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Prednisone is a widely used prescription corticosteroid. It is a commonly used anti-inflammatory and immunosuppressive medication. It may be used in the treatment of conditions such as rheumatoid arthritis, severe allergic reactions, lupus, and multiple sclerosis, among other conditions.1
The medication is taken by mouth, either as a tablet or oral solution,1 and it is available in both immediate-release or delayed-release formulations.2,3
Though it’s a valuable pharmacotherapeutic used in a number of medical situations, prednisone has several significant side effects—especially if used in large amounts or for sustained periods of time. Side effects can range from mild to severe, and they may worsen over time, especially with higher doses of the medication.4
Side effects may include:1,5
Some side effects may be more serious, including:1,5,6
Prednisone may negatively interact with other medications, both over-the-counter and prescription. Because prednisone is associated with a risk of gastrointestinal ulceration, patients are advised to avoid taking it in combination with aspirin or other NSAIDs.4,6 Other drug interactions include the following:
Prednisone may also interfere with the body’s normal response to vaccines, making them less effective. 4 Your doctor can evaluate the potential impact of these drug combinations to make a recommendation for your specific treatment plan needs.
There may be some negative risks associated with even short-term use of corticosteroids like prednisone. One study noted that over a 3-year period, approximately 1 in 5 Americans used an oral corticosteroid for less than 30 days. This short-term use of corticosteroids increased the risk of sepsis, venous thromboembolism, and bone fractures even at low doses.7
Another concern with the use of prednisone is that some of the conditions that the drug treats are long-term chronic conditions, such as rheumatoid arthritis or asthma, but long-term use of prednisone continues to increase the risk of negative side effects. This puts many patients and doctors in a difficult position, as they need the medication to manage the symptoms of chronic conditions, but they may end up with other problems due to long-term use of the drug.7
Corticosteroid therapy is the first line of treatment for several inflammatory conditions and, in some cases, may be the only appropriate treatment option. Your doctor can discuss the risks and benefits of prednisone with you.
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