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Ask the Expert: What are the side effects of taking a low dose prednisone every day? It's the only thing that helps with my pain, but I hear it's not a long-term solution?

Prednisone belongs to the class of medications known as corticosteroids (or anti-inflammatory agents). These medications provide relief of inflammation and are used to treat a variety of medical conditions including pain, asthma, Sjögren’s and rheumatoid arthritis. As with all medications, corticosteroids have some adverse side effects related to the dose and the duration in which the medication is taken. Side effects associated with low dose (7.5 mg/day or less) daily prednisone are less severe than those seen with higher doses (greater than 30mg/day) and can usually be managed with precautions. Common side effects of daily low dose prednisone include elevated blood pressure, swelling, changes in blood sugar, increased appetite, weight gain, insomnia, osteoporosis (thinning of bones), irregular menstrual periods, and mood changes. Serious side effects associated with higher doses and long-term use (greater than 1 month) are impaired wound healing, decreased growth (in children), decreased muscle production, fat deposits, stomach ulcers or bleeding, vision problems, higher risk for infection, and in rare cases life-threatening allergic reactions.

Although the list of side effects may make you wonder whether you should take this medication or not, please be reassured that many people take daily low dose prednisone with minor or no side effects. The following self-care tips may help minimize some of the side effects associated with prednisone. For those experiencing swelling and/or elevated blood pressure, a healthy low sodium diet, regular exercise, and stress management can help to keep your blood pressure under control while taking daily low dose prednisone. If you have diabetes, it is important to monitor your blood sugar and report any severe fluctuations in blood sugar to your provider. It is recommended that prednisone be taken with food or milk to minimize stomach upset and reduce the chance of stomach ulceration. Schedule yearly eye exams and report any new changes in vision to your eye doctor. Long term corticosteroid therapy may cause thinning of bones (osteoporosis) which increases the risk of bone fracture. Talk to your doctor or pharmacist about vitamin D and calcium supplementation to help protect your bones. Since long term prednisone use can increase your risk for infection, ask your doctor or pharmacist to review your vaccination history and be sure to stay up to date on all of your recommended vaccines. Alert your family members and friends about the possibility of mood changes associated with this medication, so they can help detect any unusual changes in your behavior. Report any changes in mood or behavior to your doctor.

Although experiencing side effects is unpleasant, it is crucial to avoid sudden discontinuation of this medication. Never stop or decrease your dose unless instructed by your doctor. Your doctor can instruct you on how to slowly decrease your dose if you need to stop taking this medication for any reason.

By Ajay John, Pharmacy Intern and Kayli Smith, Pharm.D

This article was first printed in  the Foundation's patient newsletter for members. Click here to learn more about becoming a member. 


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Comments

When weaning off...once down to 5mgs you need to wean VERY slow. It takes time for your adrenal glands to kick in. Infact weaning to swiftly causes pain and often is mistaken that the PMR is still there. Every few weeks drop a mg. You may not feel the best for a couple days as your adrenal glands adjust. Be kind to yourself and rest and take Tylenol if needed. At 2.5mgs I went down in half mgs every week to two weeks.

For those that may have additional autoimmune problems PMR may be a long term problem with flares. Much like fibromyalgia. I still get flares but opted not to do very long term low dose prednisone. I posted here in another post why.

I am on an anti inflamatory diet. I use cannibus gummies for sleep. I just bite a piece off...not a whole one. It works. On bad days I take 1 Tramadol and Tylenol. Not daily...just as needed. I also take vitamins and minerals.
Best to you😊

— Aug 2, 2022

I have ongoing pyaderma gangriosums which keep appearing over my body. I have seen a heamotologist , rheumatologist, gastroenterologist & dermatologist. Am currently on 39mgms a day and they don’t seem to be helping. I have been on prednisone for the past 2 years off and on anywhere from 75mgs to 5 over this period. I also have COPD and they help considerably with this and help me breath more easily. I also have issues when not on the prednisone with eating, food is simply repulsive to me and I actually gag at the thought of eating, no matter what the food is. I have lost a considerable amount of weight. The gastroenterologist is treating me for chrones disease that the infusions are working to some extent, but they now at 8 weekly intervals and don’t have the immediate effect. My appetite is lagging in between doses and the pyodermas seem to escalate in between doses. Any suggestions, comments or advice would be greatly appreciated as this has been an ongoing, painful ailment for about 2 years now.

