Do Short-Term Prednisone Side Effects Exist?

Did your doctor tell you:

“I’m only prescribing prednisone short-term, so you won’t have any side effects”?

The most well-respected drug reference today, Clinical Pharmacology, states this about prednisone:

“Short-term administration of large doses typically does not cause adverse effects.”

I firmly disagree. 

Short-term use of prednisone can cause a range of side effects, including headaches, mood changes, moon face, hot flashes, heart rhythm changes, muscle wasting, increased risk of infections, glucose level changes, bone loss, and adrenal suppression.

Watch this video or read on to understand more about each of these side effects and how to cope.

Watch 9+ Prednisone Side Effects Short-Term now!

What is Short-Term Prednisone?

According to some definitions, less than 21 days of prednisone is short-term. Other research defines prednisone short-term as less than 30 days. Finally others define short-term prednisone as a prescription lasting less than 3 months.

9+ Prednisone Side Effects Short-Term

There are many possible side effects of prednisone when only taken for a short time. However, since prednisone is an old drug, there’s no definite list of what to expect compiled by the drug company.

Here’s a list of short-term prednisone side effects I compiled from various scientific articles, which tested side effects in healthy people, people with pneumonia, COPD, or large insurance databases.

The list of prednisone side effects short-term is not necessarily in the order of most common side effects, but instead in the order from the top of your body (head) on down.

1. Headache

Headache is one of the most common side effects of prednisone, according to a study in healthy people. Some individuals may experience mild headaches, while others may suffer from more severe migraines.

It is important to stay hydrated and talk to your healthcare provider if you are experiencing persistent headaches while taking prednisone.

Headaches can be managed with over-the-counter pain medications and other remedies such as relaxation techniques or applying a cold compress to the forehead.

2. Mood Changes

Prednisone can also affect your mood, leading to mood swings, irritability, and even depression. It is important to monitor your emotions while taking this medication and seek help if you notice significant changes in your mental health.

UpToDate said that you may feel “an improved sense of well-being within several days.”

According to Warrington and colleagues at the Mayo Clinic, at the beginning of taking prednisone, you might feel euphoria and hypomania. Judd and other researchers said at the beginning you are more likely to experience emotional lability or mania than depression.

Basically, these all mean you may feel extra energy and finally feel better from your condition for the first few days on prednisone.

Here are several levels of mood changes from mild to severe, with the most severe more rare:

• Euphoria: feel an exceptionally good mood
• Emotional lability: emotional roller coaster from highs to lows
• Hypomania, activated states: feel so good, you almost feel crazy; may go without sleep or push yourself too far
• Anxiety: worried to the point it makes you feel unwell; may need medications to cope
• Mania: severe changes to your mood that may make you feel crazy; some need to be hospitalized at this point
• Steroid dementia: most severe, causing memory loss and inability to function normally

UpTodate states that at very high doses, 75-100 mg per day, around 30% of people had hypomania within 1 week. About 10% experienced depression in that time period.

Read more here about how to cope with psychiatric side effects.

3. Moon Face – Cushingoid Changes

Another well-known side effect of prednisone is the development of a round, swollen face known as “moon face.” This side effect is usually temporary and will resolve once you stop taking the medication. However, it can be distressing to not be able to see your normal self when you look in the mirror.

Prednisone causes other changes to how fat distributes across the body. First it causes moon face, a round puffy face with swollen cheeks. Next it causes abdominal weight gain, making some people feel like they look pregnant with a big belly. Prednisone can also cause a buffalo hump of fat deposits on the shoulder and neck area. Normally this takes more than a month to show up, but can happen earlier based on how high of a dose you are taking.

4. Hot Flashes

Hot flashes and flushing. When I took prednisone for a few days, I wrote this in my journal: “Hot flushes and red flushing! My heart beating so hard and fast as if I’d run a race but I was just sitting down.”

Check out this picture of me with no make up, no filter, or editing so that you can see my hot flashes from prednisone!

Prednisone can cause hot flashes, similar to those experienced during menopause. These sudden feelings of heat and sweating can be uncomfortable but are typically not a cause for concern.

5. Heart Rhythm Changes

In some cases, prednisone can affect your heart rhythm, leading to palpitations or irregular heartbeats.

In addition to my heart beating hard, I also noticed it felt like it would skip a beat every so often.

It is important to monitor your heart health while taking this medication and seek medical attention if you notice any concerning symptoms.

Heart rhythm changes can happen unrelated to previous heart disease. Fast heartbeats are common.

More rare heart problems include serious cardiovascular disease, and sudden death. Especially for extremely high doses of 1000 mg given as an injection, “pulse infusions” should be given while hooked up to a heart monitor.

6. Muscles

Prednisone can impact your muscles in various ways, including muscle weakness, muscle loss, and muscle pain.

These effects can make it challenging to engage in physical activities and may impact your overall strength and mobility.

Myopathy, muscle weakness, and other muscle wasting can happen within weeks to months of starting prednisone.

I personally felt my body was out of proportion while on prednisone, with thin arms and legs from muscle loss, especially when compared to the weight gain around my belly.

It is important to incorporate regular exercise into your routine, focusing on both strength training and cardiovascular activities to help maintain muscle mass and function while on prednisone.

