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Common Side Effects of Prednisone & How to Cope

Common Side Effects of Prednisone & How to Cope

Common Side Effects of Prednisone & What You Can Do About It

Which Side Effects of Prednisone are Common?

Your doctor prescribed prednisone and your pharmacy gave you a long list of side effects. But which ones are the most common side effects of prednisone? In this article I will share the top 15 side effects of prednisone according to the five most comprehensive pharmacy drug databases.

This content is a summary of the most common side effects of Prednisone

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Research: Side Effects of Prednisone

I was also prescribed prednisone and even though I’m a pharmacist, I wanted to know which adverse effects of prednisone to really expect. Surprisingly, this is a tough answer to find! There is no comprehensive list of adverse effects of prednisone–each one is a little different.

I made it my mission to compile all this research into a complete list of side effects to prednisone. I searched the following well-respected top 5 databases for their list of prednisone side effects:

  1. The package insert published by the drug manufacturers and found at the United States National Institutes of Health’s DailyMed website.
  2. Clinical Pharmacology, the most comprehensive pharmacy database available today.
  3. Lexicomp
  4. Micromedex
  5. UpToDate, the most relied-upon medical database by doctors.

Side Effects Not Consistent

Each database listed certain side effects of prednisone and some listed more than others. Clinical Pharmacology listed the most side effects, and Micromedex listed the least. This list below includes the side effects that the databases labeled “common” but with no definition of what common means between them all. If prednisone were a newer drug, the tests would have shown the percentage of patients that experience that side effect. However, the U.S. FDA grandfathered in prednisone, discovered in 1955, so that kind of rigorous testing is absent.

For some of the side effects, the databases listed when it is most common, such as at high doses or when taken long-term. I included both the scientific name that they listed plus my simplified version of that term. Sometimes the databases listed similar but different terms, which I lumped together to simplify the list down to 150 total side effects.

Surprisingly the side effects of prednisone which cause the most wide-spread suffering are not universally listed in all five databases. For example, the #1 tweeted side effect to prednisone is not included on any of these lists. Insomnia causes much suffering, yet surprisingly none of the databases included it.

The Side Effects of Prednisone Listed by All Five Databases as Common.

  1. Osteoporosis. This invisible side effect of prednisone cannot be felt and many people do not know about it. Osteoporosis is also listed as bone matrix atrophy. Prednisone is the #1 drug that causes bone loss, which can lead to broken bones, decreased height, and compressed spines.
  2. Fluid retention. Most patients complain of retaining water and possible swelling of legs or joints. Prednisone has mineralocorticoid effects that lead to increased plasma volume. This means the body has extra liquid in the blood for the heart to pump.
  3. Hypertension. Also known as high blood pressure, this common side effect of prednisone happens most at high doses and while on long-term treatment. The fluid retention can lead to the high blood pressure since it makes it harder for the heart to push the extra blood.
  4. Emotional lability. This fancy term really means mood swings. Prednisone commonly causes emotional roller coasters from depression to anxiety to mania.
  5. Posterior subcapsular cataracts. Another invisible side effect of prednisone, cataracts can lead to irreversible blindness. While they are more likely the longer a person takes prednisone, cataracts can happen even at low doses.
  6. Skin atrophy. One database listed this skin thinning side effect as a “most common” adverse effect of prednisone, with a 46% statistic. However, most patients do not complain about the thin, fragile skin, or parchment-like skin.

Side Effects of Prednisone Listed by Three Databases as Common

These three side effects listed by three databases are related.

  1. Appetite stimulation. Prednisone makes people feel hungrier. People on prednisone often crave sweets and salty foods.
  2. Weight gain. The increased hunger leads to gaining weight, especially in the belly. This is common even at low doses, but the higher the dose, the more weight gain.
  3. Decreased carbohydrate tolerance. Prednisone makes it harder for the body to handle too much sugar. This common carbohydrate intolerance happens because prednisone is a glucocorticoid hormone. Gluco meaning like glucose. Prednisone changes the way the body uses glucose, the main source of sugar.

Side Effects of Prednisone Listed by Two Databases as Common

  1. Hypercholesterolemia. Most people know this side effect as high cholesterol. Also known as atherosclerosis, arteriosclerosis, premature atherosclerotic disease, this side effect is irreversible and more common at doses over 7.5 mg of prednisone per day.
  2. Osteopenia. Another effect of bone thinning, this side effect is the precursor to osteoporosis. Also listed as decreased bone mineral density, accelerated reduction in bone thinning, this side effect is also irreversible.

Side Effects of Prednisone Listed by One Database as Common

  1. Leukocytosis. This medical term for high white blood cells can look like a sign of infection, but is not, on its own.
  2. Irritability. Related to emotional lability above, prednisone commonly makes people feel cranky.
  3. Immunosuppression. While listed as a side effect, often this is the purpose for which the doctor prescribed prednisone. To treat many autoimmune conditions, doctors prescribe prednisone to weaken the immune system’s overactive response. This is more common the higher the dose.

A Side Effect NO ONE LISTED!

  1. Insomnia. I personally consider this to be the most common side effect to prednisone. Prednisone notoriously causes trouble sleeping. According to a study, the #1 Tweeted prednisone side effect is insomnia. How strange that people tweet this more often than any other side effect, yet it doesn’t show up as “common.”

What You Can Do About the Top 15 Most Common Side Effects of Prednisone

These most common side effects of prednisone listed by the drug databases can cause immense suffering to patients taking prednisone. Despite the irreversible nature of many of these side effects, many of them can be prevented. But most people don’t know what they can do to fight back.

That’s why I created the Prednisone Checklist.

Scroll down to get access to this valuable list of the top 15 adverse effects of prednisone and what you can do about it.

  • Discover how to avoid the top 7 mistakes prednisone patients make, and find my top 25 tips for coping with prednisone side effects.

Free Prednisone Checklist

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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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