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How Does Prednisone Work? A Deep Dive into its Effects

How Does Prednisone Work? A Deep Dive into its Effects

How does prednisone work? Ever wondered how a tiny pill called prednisone can have such a big impact on conditions like asthma or arthritis? It’s not magic; it’s science. Prednisone falls under the umbrella of corticosteroids, acting much like the cortisol our adrenal glands pump out. This clever impersonation allows it to dial down inflammation and put the brakes on an overactive immune system. Think of this as merely your introduction; there’s so much more ahead.

Prednisone steps into chaotic scenes within our body—where cells are inflamed, and immunity goes rogue—and brings order, reducing swelling and calming allergic reactions. Yet, its role is nuanced; while turning down some bodily responses, it subtly enhances others.

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Table Of Contents:

What Is Prednisone and How Does It Work?

Prednisone is a powerful anti-inflammatory drug that falls under the category of corticosteroids. It’s often referred to as a “cortisone-like medicine” because it mimics the effects of cortisol, a hormone naturally produced by the adrenal glands in our bodies.

So, how exactly does this potent pill work? Let’s break it down.

Prednisone Is a Corticosteroid

When you pop a prednisone, you’re essentially giving your body a boost of synthetic cortisol. Cortisol is like your body’s built-in stress-fighter, helping to regulate inflammation and immune responses.

By acting as a stand-in for cortisol, prednisone can provide relief for a wide range of conditions involving inflammation, allergic reactions, and overactive immune systems.

Prednisone Mimics Cortisol Produced by the Adrenal Glands

Your adrenal glands, those little hormone factories perched atop your kidneys, are responsible for pumping out cortisol. This vital hormone helps your body cope with stress, illness, and injury.

When you take prednisone, it steps in and does the job of your natural cortisol, giving your adrenal glands a bit of a break. It’s like having a temporary substitute teacher for your body’s stress management class.

Prednisone Reduces Inflammation and Suppresses the Immune System

Inflammation is your body’s natural response to injury or infection, but sometimes it can get out of hand. That’s where prednisone comes in – it helps to tone down that inflammatory response, providing much-needed relief.

But prednisone doesn’t stop there. It also has the power to suppress your immune system, which can be a lifesaver for people with autoimmune disorders or those undergoing organ transplants.

By dialing back your body’s defense mechanisms, prednisone can help prevent your immune system from attacking your own tissues or rejecting a transplanted organ.

Conditions Treated with Prednisone

Prednisone is like a Swiss Army knife of medications – it has a wide range of uses and can tackle a variety of health issues head-on. From calming down an overactive immune system to reducing inflammation, this corticosteroid is a go-to for many doctors.

So, what kind of conditions can prednisone help with? Let’s take a closer look.

Autoimmune Disorders

When your body’s defense system goes rogue and starts attacking your own tissues, it can lead to autoimmune disorders like rheumatoid arthritis, lupus, and multiple sclerosis. Prednisone can help rein in that rebellious immune response, reducing inflammation and giving your body a chance to heal.

Inflammatory Conditions

Inflammation is a major culprit behind many health woes, from asthma to inflammatory bowel disease. Prednisone’s anti-inflammatory powers can provide much-needed relief, helping to reduce swelling, redness, and discomfort.

Allergic Reactions

When your body overreacts to a harmless substance like pollen, or a harmful substance like poison ivy, it can trigger an allergic reaction. Prednisone can help calm down that overzealous immune response, easing symptoms like itching, hives, and swelling.

Cancer Treatment

Prednisone is sometimes used as part of cancer treatment, helping to alleviate side effects like nausea and inflammation. It can also be used to help prevent rejection in people undergoing bone marrow transplants for certain cancers.

Organ Transplants

When you receive a new organ, your body’s first instinct is to reject it as foreign. Prednisone can help suppress that natural rejection response, increasing the chances of a successful transplant.

