Prednisone and other corticosteroids

Weigh the benefits and risks of corticosteroids, such as prednisone, when choosing a medication.

By Mayo Clinic Staff

Corticosteroid drugs — including cortisone, hydrocortisone and prednisone — are useful in treating many conditions, such as rashes, inflammatory bowel disease and asthma. But these drugs also carry a risk of various side effects.

How do corticosteroids work?

When prescribed in doses that exceed your body's usual levels, corticosteroids suppress inflammation. This can reduce the signs and symptoms of inflammatory conditions, such as arthritis, asthma or skin rashes.

Corticosteroids also suppress your immune system, which can help control conditions in which your immune system mistakenly attacks its own tissues.

How are corticosteroids used?

Corticosteroid drugs are used to treat rheumatoid arthritis, inflammatory bowel disease (IBD), asthma, allergies and many other conditions. These drugs also help suppress the immune system in order to prevent organ rejection in transplant recipients. Corticosteroids also treat Addison's disease, a relatively rare condition where the adrenal glands aren't able to produce even the minimum amount of corticosteroid that the body needs.

Corticosteroids are administered in many different ways, depending on the condition being treated:

  • By mouth. Tablets, capsules or syrups help treat the inflammation and pain associated with certain chronic conditions, such as rheumatoid arthritis and lupus.
  • By inhaler and intranasal spray. These forms help control inflammation associated with asthma and nasal allergies.
  • In the form of eyedrops. This form helps treat swelling after eye surgery.
  • Topically. Creams and ointments can help heal many skin conditions.
  • By injection. This form is often used to treat muscle and joint signs and symptoms, such as the pain and inflammation of tendinitis.

What side effects can corticosteroids cause?

Corticosteroids carry a risk of side effects, some of which can cause serious health problems. When you know what side effects are possible, you can take steps to control their impact.

Side effects of oral corticosteroids

Because oral corticosteroids affect your entire body instead of just a particular area, this route of administration is the most likely to cause significant side effects. Side effects depend on the dose of medication you receive and may include:

  • Fluid retention, causing swelling in your lower legs
  • High blood pressure
  • Problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium
  • Upset stomach
  • Weight gain, with fat deposits in your abdomen, your face and the back of your neck

When taking oral corticosteroids longer term, you may experience:

  • Elevated pressure in the eyes (glaucoma)
  • Clouding of the lens in one or both eyes (cataracts)
  • A round face (moon face)
  • High blood sugar, which can trigger or worsen diabetes
  • Increased risk of infections, especially with common bacterial, viral and fungal microorganisms
  • Thinning bones (osteoporosis) and fractures
  • Suppressed adrenal gland hormone production that may result in a variety of signs and symptoms, including severe fatigue, loss of appetite, nausea and muscle weakness
  • Thin skin, bruising and slower wound healing

Side effects of inhaled corticosteroids

When using an inhaled corticosteroid, some of the drug may deposit in your mouth and throat instead of making it to your lungs. This can cause:

  • Fungal infection in the mouth (oral thrush)
  • Hoarseness

If you gargle and rinse your mouth with water — don't swallow — after each puff on your corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Some researchers have speculated that inhaled corticosteroid drugs may slow growth rates in children who use them for asthma.

Side effects of topical corticosteroids

Topical corticosteroids can lead to thin skin, red skin lesions and acne.

Side effects of injected corticosteroids

Injected corticosteroids can cause temporary side effects near the site of the injection, including skin thinning, loss of color in the skin, and intense pain — also known as post-injection flare. Other signs and symptoms may include facial flushing, insomnia and high blood sugar. Doctors usually limit corticosteroid injections to three or four a year, depending on each patient's situation.

Reduce your risk of corticosteroid side effects

To get the most benefit from corticosteroid medications with the least amount of risk:

  • Ask your doctor about trying lower doses or intermittent dosing. Newer forms of corticosteroids come in various strengths and lengths of action. Ask your doctor about using low-dose, short-term medications or taking oral corticosteroids every other day instead of daily.
  • Talk to your doctor about switching to nonoral forms of corticosteroids. Inhaled corticosteroids for asthma, for example, reach lung surfaces directly, reducing the rest of your body's exposure to them and leading to fewer side effects.
  • Ask your doctor if you should take calcium and vitamin D supplements. Long-term corticosteroid therapy may cause thinning bones (osteoporosis). Talk with your doctor about taking calcium and vitamin D supplements to help protect your bones.
  • Take care when discontinuing therapy. If you take oral corticosteroids for a long time, your adrenal glands may produce less of their natural steroid hormones. To give your adrenal glands time to recover this function, your doctor may reduce your dosage gradually. If the dosage is reduced too quickly, your adrenal glands may not have time to recover and you may experience fatigue, body aches and lightheadedness.
  • Wear a medical alert bracelet. This or similar identification is recommended if you've been using corticosteroids for a long time.
  • See your doctor regularly. If you're taking long-term corticosteroid therapy, see your doctor regularly to check for side effects.

