Prednisone is not like a gun sniper with a narrow target. Taking prednisone is like shooting with a shotgun blast: its effects are everywhere and potentially devastating. Since it affects every part of your body, it can help in many ways. Prednisone isn’t just used for one disease. Prednisone is used for many diseases, diagnoses, and conditions. See the complete list of reasons people use prednisone at the end of this article.
Risk vs. Benefit
Prednisone causes many side effects all over the body; but in return, it can help many varied conditions. Prednisone has a slim risk-benefit ratio: it has many risks, so the benefits must be very high to justify its use.
For many patients, prednisone is a miracle, saving their lives and helping them to feel well. That miracle comes at a price: the miserable side effects.
Prednisone Commonly Prescribed
As the 22nd most commonly prescribed drug, prednisone is a drug prescribed often for a long list of conditions, shown below. Prednisone can be lifesaving and miraculously relieving for conditions such as pneumonia, organ transplants, asthma, chronic obstructive pulmonary disease (COPD), lupus (systemic lupus erythematosus or SLE), rheumatoid arthritis (RA), and psoriatic arthritis (PsA).
Two Sides of Prednisone Coin
The list of conditions for which prednisone is used is the opposite side of the coin of the side effects that it causes. Basically, if you look at a list of potential side effects of any typical prescription drug, prednisone causes most of the possible side effects, and the ones it does not create, it actually treats that condition.
- Many prescription medicines cause a side effect of headache; prednisone is the opposite and can be used to treat severe migraine.
- Medications may cause breathing difficulties as a side effect; prednisone can help asthma, COPD and many other respiratory conditions.
- Some medications cause kidney injury, but prednisone instead helps with kidney issues like nephritis.
Prednisone affects nearly every part of the body and can either help or hurt each part. Sometimes prednisone can both help and hurt at the same time. For example, prednisone can help migraines, but also some people can have a headache when going through prednisone withdrawal. The unique mechanism of action of prednisone causes this unpredictable effect.
This image shows which side effects Dr. Megan experienced:
Dr. Megan’s Prednisone Side Effects
Prednisone is an Old Drug
Since the Food and Drug Administration (FDA) approved prednisone in 1955, prednisone did not have to undergo as many rigorous tests as new drugs. New drugs are tested for safety and efficacy, but prednisone was not given such rigorous tests; it was grandfathered in and bypassed many tests. The FDA label, also known as the package insert, shows 91 different diseases or conditions for which prednisone is “approved,” (as shown by no star* next to the disease name). This chart, below, shows 109 different diseases or conditions for which prednisone is prescribed by doctors, but there are likely many more. All diseases with a star* are used “off-label,” or in other words, without research done before 1955 or accepted by the FDA.
- 91 conditions FDA-approved for prednisone
- 18 conditions “off-label” for prednisone use
- 109 total diseases listed in medical literature for prednisone
Since prednisone is so old, there is no single drug company holding the patent. This means there is no company or agency actively seeking for a complete and comprehensive list of all reasons prednisone is used.
No complete list of prednisone uses exists!
Let’s create a complete list, and fill in this gap of prednisone facts.
- Check to see if your condition is listed in the chart below.
- If not, and you think your condition should be added, let me know on the Contact page.
What Is Prednisone Used For?
|Type of Condition||Prednisone Indication|
|Allergic States||Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in drug hypersensitivity reactions|
|Drug hypersensitivity reactions|
|Seasonal or perennial allergic rhinitis|
|Dermatologic (Skin) Disorders||Atopic dermatitis|
|Bullous dermatitis herpetiformis|
|Erythema nodosum leprosum*|
|Pain management in herpes zoster*|
|Severe erythema multiforme (Stevens-Johnson syndrome)|
|Severe seborrheic dermatitis|
|Endocrine Disorders||Congenital adrenal hyperplasia|
|Hypercalcemia of malignancy (cancer)|
|Primary or secondary adrenocortical (adrenal) insufficiency|
|Thyrotoxicosis (type 2 amiodarone-induced)*|
|Gastrointestinal (GI) Diseases||Crohn’s disease|
|Hematologic (Blood) Disorders||Acquired (autoimmune) hemolytic anemia|
|Congenital (erythroid) hypoplastic anemia/Diamond-Blackfan anemia|
|Erythroblastopenia (red blood cell anemia)|
|Immune thrombocytopenia (formerly known as idiopathic thrombocytopenic purpura) in adults|
|Pure red cell aplasia|
|Secondary thrombocytopenia in adults|
|Duchenne muscular dystrophy*|
|Giant cell arteritis*|
|Glucocorticoid remediable aldosteronism, treatment*|
|Trichinosis with neurologic or myocardial involvement|
|Neoplastic (Cancer) Diseases||Acute leukemia of childhood|
|Multiple myeloma (previously untreated; transplant-ineligible)*|
|Palliative management of leukemias and lymphomas in adults|
|Prostate cancer (metastatic)*|
|Treatment of acute leukemia and aggressive lymphomas|
|Nervous System||Cerebral edema associated with primary or metastatic brain tumor, craniotomy, or head injury|
|Multiple sclerosis exacerbation|
|Ophthalmic (Eye) Diseases||Allergic conjunctivitis|
|Allergic corneal marginal ulcers|
|Anterior segment inflammation|
|Diffuse posterior uveitis|
|Herpes zoster ophthalmicus|
|Ocular inflammatory conditions unresponsive to topical steroids|
|Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa|
|Renal (Kidney) Diseases||Proteinuria in lupus erythematosus|
|Proteinuria in the nephrotic syndrome|
|Respiratory (Lung) Disease||Allergic bronchopulmonary aspergillosis|
|Chronic obstructive pulmonary disease (COPD) exacerbation|
|Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy|
|Idiopathic bronchiolitis obliterans with organizing pneumonia|
|Idiopathic eosinophilic pneumonias|
|Idiopathic pulmonary fibrosis|
|Loeffler’s syndrome not manageable by other means|
|Pneumocystis carinii pneumonia (PCP) associated with hypoxemia occurring in an HIV-positive individual who is also under treatment with appropriate anti-PCP antibiotics|
|Rheumatic Disorders||Acute and subacute bursitis|
|Acute gouty (gout) arthritis|
|Acute nonspecific tenosynovitis|
|Acute rheumatic carditis|
|Rheumatoid arthritis, including juvenile rheumatoid arthritis|
|Synovitis of osteoarthritis|
|Systemic dermatomyositis (polymyositis)|
|Systemic lupus erythematosus|
Was your condition listed in this chart? If not, please contact Dr. Megan and we can add it to the list! See the list growing below:
Conditions Suggested by Prednisone Warriors:
- Polymyalgia Rheumatica (PMR)
Video Explanation of What is Prednisone Used For
Watch Dr. Megan explain what prednisone is used for below!
For Which Conditions is Prednisone Used Long-term?
When taking prednisone, the lowest effective dose should be prescribed. It might start out high, but the goal should be to get the dose as low as will keep your condition stable. NEVER stop taking prednisone without talking to your doctor, as there are severe withdrawal effects. Your body stops creating certain hormones (cortisol) when you take prednisone. So, in order to give your body time to kick in the hormone-making factory, the adrenal gland, you must slowly stop taking it over weeks to months.
NEVER stop taking prednisone suddenly.
Is It Worth It?
If you wonder whether taking prednisone for your condition is really worth it, check out this article that walks you through the decision. I created it to help explain risks and benefits. Find out how to have the benefits be greater than the risks.
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