It’s often used in combination with other immunosuppressant drugs to help prevent organ rejection in people who have received kidney, liver, or heart transplants.

How Does Prednisone Affect The Immune System?

how does prednisone work

Prednisone works by suppressing the immune system, which can be both beneficial and potentially harmful. On one hand, by reducing the activity of the immune system, prednisone can help to alleviate symptoms of inflammatory conditions and autoimmune diseases. It does this by inhibiting the production of inflammatory chemicals and suppressing the immune response that causes inflammation and pain.

Prednisone affects the immune system in both genomic and non-genomic ways. Genomic effects refer to the medication’s ability to interact with specific genes and alter gene expression, leading to changes in the immune response. Non-genomic effects, on the other hand, involve rapid responses that do not involve changes in gene expression.

  • In terms of genomic effects, prednisone binds to glucocorticoid receptors in the cell, which then translocate to the cell nucleus and bind to specific DNA sequences. This interaction leads to the regulation of gene expression, ultimately influencing the production of proteins involved in the immune response and inflammation. By altering gene expression, prednisone can suppress the immune system and reduce inflammation in the body.
  • Non-genomic effects of prednisone involve rapid responses that do not involve changes in gene expression. These effects may include the modulation of signaling pathways within the cell that control immune responses. For example, prednisone may inhibit the activation of certain immune cells or reduce the production of inflammatory mediators, leading to a decrease in inflammation and immune activity.

By exerting both genomic and non-genomic effects on the immune system, prednisone can effectively suppress immune responses and reduce inflammation in the body.

How does Prednisone Affect the Cells In Your Body?

Prednisone affects “all immune cells in the human body,” according to Palmoski. Prednisone works by affecting cells in the body at a molecular level. When prednisone is ingested, it is metabolized in the liver and converted into prednisolone, which is the active form of the medication. Prednisolone then travels through the bloodstream and binds to specific glucocorticoid receptors in cells throughout the body.

how does prednisone work

Once prednisolone binds to these receptors, it triggers a cascade of events within the cell that ultimately leads to the suppression of inflammatory chemicals and the inhibition of certain immune responses. This action helps to reduce inflammation, alleviate pain and swelling, and improve symptoms of conditions such as arthritis, asthma, and autoimmune diseases.

Prednisone also affects cells by altering gene expression. By binding to glucocorticoid receptors and interacting with DNA, prednisone can regulate the expression of genes involved in the immune response and inflammation. This modulation of gene expression helps to control the body’s inflammatory response and reduce the symptoms associated with inflammatory conditions.

The Role of Prednisone in Decreasing Immune Cells

T lymphocytes, also known as T cells, are a type of white blood cell that helps to coordinate the immune response. Prednisone suppresses the activity of T cells, which can help to reduce inflammation and alleviate symptoms of autoimmune diseases and inflammatory conditions.

Monocytes and macrophages are types of white blood cells that help to engulf and destroy pathogens and foreign substances in the body. Prednisone can reduce the number and activity of these cells, which can help to dampen the immune response and decrease inflammation.

Eosinophils and basophils are also types of white blood cells that play a role in the immune response, particularly in allergic reactions and asthma. Prednisone can decrease the number and activity of eosinophils and basophils, which can help to reduce allergic symptoms and asthma attacks.

According to Palmoski

[Glucocorticoids such as prednisone] reduce the number of circulating T-lymphocytes, monocytes, macrophages, eosinophils, and basophils; lower the synthesis of pro-inflammatory cytokines such as interleukin (IL)-2 and interleukin-6, and increase the number of circulating neutrophils []. Furthermore, [glucocorticoids] modulate vessel permeability and the expression of adhesion molecules in endothelial cells [].

By targeting these immune cells, prednisone can help to suppress the immune response, reduce inflammation, and alleviate symptoms of a variety of conditions. It is important to work closely with a healthcare provider when taking prednisone to monitor for any potential side effects and ensure safe and effective treatment.