Weigh the risks and benefits of corticosteroids

Corticosteroids may cause a range of side effects. But they may also relieve the inflammation, pain and discomfort of many different diseases and conditions. Talk with your doctor to help you better understand the risks and benefits of corticosteroids and make informed choices about your health.

Dec. 16, 2020

See also

  1. 6 tips to manage rheumatoid arthritis symptoms
  2. A Pain-Free Thumbs Up!
  3. Acetyl-L-carnitine: Can it relieve MS fatigue?
  4. Acute flaccid myelitis (AFM)
  5. Acute sinusitis
  6. Acute sinusitis: Do over-the-counter treatments help?
  7. Addison's disease
  8. Adrenal fatigue: What causes it?
  9. Albuterol side effects
  10. Alcoholic hepatitis
  11. Allergies
  12. Allergies and asthma
  13. Allergy medications: Know your options
  14. Allergy-proof your home
  15. Aplastic anemia
  16. Arthritis
  17. Arthritis pain: Do's and don'ts
  18. Aspergillosis
  19. Aspirin allergy
  20. Asthma
  21. Asthma and acid reflux
  22. Asthma attack
  23. Asthma diet
  24. Adult asthma action plan
  25. Asthma inhalers: Which one's right for you?
  26. Asthma: Colds and flu
  27. Asthma medications
  28. Asthma: Testing and diagnosis
  29. Asthma treatment: 3 steps
  30. Asthma treatment: Do complementary and alternative approaches work?
  31. Asthma and menstruation
  32. Asthma-friendly products
  33. Atopic dermatitis (eczema)
  34. Avoid rebound nasal congestion
  35. Baker's cyst
  36. Barrel chest: What causes it?
  37. Base tan? Bad idea
  38. Behcet's disease
  39. Botox injections: Can they relieve arthritis pain?
  40. Explaining multiple sclerosis
  41. Bullous pemphigoid
  42. Bursitis
  43. Can arthritis pain medications be harmful?
  44. Can baby eczema be prevented?
  45. Cannabis for MS: Can it help treat symptoms?
  46. Infographic: Cardiac sarcoidosis: A heart under attack
  47. Carpal tunnel exercises: Can they relieve symptoms?
  48. Carpal tunnel syndrome
  49. Carpal Tunnel Tune-Up
  50. Chagas disease
  51. Chilblains
  52. Cholestasis of pregnancy
  53. COPD
  54. Churg-Strauss syndrome
  55. Cluster headache
  56. Croup
  57. Cryptogenic organizing pneumonia
  58. De Quervain's tenosynovitis
  59. Demyelinating disease: What can you do about it?
  60. Dermatomyositis
  61. Diffuse idiopathic skeletal hyperostosis (DISH)
  62. Does honey offer sweet relief for allergies?
  63. Does stress make rheumatoid arthritis worse?
  64. Drug allergy
  65. Dust mite allergy
  66. Ease rheumatoid arthritis pain when grocery shopping
  67. Eczema bleach bath: Can it improve my symptoms?
  68. Emerging treatments for multiple sclerosis
  69. Emphysema
  70. Estriol as a potential treatment option for multiple sclerosis (MS)
  71. Exercise and multiple sclerosis
  72. Exercising with arthritis
  73. Fingolimod during pregnancy: Is it safe?
  74. Giant cell arteritis
  75. Glomerulonephritis
  76. Hip labral tear
  77. How do I reduce fatigue from rheumatoid arthritis?
  78. How to treat baby eczema
  79. Hyperinflated lungs: What does it mean?
  80. Hypopituitarism
  81. Interstitial lung disease
  82. Is depression a factor in rheumatoid arthritis?
  83. Is there a multiple sclerosis diet?
  84. Juvenile idiopathic arthritis
  85. Knee bursitis
  86. Knee pain
  87. LABAs for asthma
  88. Living better with rheumatoid arthritis
  89. Long-term safety of natalizumab for treating multiple sclerosis
  90. Managing anxiety in MS: What works?
  91. Managing depression in MS
  92. Managing Headaches
  93. Mangosteen juice: Can it relieve arthritis pain?
  94. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  95. Mayo Clinic Minute Weathering migraines
  96. Mayo Clinic Minute: What parents need to know about pink eye
  97. Medication overuse headaches
  98. Migraine
  99. Migraine medications and antidepressants
  100. Migraine treatment: Can antidepressants help?
  101. Infographic: Migraine Treatments: Botox & Nerve Blocking
  102. Migraines and gastrointestinal problems: Is there a link?
  103. Migraines and Vertigo
  104. Migraines: Are they triggered by weather changes?
  105. Alleviating migraine pain
  106. Mindfulness practice: Can it reduce symptoms of MS?
  107. Mixed connective tissue disease
  108. Mononucleosis
  109. Mononucleosis: Can it recur?
  110. Mononucleosis and Epstein-Barr: What's the connection?
  111. MSM for arthritis pain: Is it safe?
  112. Multiple sclerosis
  113. Infographic: Multiple Sclerosis
  114. Multiple sclerosis: Can it cause seizures?
  115. Myasthenia gravis
  116. Nasal Cleaning
  117. Nasal spray addiction: Is it real?
  118. Neck pain
  119. Nephrotic syndrome
  120. Neuromyelitis optica
  121. New Test for Preeclampsia
  122. Occipital nerve stimulation: Effective migraine treatment?
  123. Ocular migraine: When to seek help
  124. Oil of oregano: Can it treat sinusitis?
  125. Oral lichen planus
  126. Osteoporosis and long-term prednisone: What is the risk?
  127. Ozone air purifiers
  128. Palindromic rheumatism: Precursor to rheumatoid arthritis?
  129. Paraneoplastic syndromes of the nervous system
  130. Personalized therapy for multiple sclerosis (MS)
  131. Pink eye (conjunctivitis)
  132. Pink eye: How long is it contagious?
  133. Pink eye treatment: What if I wear contact lenses?
  134. Plantar fasciitis
  135. Pneumonitis
  136. Polymyalgia rheumatica
  137. Polymyositis
  138. Polymyositis: Can it affect my lungs?
  139. Prednisone withdrawal: Why taper down slowly?
  140. Preeclampsia
  141. Preterm labor
  142. Protect your joints while housecleaning
  143. Pseudoclaudication: Is it related to claudication?
  144. Ramsay Hunt syndrome
  145. Reactive airway disease: Is it asthma?
  146. Rethinking Rheumatoid Arthritis
  147. Rheumatoid arthritis
  148. Rheumatoid Arthritis
  149. Rheumatoid arthritis: Does pregnancy affect symptoms?
  150. Rheumatoid arthritis and exercise
  151. Rheumatoid arthritis: Vaccines
  152. Rheumatoid arthritis diet
  153. Rheumatoid arthritis: Can it affect the eyes?
  154. Rheumatoid arthritis: Can it affect the lungs?
  155. Rheumatoid arthritis medications: Dangerous during pregnancy?
  156. Rheumatoid arthritis pain: Tips for protecting your joints
  157. Sacroiliitis
  158. Salt craving: A symptom of Addison's disease?
  159. Sarcoidosis
  160. Sciatica
  161. Sepsis
  162. Sheehan's syndrome
  163. Sinus infection and toothache: Any connection?
  164. Hand exercises for people with arthritis
  165. Joint protection
  166. Spinal stenosis
  167. Stop your next migraine before it starts
  168. Stress management for MS
  169. Sulfa allergy
  170. Sunburn
  171. Sunburn treatment: Do I need medical attention?
  172. Swollen knee
  173. Takayasu's arteritis
  174. Tanning: Does a base tan prevent sunburn?
  175. Tendinitis
  176. Tendinitis pain: Should I apply ice or heat?
  177. Thrombocytopenia (low platelet count)
  178. Thumb arthritis
  179. Thumb Reconstruction
  180. Tips for coping with rheumatoid arthritis
  181. Tips to make your mornings easier
  182. Trichinosis
  183. Trouble breathing
  184. Asthma attack video
  185. Carpal tunnel symptoms: Role of nonsurgical treatment
  186. Carpal tunnel syndrome surgery: Immediate and long-term results
  187. Dry powder disk inhaler
  188. Dry powder tube inhaler
  189. Video: How to use a peak flow meter
  190. Single-dose dry powder inhaler
  191. Using a metered dose asthma inhaler and spacer
  192. Vitamin D and MS: Any connection?
  193. Vitamins for MS: Do supplements make a difference?
  194. Vocal cord dysfunction
  195. Water exercise
  196. What is aspirin-exacerbated respiratory disease (AERD)?
  197. Whipple's disease
  198. Yucca: Can it relieve arthritis pain?