Prednisone is often prescribed to treat conditions like arthritis, asthma and other inflammatory diseases. It works to reduce inflammation.
As effective as it may be, prednisone can also come with side effects. And if you’re an older adult, you may be more sensitive to the side effects of this drug. If your health care provider recently prescribed prednisone, read on to learn more about the medication, its potential side effects and how to manage them.
What is prednisone used for?
Prednisone is a type of steroid. It helps reduce inflammation or swelling in the body. Inflammation is the body’s natural response to injury or illness, but sometimes it can go too far and cause pain or damage. That’s where prednisone comes in. It can help calm things down.
“Doctors often prescribe prednisone for conditions like arthritis, skin diseases, cancer, COPD and immune system diseases,” said Kevin Yee, a pharmacist with Banner Health. “Sometimes it’s used short-term for flare-ups and other times it’s needed for longer periods.”
Common reasons older adults take prednisone:
- Arthritis is common in older adults, causing joint pain and swelling. Prednisone helps ease that discomfort.
- Older adults with breathing issues, like asthma or COPD, may also need it. These conditions can cause the airways to swell, making it hard to breathe. Prednisone helps reduce swelling so you can breathe easier.
- Autoimmune diseases, like lupus, often require prednisone too. In these cases, the body’s immune system mistakenly attacks healthy cells. Prednisone helps to slow this down, preventing further damage.
Common side effects of prednisone
Older adults may experience more pronounced or severe side effects from prednisone, especially with long-term use. “Older adults may often have more underlying health conditions such as diabetes, high blood pressure and frailty, which corticosteroids like prednisone may worsen if not monitored,” Dr. Yee said.
Here are some of the most common side effects:
- Increased appetite and weight gain: Prednisone can make you feel hungrier, leading to weight gain over time. This can be frustrating, especially if you’re trying to maintain a healthy weight.
- Mood swings and anxiety: Some people on prednisone experience mood swings, anxiety or even depression. This is due to the way the medication affects your hormone levels. These mood changes can feel sudden or severe.
- Sleep problems: Prednisone can interfere with sleep, causing insomnia or restless nights. This is especially common if you take it later in the day or at higher doses.
- Muscle weakness: Prednisone can cause muscle weakness, making it harder to do everyday tasks. This is more likely to happen with long-term use.
- High blood sugar (hyperglycemia): Prednisone can cause blood sugar levels to rise, even if you do not have diabetes. High blood sugar levels over time can increase the risk of diabetes complications such as heart disease, kidney problems and nerve damage.
- High blood pressure: Prednisone can raise blood pressure due to its effect on fluid retention and its influence on the body’s balance of electrolytes.
Serious risks for older adults
While common side effects are troublesome, prednisone carries some more serious long-term risks if you are an older adult:
- Infections: Prednisone weakens your immune system, making it easier to get infections. This is especially concerning for older adults, whose immune systems are naturally weaker.
- Bone thinning (osteoporosis): One of the most serious side effects of prednisone for older adults is the increased risk of osteoporosis. This condition causes your bones to become weak and brittle, increasing the chance of fractures. “Prednisone reduces the calcium in your bones, weakening their structure over time,” Dr. Yee said.
- Cataracts and glaucoma: Long-term use of prednisone can increase your risk of eye conditions. Regular eye exams are important if you’re taking the drug over a long period.
- Stomach issues: Prednisone can irritate your stomach lining, leading to ulcers or bleeding.
How to reduce the risk of side effects
You don’t have to just accept these side effects. There are ways to minimize them. Dr. Yee advises that “the lowest effective dose for the shortest duration will be the best way to mitigate side effects.”
Here are some tips for reducing the risks:
- Communicate with your health care provider: Before starting the medication, ensure your provider knows about all your health conditions and current medication. This can help avoid any dangerous drug interactions.
- Monitor your blood sugar and blood pressure: If you have diabetes or high blood pressure, check your levels regularly. “It’s always important to monitor your blood sugar and blood pressure daily so your provider can adjust other medications to keep your numbers stable,” Dr. Yee said. “Typically, the effects on blood sugar and blood pressure will return to baseline once the prednisone course is completed.”
- Take prednisone with food: To help protect your stomach, take prednisone with a meal or snack. This can reduce the chances of getting heartburn or indigestion.
- Take it early in the day: If you’re struggling with insomnia, take prednisone earlier in the morning to reduce the risk of sleepless nights.
What to do if you experience side effects
If you start noticing side effects that make you uncomfortable or worried, don’t hesitate to contact your provider.
“Always contact your provider immediately if you experience any intolerable side effects,” Dr. Yee said. “Your provider might adjust your dose or recommend other medications to help manage the side effects.”
Never stop taking prednisone abruptly without your provider’s advice, as it can cause serious complications. Your medication may need to be tapered off.
Are there alternatives to prednisone?
Prednisone is a very effective medication, but it’s natural to wonder if there are alternatives with fewer side effects.
“Since prednisone is used for so many different indications, alternative treatments may depend on your specific health issue,” Dr. Yee said. “Your provider can explore other options with you.”
Takeaway
Prednisone can be an important tool in managing your health. But it’s important to be aware of the potential side effects, especially as an older adult. Contact your health care provider or a Banner Health specialist if you have any concerns or notice any new symptoms. Working closely with your health care team can help you stay healthy while taking prednisone.
