therapy and may include:

The risk of other types of infection may also increase, particularly if there is underlying immunosuppression.

Discontinuing Treatment

Prednisone should not be stopped suddenly as doing so can lead to a serious condition known as an adrenal crisis. Because the adrenal glands have been effectively "off duty" due to ample supplies of the cortisol substitute, stopping suddenly can leave your body without enough to function properly.

Symptoms of an acute adrenal crisis include:

  • Headache
  • Fatigue
  • Nausea or vomiting
  • Dizziness or fainting
  • Severe stomach pain
  • Weakness
  • Confusion

Severe cases can lead to hypovolemic shock, coma, and even death. To avoid this, the prednisone dose should be decreased gradually over a period of time.

The tapering schedule for prednisone can vary depending on the dose you were prescribed and how long you were on treatment. People on long-term therapy often need months to get off the drug completely.

A Word From Verywell

Prednisone can be a very effective drug if used appropriately. If your healthcare provider prescribes prednisone, take the drug as directed, neither altering the dose or duration of therapy.

If you experience any side effects or have signs of infection, let your healthcare provider know without delay. Never stop treatment or reduce the dose because it "makes you feel better." Doing so may not only undermine the aims of treatment but trigger a potentially serious adrenal crisis.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. MedlinePlus. Prednisone.

  3. Youssef J, Novosad SA, Winthrop KL. Infection risk and safety of corticosteroid use. Rheum Dis Clin North Am. 2016 Feb;42(1):1570-76. doi:10.1016/j.rdc.2015.08.004

  4. Dineen R, Thompson CJ, Sherlock M. Adrenal crisis: prevention and management in adult patients. Ther Adv Endocrinol Metab. 2019;10:2042018819848218. doi:10.1177/2042018819848218

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By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.