Prednisone

Prednisone is a synthetic version of glucocorticoid, a natural hormone produced in the adrenal glands. It supplements low levels of steroids in the body and acts as an anti-inflammatory agent to relieve symptoms of a variety of conditions, particularly aches, pain and itching.

Prednisone may not cure a condition, but it helps ease symptoms such as itching, joint and body aches, and pain. Health care providers consider prednisone a strong, reliable steroid.

You can take prednisone as a regular or delayed-release tablet or as a drinkable liquid. The medication is also available in generic form and under brand names Deltasone, Prednisone Intensol and Rayos.

Prednisone dosage depends on the condition being treated and how well someone responds to a prescribed dose. Drugmakers set no dosage levels on the drug label because doctors tailor dosages to each patient’s needs. Initial dosages vary from 5 mg to 60 mg, once a day.
Quick-release forms (tablets and oral liquid) work best when taken before 9 a.m. and with food or milk. Optimal timing for taking delayed-release tablets depends on the dosage, the condition being treated and the person’s stomach tolerance.

Some people may need antacids between meals to avoid stomach ulcers when taking large doses of prednisone. Swallow delayed-release tablets whole and don’t chew, break or divide them.

Prednisone immediate-release tablets are available in six strengths: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg and 50 mg. Delayed-release tablets are available in three strengths: 1 mg, 2 mg and 5 mg. Prednisone oral liquid is available in one strength: 5 mg/5 mL.

How Long Does Prednisone Stay in Your System?

Prednisone has a half-life of about 2 to 3 hours, according to the 2022 Rayos drug label, though other studies place its half-life closer to 3 to 4 hours. Half-life is the time it takes for the drug level in the body to decrease to 50% of what it was when a person first took it.

For example, if a person took 5 mg of prednisone, the dose remaining in the body after three hours would be approximately 2.5 mg.

It takes about seven half-lives for a drug to leave the body. Based on a half-life time of 2 to 3 hours, it would take 14 to 21 hours for prednisone to leave the body. This is an average and may be different depending on a person’s age, weight and general health.

Can You Overdose on Prednisone?

Because prednisone has a half-life that is longer than some other glucocorticoids, overlapping doses or taking too much of it in successive doses increases the risk of an overdose.

The chance of dying from prednisone overdose is low, although it has happened. Some people may have no symptoms, and others may have life-threatening health issues.

Side effects from prednisone range from mild to serious. Mild side effects include nausea, headache, fluid retention, weight gain and insomnia. Serious side effects include difficulty breathing or swallowing, vomiting, high blood pressure, seizures and fetal toxicity.

Many people experience little to no side effects from taking prednisone, although women are more likely to have them. The higher the dosage and the longer the duration of use, the more likely side effects will appear. Other factors that influence whether side effects appear are age, overall health and other current medications.

If you have any significant side effects after taking prednisone, contact your doctor immediately.

People who are allergic to prednisone or have a systemic fungal infection should not use this drug.

Pregnant women, women trying to become pregnant or women who breastfeed should avoid prednisone. Multiple studies show that prednisone and other steroids can harm the fetus when taken during pregnancy, according to the drug’s label.

The medication also travels to infants through breast milk, although the U.S. Food and Drug Administration has no reports of adverse events. However, high doses of prednisone over long periods of time might cause growth problems in breastfed infants.

People who receive immunosuppressive doses of prednisone should not receive live or live-attenuated vaccines. Physicians can substitute inactivated vaccines, but the reaction to these vaccines is unpredictable. Your doctor should monitor you for allergic reactions and adverse events.

As a steroid, prednisone interacts with a long list of drugs and substances. That makes it important for anyone who takes the medication to communicate with doctors the full list of other drugs they take before starting on prednisone.

Women who rely on birth control pills with estrogen and take prednisone can experience stronger steroid side effects and potentially less-effective results from their oral contraceptive.

Estrogen enhances the effectiveness of prednisone, essentially making it a more potent dose than intended.

Patients should tell their health care providers about all the medicines they take and ones they may take.

Medical and drug research also shows other adverse prednisone combinations worth considering. For instance, drugmakers issued no specific label warnings about drinking alcohol with prednisone, but the U.K.’s National Health Service warns that drinking alcohol with the medication may increase the risk of developing an upset stomach.

Because prednisone treats several skin disorders, it can have a suppressing result for people who take it and need to have a skin test.

Finally, taking thalidomide while also taking prednisone can lead to a serious skin reaction called toxic epidermal necrolysis.