6. Infection

One of the risks associated with taking prednisone is an increased susceptibility to infections. Prednisone works by suppressing the immune system, which can make it more difficult for your body to fight off harmful bacteria and viruses. This can increase your risk of developing infections, such as respiratory infections, urinary tract infections, or skin infections.

Short-term prednisone use is associated with a nearly five times greater risk of sepsis and a three times greater risk of blood clots, according to a large study of 300,000 individuals.

Another study in people who took prednisone for pneumonia showed a 2.5 times greater risk of pneumonia recurring after 30 days, plus a 2 times greater risk of other infections.

To reduce your risk of infection while taking prednisone, it is important to practice good hygiene habits, such as washing your hands frequently, avoiding close contact with sick individuals, and keeping your living spaces clean.

Additionally, make sure to stay up to date on vaccinations, including the flu shot and pneumonia vaccine, to help protect yourself against preventable infections.

If you develop signs of an infection while on prednisone, such as fever, cough, sore throat, or unusual discharge, it is important to seek medical attention promptly. Your healthcare provider may recommend additional testing, antibiotics, or other treatment options to help you recover from the infection effectively.

Remember to communicate any changes in your symptoms or health status with your healthcare team to ensure timely and appropriate care. By taking proactive steps to prevent and manage infections while on prednisone, you can help protect your overall health and well-being during treatment.

7. Abdominal discomfort

Prednisone can cause a range of gastrointestinal symptoms, including bloating, stomach pain, indigestion, and changes in bowel habits. One study of 500 people showed abdominal discomfort was the most common adverse effect of prednisone. These symptoms can be uncomfortable and impact your daily quality of life while taking the medication.

It is important to identify potential trigger foods or beverages that may exacerbate abdominal discomfort and avoid consuming them while on prednisone.

Additionally, incorporating dietary modifications such as increasing fiber intake, staying hydrated, and eating smaller, more frequent meals can help alleviate gastrointestinal symptoms.

Over-the-counter medications, such as antacids or anti-gas medications, may also provide relief for abdominal discomfort while on prednisone. If symptoms persist or worsen, it is essential to consult with your healthcare provider for further evaluation and management strategies to address gastrointestinal issues effectively.

Remember to prioritize your digestive health, listen to your body, and seek professional guidance to minimize abdominal discomfort and maintain overall well-being during treatment with prednisone.

7. Adrenal Suppression

A single dose of steroids like prednisone can turn off the normal body system that regulates stress, the hypothalamic-pituitary-adrenal axis. This causes suppression of the adrenal glands. Prednisone can impact the function of your adrenal glands, leading to adrenal insufficiency and fatigue.

The adrenal glands are responsible for producing hormones that help regulate your body’s stress response and energy levels. When taking prednisone, the medication can suppress the natural production of these hormones, potentially leading to adrenal dysfunction.

Symptoms of adrenal insufficiency may include fatigue, weakness, dizziness, weight loss, and low blood pressure. It is important to work closely with your healthcare provider to monitor your adrenal function while on prednisone and gradually taper off the medication to minimize the risk of adrenal suppression.

If you experience symptoms of adrenal insufficiency while taking prednisone, such as extreme fatigue or weakness, it is crucial to seek medical attention promptly. Your healthcare provider may recommend additional testing, hormone replacement therapy, or other interventions to support adrenal function and alleviate symptoms.

Remember to communicate any changes in your health status with your healthcare team and follow their guidance to manage adrenal suppression effectively during treatment with prednisone. Prioritize self-care, rest, and stress management to support your adrenal health and overall well-being while on this medication.

Evidence: Short-Term Prednisone Causes Side Effects

The Downsides of Short-term Corticosteroids:

In this huge study, they looked at nearly 300,000 lives insured by a health insurance company in the United States. Around 1 in 5 adults received a prescription for short-term, less than 30 days of prednisone or another steroid, in a 3 year study period. Of these adults, they found an increased risk for the following side effects within those 30 days:

• Sepsis (huge infection) = nearly 5 times greater risk
• Venous thromboembolism (clot) = 3 times greater risk
• Fracture (broken bone) = 1.8 times greater risk

Anyone who says short-term prescriptions won’t cause side effects are wrong based on this study.

I found evidence for all of these short-term side effects in many articles because no one else ever compiled such a list.

What You Can Do About the Side Effects of Short-Term Prednisone?

Many of the short-term side effects of prednisone can be prevented. But most people don’t know what they can do to fight back.

That’s why I created the Prednisone Checklist. It includes my 25+ top tips to feel well even while taking prednisone. Plus you can avoid the Top 7 Mistakes people often make with prednisone by downloading it now.

References:

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5. Blum CA, Roethlisberger EA, Cesana-Nigro N, Winzeler B, Rodondi N, Blum MR, Briel M, Mueller B, Christ-Crain M, Schuetz P. Adjunct prednisone in community-acquired pneumonia: 180-day outcome of a multicentre, double-blind, randomized, placebo-controlled trial. BMC Pulm Med. 2023 Dec 11;23(1):500. doi: 10.1186/s12890-023-02794-w. PMID: 38082273; PMCID: PMC10712075.
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