Prednisolone is a corticosteroid or steroid. It's only available on prescription.
It usually comes as tablets and soluble tablets. But you can get it as an injection, eye drops, rectal foam or suppositories. Adults usually get it as tablets.
Brands available in Ireland are Deltacortril and Prednesol.
Uses for prednisolone
Prednisolone reduces inflammation and helps to control autoimmune illnesses, including rheumatoid arthritis.
It is used to treat a wide range of health problems including:
- allergies
- blood disorders
- skin diseases
- infections
- certain cancers
It also helps prevent organ rejection after a transplant.
Check if you can take prednisolone
Prednisolone may be taken by adults and children. But it is not suitable for some people.
Before starting to take prednisolone, tell your GP if you:
- have other medical problems - including mental health problems or wounds that have not healed
- had an allergic reaction to medicine in the past
- have an infection - including eye infections
- have been around someone with shingles, chickenpox or measles in the last few months
- have recently had any vaccinations or are about to have a vaccine
Prednisolone for children and teenagers
Check with your GP about the benefits and risks of giving prednisolone to your child or teenager. Their growth can be slowed if they take it for a long time.
Your GP will:
- watch their growth carefully while they are taking steroids
- change treatment if necessary
Pregnancy and prednisolone
Tell your GP immediately if you are pregnant, think you are pregnant or are trying to get pregnant.
Prednisolone usually is not recommended if you’re pregnant.
High doses or long-term use can affect your baby's growth. Your baby's growth will be checked often if you take prednisolone.
In some cases, you may be advised to continue taking prednisolone during your pregnancy. Your GP will decide if the benefits outweigh the risks.
Breastfeeding and prednisolone
Tell your GP if you are breastfeeding or about to start breastfeeding before taking prednisolone.
Prednisolone can get into breast milk. Your GP may want to monitor your baby for side effects if you’re taking it.
Fertility and prednisolone
There's no clear evidence to suggest that taking prednisolone reduces fertility in either men or women.
Contraception and prednisolone
Tell your GP if you're taking oestrogen. These are found in the contraceptive pill or hormone replacement therapy (HRT).
When you start taking prednisolone
You might feel better after a few days of taking prednisolone. But it depends on your illness.
For some illnesses, you may not notice any difference in how you feel after you start taking prednisolone. This does not mean the medicine is not working. Ask your GP what to expect.
Tell your GP about risks of infections
You are more likely to get infections when you're taking prednisolone.
If you had tuberculosis (TB) in the past, you might get it again.
Keep away from people with an infectious disease, especially chickenpox, shingles or measles.
If you have never had these illnesses, they could make you very ill.
Urgent advice: Contact your GP immediately if:
- you're exposed to infectious illnesses such as chickenpox, shingles or measles
How long you need to take prednisolone
You may only need a short course of prednisolone. For example, up to a week.
But some people need to take it for years or for the rest of their life.
Ask your GP what to expect for your illness. Follow their advice.
Changes to your dose
Your dose may go up or down. When your illness starts to get better, it's likely that your dose will go down.
Your GP may reduce your dose before stopping it. This is to reduce your risk of withdrawal symptoms.
Your dose may go up if your illness gets worse.
Food and drink
Do not eat liquorice while taking prednisolone.
Liquorice plant extract may increase the amount of prednisolone in the body. It may also increase your risk of low potassium.
Alcohol and prednisolone
You can drink alcohol when you are taking alcohol. Stick to the recommended weekly low-risk alcohol guidelines.
How and when to take prednisolone
Take prednisolone exactly as your GP has advised.
Usually, you’ll take a single dose once a day in the morning so it does not:
- make you feel sick
- keep you awake at night
Your GP will decide on the dose. They might tell you to take it every other day.
Your child's dose is based on their height and weight. So it may be lower than for an adult.
Taking enteric-coated or gastro-resistant tablets
If the label on your prednisolone tablets says enteric coated or gastro resistant, you can take the tablets with or without food. Make sure to swallow them whole.
Do not take indigestion medicines 2 hours before or after taking enteric-coated or gastro-resistant tablets.
Avoid stopping prednisolone suddenly
Prednisolone can cause extra side effects and withdrawal symptoms if you stop taking it suddenly. Do not stop taking prednisolone without talking to your GP. They may need to reduce your dose gradually to prevent withdrawal side effects.
