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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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— 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 14, 2023

PMR here - started at 10mg then tapered to 7.5 after 1 week. After 3 month down to 6mg a day with return of symptoms in the AM that are not as severe as untreated and abate during the day. Weirdly, I also have Sjogrens antibodies (asymptomatic) AND I lost sense of taste and smell several years ago though the prednisone on the dose I am on did not help with that... I can't function with PMR without some intervention - the pain is unbelievable and no painkiller of any kind touches it. Definitely don't want to be taking prednisone because of all the negative side effects mentioned but I can't get out of bed without it.

— Mar 18, 2023

Several weeks ago I got Ptosis where my left eyelid drooped and closed while my right eyelid was fully open. It looks weird and makes anything visual more difficult (driving, watching TV, computer use). It was getting worse and I went to my doctor. She ordered MRI scans of my neck and head (brain was normal) along with blood tests (normal). She also prescribed 50mg Prednisone to clear up redness in my left eye from taping it open which reduce blinking. After about eight days my eyes went back to normal. She has me tapering down on the dosage but I may need to stay at a low dose. I feel better than usual with minor side effects which I think will go away at a low dose. On my Medicare Advantage plan it is no cost.

— May 5, 2023

What can I take to improve muscle strength and growth along side prednisone.
Have lupus and take 5mg prednisone since forever.
I take vit D and have osteoporosis. 48 years old

— Jul 5, 2023

Is 10 mg of prednisone safe for copd. Don't want to have any long term side affects

— Jul 11, 2023

Hi! I was on 5mg prednisone for 18 years to help with my RA. I’m in remission now. Asked doc if I could wean off. I’ve been weaning off for the last 6 months and now finish on July 1st. I’m experiencing knee and calf pain and have difficulty walking at times. I know it’s withdrawal symptoms but how long before I’m not in pain? Anyone have this happen to them? Did you ever go back to normal? Thanks

Update…I couldn’t take it anymore. I went back on the 5mg. It was so difficult to walk or go down the stairs. I guess my body needs it. I really tried, but let me say it was rough. I’ll continue to get my bloodwork done. Thankfully I never had any issues with low dose. Hopefully you all have better luck than me trying to get off of it.

Hi Stephanie. I was interested reading your posts as I was just diagnosed with RA in January of 2022. I've been on 7.5 mg of pred since then along with plaquenil, methotrexate, and Humira. I just recently started trying to slowly taper my pred and it's miserable. My doctor says there is no harm in staying on 7.5 mg indefinitely. Did you have any side effects from many years on 5 mg?

I just started methotrexate a couple of weeks ago. I take 2.5 mg once a week. I feel like I have the flu. But the medication is working to reduce inflammation and itching on my face. What was your experience with methotrexate? Will the feeling sick go away? I’m considering stopping the medication.

— Aug 9, 2023

Hi i have been taking predisone 30mg for 6 days for copd my breathing has improved but i'm getting really thirsty heart palpitations, blurred vision dizziness and a tingly face, not sure if i'm being paranoid, will these symptoms go away once i stop i only have one more day to do. Thank you

— Aug 10, 2023

I have been on Prednisone for just over 2 years for PMR, started at 20 mg managed to get down to 5 mg but had a flare went up to 17 mg and finally have worked down to 7 mg..however the side effects even at this low dose are frightening. I have had significant weight gain, more then 45 lbs, my hair is thinning, my skin has developed small bumps that bleed easily then form a white crust appearance, and worst of all is a change in my personality...I have become very moody and find small things set me off.
So yes this is a wonder drug but there are times when I wish I had never started it...I also have moderate RA and am about to start a new Biologic called Orencia..hopefully with decreased inflammation I can get off the Prednisone. As a result of elevated SED rate I have developed anemia which required a total of 7 I/V infusions of Venofer...Hard to keep going some days but love of family keeps me present. Best to all ...

— Aug 26, 2023

I have been on Prednisone for inflammation in both lungs started with 30mgmd and now tapered down to 5 mgm once a day a breakfast I have awful weight gain. Specialist advised to take five mgms for another six months. By then I will be the size of a house. Can I cut down myself the dosage. Thanks for any help

— Sep 15, 2023

I've just been prescribed 40mg prednisone for lung fibrosis and I'm terrified of the side effects it's going to be a tapered dose over four months anyone had experience with this and how did it effect you and your symptoms.

— Oct 14, 2023

I have been taking prednisone for the past 6 years for PMR. MY consultant tapered them of me fo and I stopped taking them in September this year. My follow up appointment was cancelled so I never got to see him. I became so unwell as the weeks have passed. Every part of my body hurt even my head became painful and my jaw. I cannot explain how ill I felt. I woke up o e morning and could not move at all. I called my GP and she started me back on 5mg daily and within 72 hours I started to feel a lot better and now just waiting to see consultant again.

— Oct 19, 2023

I was recently diagnosed with polymyalgia rheumatica started dose 15mg then tapered down I’m now on 5 mg I have been on perdnisone for 5 months now but I would really like to stop taking them as all these Side effects seem to frighten me but I just wondering if the pain will come back

— Dec 21, 2023

I’ve been on Methotrexate and low dose Prednisone since 10/23 after being diagnosed with RA. My Rheumatologist took me off Prednisone recently and the nausea from Methotrexate is even more intense than when I first started taking it. I noticed this almost immediately after stopping the Prednisone. It’s been a week and I’ve been extremely nauseated every single day. My Rheumatologist says my nausea is not from stopping the Prednisone and that Prednisone does not help with nausea caused by Methotrexate. Every recent article I can find completely contradicts her opinion and she’s done nothing to help me with the nausea. Time for a new Rheumatologist. Thoughts?

— Apr 10, 2024

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