— Sep 16, 2022

I have developed itching all over my body for about one year for which I see dermatologist.He has prescribed me prednisone 10 mg on and off which controls itching very well.If I stop prednisone itching starts.I am 80years old.Can I take low dosage like 2.5 to 5 mg a day for the rest of my life?Mydermatologist has done biopsy and blood tests a few times but everything is normal.

— Nov 2, 2022

I have terrible fibro I. Pain all rhe time. But I have electrical pro lem (bigemeney) so my heart dr said no I eas o. Ir for a few days it leaped sooooo much wish u could take it

— Nov 3, 2022

Man I just had a awful experience with 10mg a day prednisone.
Obviously more an allergic reaction than side effect.
I think the word is gastro issues. Any how couldn’t keep food down, in, out. You name it, persevered for week until really was forced to stop due to weakness and dehydration. 2 days latter appetite returning , nausea diminished.
I’m writing this because symptoms were extreme for low dose, and didn’t seem to fit. So may help someone else in similar circumstances.
I should of stopped well before, 6 days
Thanks to others that shared.
I have no idea where this is based , but I’m in New Zealand
Darryl

— Dec 1, 2022

I enjoyed reading the comments. I've had autoimmune problems for years and developed sjorgrens and then Polymylagia Rhuematica. The doctor wanted long term 5mgs. I opted for 3mgs and was on it three years until the PMR somewhat subsided.

It left me with some permenant effects and feel badly about it. I had phenomenal bones. Now they are just good and have developed the very beginning of osteoporosis in my hips. I always had perfect sugar numbers and now they are mildly elevated and despite losing pounds to my ideal weight remain elevated. I have severe muscle loss in my back. It shouldn't be as I'm very active. I had horrendous vision problems. Thank goodness no cataracts. It took over a year for my vision to return to normal. I know I'm older...but my skin thinned and aged fast. I did research and it can destroy collagen which can't be replaced. My hair thinned and as of this date has not thickened back. The whole time on it I had stomach distress despite taking Prevacid. It elevated my liver numbers. They seem to slowly be improving.

Did it help with pain? Absolutely and I had energy galore. I thought it was a miracle medicine. I supose I needed it with PMR. I was so sick. Now I wonder if it was the right thing to do.

Everyone is different, but I advise to be your own advocate and research it throughly and listen to your bodies symptoms. Best to everyone suffering pain. We are all in the same boat trying to find the best quality of life with chronic pain.😊

— Jan 3, 2023

I'm really struggling with my mum's health how it has deterated in short space of time since my mum became ill in Blackpool before boxing day and she is getting worse in my oppion can please let me know how long it will take to see a improvement to my mum health please email me back with your advice so I know long before my mum will take before she is feeling better many thanks Stephen ollier

— Jan 29, 2023

Although steroids should not used as a first line of treatment or be used long term if at all possible, healthcare professionals should stop being scared of prescribing steroids to patients and educate themselves. Inflammation can cause irreversible damage and pain and steroids may prevent this. Stop making patients suffer.

— Jan 29, 2023

Do side effects of steroid vs inflammation and organ damage by not prescribing steroids give an excuse for healthcare professional not to prescribe steroids? CERTAINLY NOT

— Jan 29, 2023

Could I take prednisolone 5mg daily? For life time.

I'm dealing with multiple sclerosis since 2015.

— Feb 1, 2023

I tested positive for HSV a few months ago and At first I was devastated thinking I have an incurable STD for life. After doing hours of research I quickly realized genital herpes is a filthy parasite that just likes to hide in the human nerves. I literally flush it out of my system with the help of natural herbal medicine which I ordered after doing some research And now I’m negative of the virus, I never believed it until my doctor finally gave me the test results and behold I'm Herpes free. You can also get your help from the herbal man through his site https://excelherbalcure.com you can call him or send a direct message to his WhatsApp [204] 480 7423

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