Digestive Health Inflammatory Bowel Disease Treatment What Are Prednisone Side Effects? Prednisone has several potential side effects that may be problematic By Amber J. Tresca Amber J. Tresca Facebook LinkedIn Twitter Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Updated on April 11, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Robert Burakoff, MD, MPH Medically reviewed by Robert Burakoff, MD, MPH LinkedIn Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What Is Prednisone? Common Side Effects Severe Side Effects Risk of Infection Discontinuing Treatment 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. 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. What You Should Know Before Taking Prednisone 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 How to Reduce Prednisone Side Effects 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: Bacterial skin infections Pneumonia, both bacterial and fungal Shingles (herpes zoster virus) Surgical site infection Tuberculosis The risk of other types of infection may also increase, particularly if there is underlying immunosuppression. Benefits and Risks of Immunosuppressants 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: HeadacheFatigue Nausea or vomitingDizziness or faintingSevere stomach painWeaknessConfusion 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. How to Avoid Prednisone Withdrawal 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. Oray M, Abu Samra K, Ebrahimiadib N, Meese H, Foster CS. Long-term side effects of glucocorticoids. Expert Opin Drug Saf. 2016;15(4):457-65. doi:10.1517/14740338.2016.1140743. MedlinePlus. Prednisone. 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 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 Amrein K, Martucci G, Hahner S. Understanding adrenal crisis. Intensive Care Med. 2017;44(5):652-55. doi:10.1007/s00134-017-4954-2 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. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit