Experiences with
Prednisolone

Prednisolone is a medicine used to treat a wide range of health problems including allergies, blood disorders, skin diseases, inflammation, infections and certain cancers and to prevent organ rejection after a transplant.

It helps by reducing swelling (inflammation) and can also calm down your immune system. This helps autoimmune conditions, like rheumatoid arthritis, where your immune system mistakenly attacks its own tissues.

Prednisolone is a steroid or corticosteroid medicine. Corticosteroids are not the same as anabolic steroids.

Prednisolone is available only on prescription as tablets and as a liquid you swallow. It can also be given by injection but this is usually only done in hospital.

As long as you do not have any symptoms of COVID-19, carry on taking your prescribed steroid medicine as usual.

If you develop any COVID-19 symptoms, do not stop taking your steroid medicine suddenly. Ask your doctor about whether you need to stop taking it or not.

Updated: 20 March 2020

Who can take prednisolone tablets and liquid

Most adults and children can take prednisolone tablets and liquid.

To make sure prednisolone is safe for you, tell your doctor or pharmacist before taking it if you:

have ever had an allergic reaction to prednisolone or any other medicine
have an infection (including eye infections) or any unhealed wounds
are trying to get pregnant, are already pregnant or you are breastfeeding
have recently been in contact with someone with shingles, chickenpox or measles
have recently had, or are about to have, any vaccinations
have liver problems
have ever had or any close family members have had mental health problems
have heart failure or have had a recent heart attack
have high blood pressure (hypertension)
have diabetes
have epilepsy
have glaucoma
have an underactive thyroid
have thinning bones (osteoporosis)
have ever had a stomach ulcer

Dosage and strength

The dose of prednisolone you'll take depends on your health problem and whether you are taking it as a short course or for longer.

The usual dose varies between 5mg and 60mg daily but occasionally higher doses may be prescribed.

The strength of tablets range from 1mg to 25mg. There are 2 strengths of liquid with either 1mg or 10mg in every 1ml.

In children, the dose may be lower than for an adult with the same problem because it is calculated based on their height and weight.

Your dose may go up or down.

Once your health problem or condition starts to get better, it's likely that your dose will go down.

Your doctor may reduce your dose before you stop treatment completely. This is to reduce the risk of withdrawal symptoms.

Your dose may go up if your symptoms get worse.

How to take it

Unless your doctor or pharmacist gives you different instructions, it's best to take prednisolone as a single dose once a day, with breakfast. For example, if your dose is 40mg daily, your doctor may tell you to take 8 tablets (8 x 5mg) all at the same time.

Take prednisolone with breakfast so it does not upset your stomach. Taking prednisolone in the morning also means it's less likely to affect your sleep.

If your prednisolone tablets are labelled as "enteric coated" or "gastro resistant", you can take these with or without food but make sure to swallow them whole. Do not take indigestion medicines 2 hours before or after taking enteric coated or gastro resistant tablets.

Sometimes, your doctor may advise you to take prednisolone on alternate days only.

How long to take it for

This depends on your health problem or condition.

You may only need a short course of prednisolone for up to 1 week.

You may need to take it for longer, even for many years or the rest of your life.

If you forget to take it

If you miss a dose of prednisolone, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take the next one at the usual time.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Stopping prednisolone

It can be dangerous to stop taking prednisolone suddenly, especially if you have been on a high dose for a long time.

Your health condition may flare up again. You may also get withdrawal side effects including:

severe tiredness
weakness
body aches
joint pain

These side effects are most likely to happen if you have taken prednisolone for more than a few weeks or you take more than 40mg daily.

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects.

Do not stop taking prednisolone without talking to your doctor – you will need to reduce the dose gradually.

Taking too many prednisolone tablets is unlikely to harm you.

If you're worried, talk to your doctor or pharmacist.

Common side effects

These common side effects of prednisolone happen in more than 1 in 100 people. There are things you can do to help cope with them:

Speak to a doctor or pharmacist if the advice on how to cope does not help and any of these side effects bother you or last more than a few days.

You are more likely to have a serious side effect if you take a higher dose of prednisolone or if you have been taking it for more than a few weeks.

Call a doctor or contact 111 straight away if you get:

a high temperature, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva (yellowish and possibly with streaks of blood), pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
sleepy or confused, feeling very thirsty or hungry, peeing more often, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar
weight gain in your upper back or belly, "moon face" (a puffy, rounded face), very bad headaches and slow wound healing – these can be signs of Cushing's syndrome
a very upset stomach or you're being sick (vomiting), very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
muscle pain or weakness, muscle cramps, or changes in your heart rate – these can be signs of low potassium levels
severe stomach pain, severe back pain, severe upset stomach or you're being sick – these can be signs of pancreas problems
breathlessness
swelling in your arms or legs
changes in your eyesight
any bruising or bleeding that is not normal
red or black poo

Go to 111.nhs.uk or call 111. Call 111 if you're worried about a child under the age of 5 years.

you have black or dark brown vomit or you're vomiting blood

Find your nearest A&E

You may notice mood changes and mental health problems while taking prednisolone.

Talk to your doctor or contact 111 if you have any mood changes including:

feeling depressed
feeling high, or moods that go up and down
feeling anxious, having problems sleeping, difficulty in thinking, or being confused and losing your memory
feeling, seeing or hearing things that do not exist (hallucinations)
having strange and frightening thoughts, changing how you act, or having feelings of being alone

The higher the dose, the more intense the mood changes can be.

Go to 111.nhs.uk or call 111.

you have thoughts about harming yourself or ending your life

Find your nearest A&E

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to prednisolone.

Taking prednisolone for a long time can lead to side effects such as:

thinner bones (osteoporosis)
poorly controlled diabetes
eyesight problems
high blood pressure (hypertension)

Children and teenagers

Taking prednisolone at higher doses for a long time can slow down the normal growth of children and teenagers.

Your child's doctor will monitor their height and weight carefully for as long as they're taking this medicine. This will help them spot any slowing down of your child's growth and change their treatment if needed.

Even if your child's growth slows down, it does not seem to have much effect on their eventual adult height.

Talk to your doctor if you're worried. They'll be able to explain the benefits and risks of giving your child prednisolone.

These are not all the side effects of prednisolone. For a full list, see the leaflet inside your medicine packet.

Prednisolone and pregnancy

You can take prednisolone while you're pregnant. It has occasionally been linked to problems in the first 12 weeks of pregnancy and possible effects on the baby's growth, however, the benefits of taking it usually outweigh any risks.

Only small amounts can cross over the placenta, so your baby is exposed to very little prednisolone in the womb.

If you take prednisolone in pregnancy, your baby's growth will be checked regularly.

It's important that immune and inflammatory problems are well treated as these can affect you and your baby's wellbeing.

Speak to your doctor if you become pregnant. They will discuss the risks and benefits with you and help you decide on the best treatment for you and your baby.

If your doctor or health visitor says that your baby is healthy, it's OK to take prednisolone while breastfeeding.

Prednisolone passes into breast milk in small amounts. It has been used for many years in breastfeeding women without side effects in their babies.

If you're taking a dose of more than 40mg of prednisolone each day for a long time, your baby may need extra monitoring.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.

Prednisolone and fertility

There's no clear evidence to suggest that taking prednisolone reduces fertility in either men or women.

Cautions with other medicines

There are many medicines that can affect the way prednisolone works, or increase the risk of side effects. It's very important you check a medicine is safe to take with prednisolone before you start taking it.

This includes anti-inflammatory painkillers such as ibuprofen and aspirin.

There's very little information about taking herbal remedies and supplements with prednisolone.

It's not possible to say that herbal remedies and supplements are safe to take with prednisolone. They're not tested in the same way as pharmacy and prescription medicines.