Withdrawal side effects are more likely to happen if you have:
- been on it for more than 3 weeks
- taken high doses (more than 40mg) for more than 1 week
Urgent advice: Contact your GP immediately if:
you get severe withdrawal symptoms, such as:
- severe tiredness
- weakness
- body aches
- joint pain
If you forget to take your prednisolone
If you forget a dose of prednisolone, take it as soon as you remember. But skip the missed dose if you do not remember until the following day.
Do not take a double dose to make up for a forgotten dose.
Use an alarm to remind you if you forget doses often.
If you take too much prednisolone
Urgent advice: Phone your GP or go to your nearest emergency department (ED) if you:
- take too much prednisolone
Do not drive yourself. Get someone else to drive or call 112 or 999 for an ambulance.
Bring the prednisolone packet or leaflet plus any remaining medicine with you.
Side effects
Not everyone who takes prednisolone gets side effects. But the higher your dose, the more likely it is you will get some side effects.
Common side effects
There are things you can do to manage common side effects:
Insomnia (problems sleeping)
Take prednisolone in the morning so the levels are the lowest at bedtime.
Feeling restless
If you're feeling restless when you're trying to sleep, take prednisolone in the morning so the levels are the lowest at bedtime.
Weight gain
If you have to take prednisolone for more than a few weeks, you may put on weight. Prednisolone can make you hungrier and you may also carry more water in your body.
Try to eat well without increasing your portion sizes. Physical activity will also help to keep your weight stable.
When you stop taking prednisolone, your appetite and the way your body keeps water should return to normal.
Indigestion
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 GP about taking an additional medicine to protect your stomach.
Sweating a lot
Try wearing loose clothing and use a strong anti-perspirant. If this does not help, talk to your GP as you may be able to try a different medicine.
Some side effects, such as stomach upset or mood changes, can happen straight away. Others happen after weeks or months.
Keep taking your prednisolone but tell your GP if any side effects bother you or do not go away.
Serious side effects
Taking prednisolone for a long time at a high dose or repeatedly in short courses can lead to serious side effects.
Urgent advice: Contact your GP immediately if you:
- feel breathless
- have weakness in your arms or legs
- have changes in your eyesight
- have bruising or bleeding that is not normal
- have red or black poo
- show signs of infection such as fever, chills, sore throat, a cough, or pain peeing
- show signs of high blood sugar such as feeling sleepy, confused, very thirsty or hungry, peeing more often, having breath that smells like fruit
- show signs of a hormonal disorder such as weight gain in your upper back or tummy, a puffy 'moon' face, bad headaches and slow-healing wounds
- show signs of an adrenal problem, such as a very upset stomach, vomiting, dizziness, tiredness, mood changes, loss of appetite and weight loss
- show signs of low potassium, such as muscle pain, weakness or cramps, a heartbeat that does not feel normal
- show signs of pancreas problems, such as severe stomach pain, back pain, getting sick
Emergency action required: Call 112 or 999 or go to an emergency department (ED) if:
- you have black or dark brown vomit or you're vomiting blood
Urgent advice: Contact your GP for an urgent appointment if
you have mood changes such as:
- feeling depressed
- feeling high, or moods that go up and down
- feeling anxious
- having problems sleeping and thinking
- being confused and losing your memory
- feeling, seeing or hearing things that do not exist (hallucinations)
- having strange and frightening thoughts
- changing how you act
- having feelings of being alone
Emergency action required: Call 112 or 999 or go to an emergency department (ED) if:
- have thoughts about harming yourself or ending your life
See the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Serious allergic reaction
If you have signs of a serious allergic reaction (anaphylaxis), you may need to go to hospital.
Emergency action required: Call 112 or 999 or go to an emergency department (ED) if:
- you get a rash that is itchy, red, swollen, blistered or peeling
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
- you have chest pain, a pounding heart or an irregular heartbeat
Stay healthy to control long-term effects
Taking prednisolone for many months or years can have harmful effects on your body, including:
- thinner bones (osteoporosis) - your GP may need to prescribe medicine to stop your bones thinning
- poorly controlled diabetes
- eyesight problems
- slower growth in children and teenagers
Ask your GP to check the height of your children and teenagers regularly.
Making lifestyle changes can help you control the possible harmful effects. For example, regular exercise and a calcium-rich diet.
Healthy eating and physical activity
Taking prednisolone with other medicines
Many medicines interfere with prednisolone or increase the risk of side effects.
If you’re taking prednisolone, talk to your GP or pharmacist before taking any other medicines.
This includes:
- pain medicines like aspirin and ibuprofen, which are sometimes called NSAIDs
- herbal remedies, vitamins or supplements
Fact check
This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).