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Prednisone for Cough and Bronchitis: How long does it take to Work?

Prednisone for Cough and Bronchitis: How long does it take to Work?

Were you prescribed prednisone for cough and bronchitis?

Bronchitis is a common respiratory infection that causes inflammation of the bronchial tubes, leading to coughing and difficulty breathing. In some cases, doctors may prescribe prednisone, a corticosteroid, to help reduce inflammation and ease symptoms.

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Prednisone for Cough and Bronchitis: How long does it take to Work?

One question I was given by Eve, she said; 

Why does the Med Pack (medrol dosepak) never really help me? Been on it for about 4 days and I still have coughing issues and breathing problems. Doctors don’t seem to care that all I do is cough, sob, and runny nose during one of those attacks. 

This is a really good question because prednisone is prescribed a lot for people who have a cough, bronchitis, or lower respiratory tract infection. The sad fact is it doesn’t work, that’s why it’s not working

The reason it doesn’t really help you is that, prednisone shouldn’t be prescribed for people who have bronchitis or cough. 

Let’s go a little deeper into why I would say such a controversial thing when clearly people are being prescribed it and why. Why are they being prescribed it?

Bronchitis, which is having a cough with some other symptoms is really hard to deal with. It’s miserable, it feels horrible, nobody wants it and doctors feel bad. They want to give you something that might help.

The problem is that if it’s a virus that caused your cough, which most of the time it is. Then antibiotics do not work because antibiotics only work on bacterial infections. 

Prednisone itself is not going to help often like an urgent care clinic or somebody might say you’re having an infection and you should have prednisone and an antibiotic Z-Pak and that combination. But they don’t work, they don’t help. Neither of them is going to help a viral lower respiratory tract infection. They’re just not going to work. 

Study on Prednisolone for Cough

In the Journal of American Medical Association, they had a study of 400 people. Half of the people were given five days’ worth of Prednisolone, which is almost the same thing as prednisone just a couple of molecules different, the other half were given five days of placebo or a fake pill. 

200 people in each group and they were given 40 milligrams, which is two 20-milligram tablets. That was the dosage for five days versus two nothing tablets for five days.

When they did that for 40 milligrams for five days, there was no difference in how long the cough lasted. There was no difference in the severity. They had people write down their symptoms, and how awful they felt. And there was absolutely no difference. If you’re taking fake pills or steroid pills, you feel exactly the same. 

It doesn’t help. But what it does do is it can cause miserable, horrible side effects such as insomnia, which you really need to be sleeping in order to get over your bronchitis or cough. It can cause weight gain, hunger cravings, mood changes, just being really irritable or having expansive thoughts and feeling amazing, but like not yourself, and issues with relationships because of that.

That’s just the tip of the iceberg of the side effects possible. You could have up to 150 side effects.

I get calls from people all the time who wished they had never taken it because It didn’t help anyway. And now they have these horrible side effects. Even just one pill is enough to cause anxiety, panic attacks, and really disabling symptoms. 

Should you take Prednisone for Cough or Bronchitis?

If prednisone doesn’t work for cough or bronchitis, it can make you really miserable with such terrible side effects.

It’s always a question of do the benefits outweigh the risks?

For cough and bronchitis, taking prednisone generally doesn’t outweigh the risks except for who it might benefit and who prednisone may have provided help for people. This is a quote from a study and it says; 

A short course of oral corticosteroids is appropriate for many patients with acute exacerbation of asthma or chronic obstructive pulmonary disease, and for selected patients with peritonsillar abscess, severe pharyngitis (characterized by pain with swallowing and moderate to severe pharyngeal erythema), and community-acquired pneumonia requiring hospitalization.

If your tonsils have an abscess and are so infected, they have an abscess or severe pharyngitis. It’s when your throat is so sore you can’t swallow and it’s super red, a doctor would have to look down your throat with a scope to see that.

If you have pneumonia and you don’t have to go to the hospital, then you don’t need this. But if you have pneumonia and you’re so severe that you have to be hospitalized, then the prednisone might help. Otherwise, it says; 

Widespread use of corticosteroids in patients with non-pneumonia lower respiratory tract infection, non-severe sore throat, or low back pain is inappropriate and not worth the risk of rare but potentially serious harms.

I completely agree with this. It’s being prescribed more than ever before by urgent care clinics or doctors who don’t know what else to give you.

Q&A: Prednisone for Cough

How long does Prednisone take to work for cough?

It may not work at all. When they compared the two, there was no difference. It doesn’t work for cough unless it’s one of those five reasons before. 

What is the Prednisone dry cough dosage?

It’s often about 40 milligrams for five days. That means prednisone, 20 milligram tablets take two every day for five days, but it probably doesn’t work. Unless your doctor says that you should use this for one of those five reasons, then do it. But otherwise, that information is worthless to you.

What about if you’re still coughing off after prednisone, what should you do?

It’s probably not going to help you. If you have prednisone for cough being prescribed and you’re like, is this worth it? It’s generally not worth it unless you have one of those five reasons.

What else could they possibly give you for cough instead of prednisone?

You can read this article and watch this video about alternatives to prednisone for cough.

Honey or tea is probably one of the best options and I go through a whole list of things. So check out that article all about alternatives to prednisone for cough because prednisone isn’t going to work for cough. 

  1. Hay AD, Little P, Harnden A, et al. Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection: A Randomized Clinical Trial. JAMA. 2017;318(8):721–730. doi:10.1001/jama.2017.10572
  2. Kueiyu Joshua L, Evan D, Aaron SK, rescribing systemic steroids for acute respiratory tract infections in United States outpatient settings: A nationwide population-based cohort study: PLOS MEDICINE.2020
  3. The Risks of Using Steroids for Respiratory Infections

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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