Key Takeaway: 

Prednisone works like a synthetic cortisol, reducing inflammation and calming an overactive immune system across various conditions, from autoimmune disorders to organ transplants. It’s versatile but requires careful dosing and tapering as directed by a doctor.

Potential Side Effects and Risks of Prednisone

If you’re considering prednisone for treatment, remember – it’s effective but not risk-free. It’s important to be aware of the potential side effects, both common and serious, as well as the long-term risks associated with taking this drug.

Common Side Effects

Some of the most common side effects of prednisone include weight gain, increased appetite, high blood pressure, and elevated blood sugar levels. You might also experience blurred vision, trouble sleeping, or an irregular heartbeat.

These side effects can be bothersome, but they’re usually not severe. However, if you experience any of these symptoms to a significant degree, it’s important to let your healthcare provider know right away.

Serious Side Effects

In some cases, prednisone can cause more serious side effects. These may include a higher risk of infections, bone mineral density loss, and even cataracts. Long-term use of high-dose prednisone (40 mg/day or more) is particularly associated with these risks.

If you notice any signs of infection, such as fever, chills, or persistent cough, contact your doctor immediately. The same goes for any vision changes, severe muscle weakness, or other unusual symptoms.

Long-Term Risks

Taking prednisone for an extended period can lead to significant health risks. These may include osteoporosis, due to the medication’s impact on bone mineral density, as well as skin fragility and delayed wound healing.

There’s also an increased risk of developing hypertension, hyperglycemia, and dyslipidemia, which can contribute to cardiovascular problems over time. The longer you take prednisone and the higher your dose, the greater these risks become.

Monitoring for Side Effects

Because of the potential for serious side effects, it’s crucial to work closely with your healthcare team while taking prednisone. Your doctor will likely monitor your blood pressure, blood sugar, and bone density regularly.

Be sure to report any new or worsening symptoms to your doctor right away. They may need to adjust your dose or recommend additional treatments to manage side effects. Remember, the lowest effective dose of prednisone is always the goal.

Key Takeaway: 

Prednisone packs a punch against inflammation but comes with a list of side effects and risks. From weight gain to serious infection risk, it’s crucial to stay in touch with your doctor, follow dosing instructions carefully, and take steps like storing meds correctly and making healthy lifestyle choices.

FAQs in Relation to How Does Prednisone Work

What exactly does prednisone do to the body?

Prednisone fights inflammation and calms your immune system, helping tackle diseases from arthritis to asthma.

How long does it take for prednisone to work?

It kicks in fast. Most feel better within a few days, but it varies by condition and dose.

Why is prednisone so effective?

Prednisone mimics cortisol, reducing swelling and dialing down your immune response—key for many conditions.

What should I avoid while taking prednisone?

Avoid booze, NSAIDs like ibuprofen, and live vaccines. Check with docs on other medications or supplements too.


In wrapping up this journey through the workings of prednisone, we’ve peeled back layers beyond its facade as just another medication crossing pharmacy counters worldwide. We now understand that how does prednisone work isn’t answered simply—it orchestrates inside our bodies to quell fires without water but with sheer biochemical finesse. This drug blindly bulldozes through problems by mimicking cortisol.

Is it Worth It?

If you’re wondering, “is it worth it to have prednisone do all of those things to my immune system and my ability to combat inflammation?” If yes, you should download my Prednisone Checklist.

It includes the Top 7 Mistakes people make while on prednisone and guides you on your journey to counteract the side effects of prednisone and support your immune system.

Free Prednisone Checklist

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  • Palmowski A, Buttgereit F. Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis. Curr Rheumatol Rep. 2020 Oct 12;22(12):85. doi: 10.1007/s11926-020-00961-0. PMID: 33047263; PMCID: PMC7550368.
  • Samuel S, Nguyen T, Choi HA. Pharmacologic Characteristics of Corticosteroids. J Neurocrit Care 2017;10(2):53-59

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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