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Can Prednisone Side Effects Be Prevented?

Can Prednisone Side Effects Be Prevented?

Side effects are what is concerning when we are prescribed prednisone. Sometimes when we are put in a subservient role as a medical patient, we feel powerless.

I know when I went from one side of the healthcare balance–the provider, to then having to take advice from other healthcare providers as a patient, it was hard.

I was used to being the one who knew the answers.

Suddenly with a bizarre rash, I had to be the behaving patient.

My doctor said, “I know you don’t feel sick, but you can’t use the bathroom without someone accompanying you.”

My blood levels were so low, they wanted to make sure I didn’t have an accident, even minor, that could cause my brain to bleed to death.

It was so demeaning being so dependent on others.

The doctors are worried about the worst-case scenario.

But we as patients are worried about how it makes us feel.

Doctors who prescribe prednisone the most got together and created a list of “The 4 Most Worrisome Adverse Effects of Prednisone.”

Then they did something helpful and hopeful.

They said, “Some of these negative effects can be prevented or treated.”

Today I’m excited to share their list of ways we can prevent or treat some of the worst side effects of prednisone.

Watch now!

4 Most Worrisome Adverse Effects of Prednisone

  1. Osteoporosis
  2. Hyperglycemia/Diabetes
  3. Cardiovascular diseases
  4. Infections

Some of these negative effects can be prevented or treated.

Informing Patients on Prednisone

1. Adverse Effects of prednisone should be discussed with the patient BEFORE therapy is started

2. Healthy lifestyle will reduce the risk of developing diabetes, hypertension, and cardiovascular disease and prevent osteoporotic fractures.

  • Smoking cessation
  • increasing physical activity
  • Supporting a healthy body weight (both over and under: osteoporosis)

3. Increased infection risk: 1.20 (20% increased risk)

4. Increase the daily dose of prednisone during stressful situations like surgery.

    Three Prednisone Side Effects That Can Be Prevented

    1. Osteoporosis: vitamin D3 and calcium:

    • A Cochrane Review showed a clinically and statistically significant prevention of bone loss at the lumbar spine and forearm with vitamin D and calcium in corticosteroid-treated patients.
    • Prescriptions: bisphosphonates, teriparatide, etc.

    2. Peptic Ulcer Disease: gastroprotective measures

    • Inc risk for GI ADEs with OR 1.73 and 3-4 fold increased risk when GC combined with NSAIDs. If you’re taking both GC and NSAIDs, then PPIs are indicated.

    3. Infections

    • When long-term treatment is expected, vaccination should be given, preferably BEFORe starting treatment.
      • Pneumococcal
      • Influenza

      Research in selective glucocorticoid receptor agonists (SEGRAs) or dissociated agonists of the glucocorticoid receptor. lacking convincing data.


      van der Goes MC, Strehl C, Buttgereit F, Bijlsma JW, Jacobs JW. Can adverse effects of glucocorticoid therapy be prevented and treated? Expert Opin Pharmacother. 2016 Nov;17(16):2129-2133. doi: 10.1080/14656566.2016.1232390. Epub 2016 Sep 20. PMID: 27590884.

      Dr. Megan Milne, PharmD, BCACP

      Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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