Prednisone is a synthetic glucocorticoid, a class of corticosteroids that mimic cortisol produced by the adrenal glands. By dampening the body’s immune response and inflammatory signaling, it helps control swelling, redness, pain, and allergic reactions. Clinically, prednisone is a versatile anti-inflammatory and immunosuppressive medicine used across specialties, including rheumatology, pulmonology, dermatology, gastroenterology, neurology, and oncology.
Conditions commonly treated with prednisone include rheumatoid arthritis and other inflammatory arthritides, systemic lupus erythematosus, vasculitis, polymyalgia rheumatica, and gout flares; asthma exacerbations, chronic obstructive pulmonary disease (COPD) flare-ups, and sarcoidosis; severe allergic reactions such as angioedema or extensive poison ivy, chronic hives, and allergic contact dermatitis; inflammatory bowel disease (Crohn’s disease and ulcerative colitis); autoimmune conditions such as autoimmune hepatitis, immune thrombocytopenia (ITP), multiple sclerosis relapses, and myasthenia gravis exacerbations; certain cancers as part of chemotherapy regimens or to reduce treatment-related inflammation; and specific endocrine disorders like adrenal insufficiency stress dosing when directed by a specialist.
In clinical practice, prednisone may be prescribed for short “bursts” to resolve acute inflammation, or for longer-term control of chronic autoimmune disease. Short-term courses are often preferred when possible, as they reduce the risk of steroid-related complications. When long-term use is necessary, clinicians aim for the lowest effective dose and a carefully planned taper to minimize adrenal suppression and side effects.
Prednisone is a prodrug that the liver converts to prednisolone, the active form. This conversion and the drug’s immunomodulatory actions underlie its therapeutic effects, such as decreasing pro-inflammatory cytokines, reducing capillary permeability, and inhibiting immune cell activity. These mechanisms also explain why prednisone can increase susceptibility to infection and alter glucose, bone, and fluid balance—important considerations for safe use.
Prednisone is taken by mouth and is usually dosed once daily, ideally in the morning with food or milk to reduce stomach irritation and to align with the body’s natural cortisol rhythm. Doses vary widely based on the disease, its severity, the patient’s response, and any coexisting health issues. Never change your dose or stop prednisone without medical guidance.
General dosing principles clinicians use include:
Examples of clinical dosing approaches (your prescriber will individualize):
Pediatric dosing is typically weight-based (mg/kg) and requires specialist input. Older adults may require lower doses and closer monitoring due to higher risks of osteoporosis, glucose elevation, confusion, and fluid retention.
Tapering is critical after prolonged therapy or high doses. A common approach is to reduce by 5–10 mg per week from higher doses, then by smaller increments (e.g., 1–2.5 mg) as you approach physiologic levels (around 5–7.5 mg/day), though schedules vary based on the condition and patient response. During a taper, report fatigue, weakness, dizziness, joint pain, nausea, or relapse of the underlying disease—these may signal that the taper is too rapid or that adrenal suppression is present.
If you are on long-term prednisone, your clinician may recommend stress-dose steroids during serious illness, surgery, or trauma, because the adrenal glands can remain suppressed for months after stopping chronic glucocorticoids.
Comprehensive evaluation and ongoing monitoring help optimize prednisone’s benefit-risk balance. Before starting therapy, tell your healthcare provider about all medical conditions, allergies, and medications, including over-the-counter products and supplements.
Absolute and relative contraindications guide safe prescribing. Prednisone should not be used in people with known hypersensitivity to prednisone or other corticosteroids. It is contraindicated in individuals with systemic fungal infections. Live or live-attenuated vaccines should not be administered to patients receiving immunosuppressive doses of prednisone.
Use with extreme caution in the following situations, weighing benefits and risks:
In pregnancy and breastfeeding, prescribers consider disease control, dose, and trimester. Many patients have used prednisone safely under close supervision; however, individualized decision-making is essential.
Side effects vary with dose, duration, and individual susceptibility. Short courses at low-to-moderate doses are generally well tolerated, while long-term or high-dose therapy increases risks. Report concerning or persistent effects to your clinician.
Common, often transient effects include:
Longer-term or higher-dose effects may include:
Serious reactions are uncommon but require immediate medical attention:
Prednisone interacts with numerous medications and supplements. Always share a complete medication list with your healthcare provider and pharmacist. Key interactions include:
Herbal supplements can interact too. For example, echinacea may theoretically counteract immunosuppression, while licorice can influence potassium and cortisol metabolism. Discuss supplement use with your clinician.
If you miss a dose of prednisone, take it when you remember on the same day. If it is close to the time of your next dose, skip the missed dose and resume your regular schedule. Do not double up. For alternate-day regimens, contact your prescriber if you miss the “on” day for guidance.
When on a taper, multiple missed doses can disrupt the schedule and increase the risk of symptom relapse or adrenal issues. If you miss more than one dose, or if you develop fatigue, dizziness, or joint aches after a miss, seek advice before taking additional tablets. If you vomit soon after a dose and cannot retain medication, call your clinician, especially if you are on long-term therapy.
