Prednisolone

Prednisolone is a type of medicine known as a corticosteroid or steroid. Corticosteroids are not the same as anabolic steroids.

Prednisolone is used to treat a wide range of health problems including allergies, blood disorders, skin diseases, infections, certain cancers and to prevent organ rejection after a transplant.

It helps by reducing inflammation. It also damps down your immune system, which can help in autoimmune illnesses, like rheumatoid arthritis, where your immune system mistakenly attacks its own tissues.

Prednisolone is available only on prescription as tablets and as a liquid to drink. It can also be given by injection but this is usually only done in hospital.

  1. Key facts

    • Take prednisolone once a day in the morning so it doesn't keep you awake.
    • Taking prednisolone can make you more likely to get infections. Tell your doctor if you're exposed to infectious illnesses like chickenpox or shingles.
    • The most common side effects of prednisolone are weight gain, indigestion, insomnia and sweating a lot.
    • Prednisolone can cause withdrawal problems if you stop taking it suddenly. Do not stop the medicine suddenly if you've been on it for more than 3 weeks or have taken high doses (more than 40mg) for more than 1 week.
    • It's also called by the brand names Deltacortril, Deltastab, Dilacort and Pevanti.
  2. Who can take prednisolone

    Prednisolone can be taken by adults and children.

    Prednisolone isn't suitable for some people.

    Tell your doctor before starting the medicine if you:

    • have had an allergic reaction to prednisolone or any other medicine
    • have an infection (including eye infections)
    • are trying to get pregnant, are already pregnant or you are breastfeeding
    • have recently been in contact with someone with shingles, chickenpox or measles (unless you are sure you are immune to these infections)
    • have recently had, or are about to have, any vaccinations

    Make sure your doctor is aware if you have:

    • had liver problems
    • had mental health problems (either you or close family members)
    • any unhealed wounds
    • heart failure or have had a recent heart attack
    • high blood pressure
    • diabetes
    • epilepsy
    • glaucoma
    • underactive thyroid
    • osteoporosis (thinning bones)
    • a stomach ulcer
  3. How and when to take

    It's important to take prednisolone as your doctor has advised.

    The usual dose varies between 5mg and 60mg daily – 1ml of liquid prednisolone is roughly equal to 10mg.

    It's best to take prednisolone as a single dose once a day straight after breakfast. For example, if your dose is 40mg daily, it's usual to take 8 tablets (8 x 5mg) all at the same time.

    Take prednisolone with breakfast so it doesn't upset your stomach. Taking prednisolone in the morning also means it's less likely to affect your sleep.

    If you have enteric coated (red or brown) tablets, you can take these with or without food but make sure to swallow them whole. Do not take indigestion medicines 2 hours before or after taking enteric coated tablets.

    Sometimes, you may be advised to take prednisolone on alternate days only.

    How much will I take?

    The dose depends on your illness and whether you are taking prednisolone as a short course or for longer.

    In children, the dose may be lower than for an adult with the same illness because it is calculated according to their height and weight.

    Will my dose go up or down?

    Your dose may go up or down.

    Once your illness starts to get better, it's likely that your dose will go down. 

    Your doctor will probably reduce your dose before you stop treatment completely.

    Your dose may go up if your illness gets worse.

    What if I forget to take it?

    If you miss a dose of prednisolone, take it as soon as you remember. If you don't remember until the following day, skip the missed dose.

    Do not take a double dose to make up for a forgotten one.

    If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways that are suitable for you and your medicines.

    What if I take too much?

    Taking too many prednisolone tablets by accident is unlikely to harm you.

    If you're worried, talk to your doctor or pharmacist.

  4. Side effects

    The higher the dose of prednisolone that you take, the greater the chance of side effects. You are less likely to get side effects if you take a relatively low dose of less than 20mg prednisolone daily.

    Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months.

    Common side effects

    Common side effects happen in more than 1 in 100 people. Keep taking the medicine, but tell your doctor if they bother you or don't go away:

    • weight gain
    • indigestion
    • not able to sleep
    • restlessness
    • sweating a lot

    Serious side effects

    You are more likely to have a serious side effect if you take a higher dose (more than 20mg daily) of prednisolone or if you have been taking it for more than a few weeks.

    Tell a doctor straight away if you get:

    • an infection – warning signs include fever, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva, pain with passing urine, mouth sores, or a wound that will not heal
    • high blood sugar – warning signs include feeling sleepy or confused, feeling very thirsty or hungry, passing urine more often, flushing, breathing quickly, or breath that smells like fruit
    • Cushing's syndrome – warning signs include weight gain in the upper back or belly, moon face, very bad headaches, and slow wound healing
    • adrenal gland problems – warning signs include a very upset stomach or vomiting, very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss
    • low potassium levels – warning signs include muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal
    • pancreas problems – warning signs include severe stomach pain, severe back pain, severe upset stomach or vomiting

    You should also tell a doctor straight away if you get:

    • breathless
    • swelling in your arms or legs
    • changes in your eyesight
    • any bruising or bleeding that isn't normal
    • black poo
    • black or dark brown vomit or vomiting blood

    These are not all the side effects of prednisolone. For a full list, see the leaflet inside your medicine packet.

    Serious allergic reaction

    The warning signs of a serious allergic reaction are:

    • skin rash
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • unusual hoarseness
    • swelling of the mouth, face, lips, tongue, or throat

    It's extremely rare to have an allergic reaction to prednisolone. If this happens to you, stop taking the medicine and contact a doctor straight away.

    Stunted growth in children

    Long periods of prednisolone treatment can slow down the normal growth of children and teenagers.

    Your child's doctor will watch their growth carefully while they are taking steroids. That way any slowing of growth can be picked up promptly and treatment changed if necessary.

    Talk to your doctor about the risks of giving prednisolone to your child if you are concerned.

  5. How to cope with side effects

    What to do about:

    • indigestion, feeling sick or vomiting – take prednisolone with food to reduce the chances of stomach problems. It may also help if you avoid rich or spicy food while you're taking this medicine. If symptoms carry on, ask your doctor if you may benefit from taking an additional medicine to protect your stomach.
    • weight gain – try to eat a healthy balanced diet without increasing your portion sizes so you don't gain too much weight. Regular exercise will also help to keep your weight stable.

    You can report any suspected side effect to a UK safety scheme.

  6. Pregnancy and breastfeeding

    Prednisolone is not usually recommended in pregnancy unless the potential benefits outweigh the risks.

    Prednisolone has occasionally been linked to problems when taken in the first 12 weeks of pregnancy and can affect the growth of the baby when high doses or long term use is needed. Close monitoring of the baby's growth will take place but it's important that the medicine is taken as advised to manage your condition.

    You can take prednisolone while you're breastfeeding. However, it passes into breast milk so if you are taking a high dose of prednisolone the baby may need to be monitored for signs of side effects.

    For safety, it's usually recommended that you wait 3 to 4 hours after taking your dose of prednisolone before feeding your baby or expressing milk.

    Tell your doctor if you're trying get pregnant, become pregnant or you are breastfeeding.

  7. Cautions with other medicines

    There are many medicines that interfere with the way prednisolone works, or that increase the risk of side effects. It's very important you check a medicine is safe to take with prednisolone before you start taking it.

    This includes some medicines that you buy over the counter like aspirin and anti-inflammatory painkillers such as ibuprofen.

    Tell your doctor or pharmacist if you take any other medicines, including herbal remedies and supplements.

  8. Common questions