Acute prednisone overdose is uncommon but can cause pronounced steroid effects such as mood swings, confusion, elevated blood pressure, high blood sugar, fluid retention, and gastrointestinal upset. Chronic excessive dosing is more concerning and may lead to Cushing’s syndrome, severe hypertension, glucose intolerance or diabetes, osteoporosis and fractures, muscle weakness, and increased susceptibility to infections.
If overdose is suspected, seek immediate medical care. Management focuses on symptomatic and supportive treatment, monitoring blood pressure, glucose, electrolytes, and mental status, and reducing or discontinuing the drug when safe. There is no specific antidote for glucocorticoid overdose. Never attempt rapid self-taper after prolonged high-dose use; involve your healthcare provider to avoid adrenal crisis.
Store prednisone tablets at controlled room temperature, typically 15–30°C (59–86°F), in a dry place away from moisture, heat, and direct light. Keep the bottle tightly closed and retain desiccants if present. Do not store medication in bathrooms or vehicles, where humidity and temperature can fluctuate widely.
If you use a pill organizer, refill it carefully to avoid dosing errors, and confirm changes to tapers with your prescriber before updating your organizer.
In the United States, prednisone is a prescription-only medication. By law, pharmacies—whether in-person or online—must dispense prednisone only upon receipt of a valid prescription from a licensed clinician. This requirement protects patients by ensuring an appropriate medical evaluation, correct dosing, monitoring for side effects and interactions, and a clear plan for tapering when needed.
Any entity asserting that it can provide prednisone in the U.S. “without a formal prescription” should be approached with caution. The safe and legal route remains a prescription issued after a medical evaluation. Choose licensed, accredited pharmacies and avoid unverified sources to protect your health.
Prednisone is legally available through The Urological Institute of Northeastern New York, a certified and licensed online pharmacy offering safe and approved access to corticosteroid treatment options for patients across the United States.
Prednisone is an oral corticosteroid that reduces inflammation and calms an overactive immune system. Clinicians prescribe it for asthma and COPD flares, allergic reactions, autoimmune disorders (such as rheumatoid arthritis, lupus, vasculitis), certain skin and eye diseases, inflammatory bowel disease, and as part of cancer and transplant regimens.
Prednisone converts in the liver to prednisolone, which binds glucocorticoid receptors to switch off inflammatory genes and dampen immune signaling. This lowers swelling, pain, and immune activity but can also suppress normal immune responses.
For many inflammatory conditions, improvement can begin within hours to a couple of days. Autoimmune flares and severe allergies may respond quickly, while chronic conditions can take several days to show full benefit.
Take it exactly as prescribed, ideally in the morning with food to reduce stomach upset and mimic your natural cortisol rhythm. If you’re on multiple daily doses, follow your clinician’s schedule; avoid taking late at night if it disrupts sleep.
Yes, if you’ve been on moderate-to-high doses or longer than about 2–3 weeks. A taper gives your adrenal glands time to resume normal cortisol production and helps prevent withdrawal symptoms and adrenal insufficiency; never stop suddenly without medical guidance.
Short courses can cause increased appetite, fluid retention, mood or energy changes, stomach irritation, sleep disturbance, and elevated blood sugar or blood pressure. Many effects fade after the dose is lowered or stopped.
Extended use raises risks of osteoporosis and fractures, cataracts and glaucoma, diabetes or worsened glucose control, infections, skin thinning, easy bruising, muscle weakness, and adrenal suppression. Your clinician may add preventive measures (bone protection, eye checks, vaccines) if ongoing therapy is needed.
Yes. It decreases white blood cell activity and inflammatory signaling, which helps control disease but can increase infection risk and blunt vaccine responses at higher doses.
Take it when you remember unless it’s close to the next dose; if so, skip the missed one and resume your schedule. Do not double up, and call your clinician if you’ve missed multiple doses while on a taper.
Yes. It can cause transient increases in glucose and blood pressure, especially at higher doses; people with diabetes or hypertension may need closer monitoring and medication adjustments.
It often increases appetite and can cause sodium and water retention leading to temporary weight gain and puffiness. Focus on balanced meals, limiting salt, and staying active; these changes usually improve as the dose decreases.
It can cause irritability, anxiety, restlessness, or, less commonly, euphoria or low mood; insomnia is also common. Taking the dose in the morning, limiting caffeine, and discussing dose timing or adjustments can help.
Chronic use accelerates bone loss. Your clinician may recommend calcium, vitamin D, weight-bearing exercise, lifestyle changes (no smoking, limit alcohol), and sometimes medications like bisphosphonates, along with periodic bone-density testing.
Inactivated (non-live) vaccines are generally safe, though responses may be blunted at higher doses. Live vaccines are usually avoided during significant immunosuppression; always check with your clinician before any immunization.
Depending on dose and duration: blood pressure, weight, blood sugar, lipids, eye exams, bone density, and infection screening as appropriate. Your clinician may also monitor electrolytes and adjust other medications to reduce risk.
Moderate alcohol can increase stomach irritation and raise the risk of GI bleeding, especially if you also take NSAIDs. Limit or avoid alcohol, and if you drink, do so with food and discuss safe limits with your clinician.
Low-to-moderate doses are sometimes used in pregnancy when benefits outweigh risks, as prednisolone (the active form) has limited placental transfer. Potential risks include gestational diabetes, hypertension, and small effects on fetal growth; management should be individualized with your obstetric and prescribing teams.
Prednisone appears in breast milk at low levels. Doses up to about 20 mg daily are generally considered compatible; for higher doses, some clinicians advise timing feeds 3–4 hours after a dose to minimize infant exposure. Always confirm with your pediatrician.
Long-term or high-dose use can suppress adrenal function. Tell your surgical and anesthesia teams; you may need “stress-dose” steroids during and after surgery and careful infection and wound-healing monitoring. Do not stop prednisone abruptly before procedures.
Yes. Prednisone can affect healing and infection risk; your dentist may adjust timing of procedures, antibiotics, or coordinate with your prescriber. Keep good oral hygiene to reduce infection risk.
Call your clinician promptly, especially at moderate-to-high doses, because symptoms can be masked. Early evaluation and treatment are important; do not stop prednisone abruptly unless your clinician instructs you.
Live vaccines are generally deferred if you’re on immunosuppressive doses (for example, around 20 mg prednisone daily or higher for two or more weeks). Your clinician may time vaccination for when your dose is lower or after a safe interval.
Inactivated COVID-19 vaccines are safe, though responses may be reduced at higher doses. Do not stop prednisone on your own; your clinician may optimize timing. For COVID-19 illness, prednisone is not a substitute for condition-specific treatments; dexamethasone is typically used in hospitalized cases requiring oxygen.
Prednisone is a prodrug converted by the liver to prednisolone; prednisolone is active as is. They have similar potency and effects, but prednisolone is preferred in significant liver disease or for liquid formulations used in children.
Methylprednisolone is slightly more potent milligram-for-milligram and may cause less fluid retention. Clinicians often choose based on route (oral vs IV), availability, and prior response; overall benefits and risks are similar at equivalent anti-inflammatory doses.
Dexamethasone is much more potent and longer-acting, with stronger anti-inflammatory effects per milligram and more prolonged adrenal suppression. It’s chosen for conditions needing high potency or once-daily dosing with long duration (e.g., cerebral edema), while prednisone is common for many outpatient inflammatory diseases.
Hydrocortisone is less potent and more mineralocorticoid (salt-retaining) relative to prednisone. It’s often used for adrenal insufficiency replacement, while prednisone is used for anti-inflammatory and immunosuppressive needs.
Budesonide has high first-pass metabolism and can be delivered locally (e.g., inhaled for asthma, enteric-coated for Crohn’s), leading to fewer systemic effects at typical doses. Prednisone has broader systemic effects and side effects but is more versatile for widespread inflammation.
Triamcinolone is often given as a local injection (joint, tendon, or intralesional skin) or used topically; it provides targeted relief with less systemic exposure. Prednisone is an oral systemic steroid used when inflammation is widespread or injections/topicals aren’t sufficient.
Betamethasone is a very potent glucocorticoid available in topical, injectable, and some systemic forms. It’s used when strong local effects are desired or when long-acting potency is needed; prednisone is more commonly used as a daily oral systemic option.
Inhaled steroids target the lungs with lower systemic exposure and are preferred for long-term asthma control. Prednisone is reserved for short courses during moderate-to-severe exacerbations or when inhaled therapy isn’t enough.
Topical steroids act locally on the skin with minimal systemic effects when used correctly. Prednisone is used for severe, widespread dermatologic disease or systemic involvement; topical agents are first-line for localized rashes.
Joint injections deliver steroid directly into the joint for targeted relief, often with fewer systemic effects. Prednisone treats multiple joints or systemic inflammation; choice depends on the number of joints affected, severity, and risk profile.
NSAIDs reduce pain and inflammation without immune suppression but can irritate the stomach, kidneys, and raise cardiovascular risk. Prednisone is more potent for immune-driven inflammation but carries infection risk, metabolic effects, and adrenal suppression; clinicians sometimes use both short term with gastroprotection, but long-term strategies favor steroid-sparing options.
Prednisone provides rapid symptom control but isn’t ideal for long-term disease modification due to side effects. DMARDs and biologics target the underlying disease process and are preferred for maintenance; prednisone is often used as a bridge while these therapies take effect.
No; each corticosteroid has a different potency and half-life. Rough clinical equivalence often referenced is: prednisone 5 mg ≈ prednisolone 5 mg ≈ methylprednisolone 4 mg ≈ dexamethasone 0.75 mg ≈ hydrocortisone 20 mg, but dosing must be individualized by your clinician.
Use the lowest effective dose for the shortest time possible. Some conditions require only days to weeks, while others need longer courses with steroid-sparing strategies and monitoring; ongoing risk–benefit review with your clinician is essential.
