Prednisone is one of the more well-known prescription steroid medications you might have heard of, even if you haven’t taken it yourself.
Steroid medications can be useful in treating various health conditions but come with potential side effects and long-term risks.
If you’ve been prescribed prednisone, you might be wondering if there is anything you need to avoid, including medications and certain foods.
We’ll discuss prednisone in detail, including its common uses, potential side effects, interactions, and foods to eat and avoid while taking it in this article.
What is prednisone?
Prednisone is a common type of corticosteroid, which is a prescription medication. The common brands of prednisone include Prednisone Intensol, Deltasone, and Rayos.
Steroids like prednisone are used to treat conditions related to low levels of corticosteroids (substances that your body makes on its own), as well as conditions that aren’t related to low levels of corticosteroids.
Some of the health problems prednisone is prescribed to help treat include:
- Certain types of arthritis
- Inflammation/swelling
- Chronic obstructive pulmonary disease (COPD)
- Asthma
- Allergies
- Adrenal gland problems
- Blood or bone marrow problems
- Endocrine (hormonal) issues
- Stomach problems (including ulcerative colitis)
- Autoimmune diseases like lupus
- Kidney problems
- Multiple sclerosis (MS) flare-ups
- Vision problems
- Skin conditions
Administration
Prednisone can be administered orally in tablet or liquid solution form. Prednisone can also be administered by a healthcare professional as an injection directly into an arthritic or inflamed joint.
Your liver has to convert prednisone into prednisolone before it can begin working. Prednisolone is considered the active form of prednisone, so it’s very similar to prednisone.
Patients with liver disease are usually prescribed prednisolone, so their liver doesn’t have to work to convert prednisone to the active form. Prednisolone is most often administered intravenously (IV) because it can be given in higher amounts than prednisone in IV form.
Dosage
Typical prednisone dosages fall between 10 to 60 milligrams/day given in a single daily dose or 2-4 divided doses every 6-12 hours.
2.5-10 milligrams per day is considered a low dose of prednisone, while a high dose is considered 1-1.5 milligrams per kilogram of the patient’s body weight per day. The maximum dose of prednisone usually doesn’t exceed 80-100 milligrams per day.
What are the side effects of prednisone?
Prednisone comes with potential side effects. The likelihood that you experience side effects from taking prednisone increases with higher doses and longer durations of taking prednisone.
The most common side effects of prednisone include:
- Weight gain
- Indigestion
- Problems sleeping (insomnia)
- Feeling restless
- Increased sweating
- Mild mood change/agitation
- Blurred vision
- Dizziness
- Headache
- Numbness or tingling in your arms or legs
- Troubled breathing/shortness of breath
- Swelling of hands, feet, and/or lower legs
If you take prednisone long-term, you might develop problems such as:
- Thinner bones (osteoporosis)
- Diabetes
- Eyesight problems
- High blood pressure (hypertension)
What drugs can prednisone interact with?
Your healthcare provider or pharmacist can advise you on which medications you should avoid while taking prednisone. In general, some of the medications that are known to not interact well with prednisone include:
- Aldesleukin (a medication used to treat some types of cancer)
- Mifepristone (progesterone blocker used to terminate pregnancies)
- Drugs that can cause bleeding/bruising such as antiplatelet drugs like clopidogrel (Plavix), blood thinners like warfarin (Coumadin), etc.
- Non-steroidal anti-inflammatories such as aspirin, celecoxib, and ibuprofen
If you need an over-the-counter anti-inflammatory, acetaminophen (Tylenol) is generally preferred over ibuprofen (Advil) because it is less likely to cause gastric bleeding and/or irritate the stomach lining.
Birth control pills containing estrogen can enhance the concentration and effects of steroids and cause stronger side effects. If you’re taking birth control pills and plan to take prednisone, you might consider discussing other birth control options with your healthcare provider.
Prednisone isn’t known to interact with any supplements or vitamins, but you should always consult with your pharmacist about any supplements you’re taking before you begin taking prednisone.
Prednisone disease interactions
The most common conditions where prednisone isn’t recommended include:
Gastrointestinal perforation (tear)
Corticosteroids can thin the lining of your stomach/digestive tract, making a GI perforation more likely to bleed or increase in severity.
Infections
Taking prednisone impacts your immune system and can make it more difficult to fight off infections. Prednisone can also delay wound healing.
Vaccinations
Because prednisone suppresses your immune system, it can make vaccinations less effective.
It isn’t recommended to receive live vaccines like the flu vaccine when taking prednisone; it’s recommended to wait around 2 weeks-30 days after your last dose of prednisone before receiving vaccinations, especially with higher doses.
You might be able to receive a vaccination on lower doses of prednisone – be sure to ask your healthcare provider.
Does alcohol interact with prednisone?
While there aren’t any known interactions between prednisone and alcohol, it isn’t recommended to consume large amounts of alcohol while taking prednisone. Alcohol can intensify certain side effects, like suppressing your immune system and worsening weight gain.
Foods to avoid when taking prednisone
Concentrated sweets
Taking prednisone can make your body more resistant to insulin, which raises your blood sugar levels. How are prednisone and diabetes related? Taking prednisone for long periods can cause steroid-induced diabetes.
If you’re taking higher doses of prednisone or need to take prednisone for a long time, you might need to be careful with your intake of sugar-sweetened foods and drinks. This is especially true if you already have diabetes.
These types of foods and drinks are considered “concentrated sweets” and include high amounts of added sweeteners.
- Cakes, candy, cookies, muffins, etc.
- Flavored milk (chocolate, strawberry, hot chocolate, etc.)
- Fruit canned in syrup
- Fruit drinks with added sugar or corn syrup (soda, sweetened teas/coffees, etc.)
- Granola and granola bars
- Honey and molasses
- Ice cream, frozen yogurt, and sherbet
- Jelly, jam, and preserves
- Milkshakes
- Pancake syrup, maple syrup, etc.
- Pastries, donuts, pies, and sweet rolls
- Regular pudding and custard (not sugar-free)
- Sugary cereals
- Sweetened yogurt
High-sodium foods
Taking prednisone can increase your risk of swelling, fluid retention, and high blood pressure. High-sodium foods can worsen swelling and cause your body to hold on to more fluids, which can worsen high blood pressure.
The highest sources of sodium (salt) are processed/convenience foods and foods that have long shelf lives.
Fast food and food from restaurants are typically higher in sodium than the food you prepare at home since salt is an easy and inexpensive way to add flavor to foods.
Some high-sodium foods to limit your portions of while taking prednisone are:
- Deli and cured meats
- Salty snacks (chips, pretzels, etc.)
- Quick-bread mixes
- Canned soups
- Frozen entrees
- Fast food like pizza, salted French fries, etc.
- Certain condiments (e.g. soy sauce) and salad dressings
Caffeine
Prednisone can cause you to feel restless and make it difficult to get a good night’s sleep. Avoid drinking large amounts of caffeine while taking prednisone to help minimize sleeping problems.
While you might be okay with light- to moderate caffeine intake, you may want to avoid excessive consumption of caffeine products while you take prednisone.
Some of the strongest sources of caffeine include:
- Strong espresso drinks (Americanos, lattes with espresso shots, etc.)
- Energy drinks or “shots”
- Caffeinated sodas
- Black teas
Foods to eat when taking prednisone
Taking prednisone might increase your risk of certain nutrient deficiencies. Some nutrients that might become slightly depleted while taking prednisone include potassium, vitamin B6, vitamin B12, and folic acid.
Your risk of nutrient deficiencies might be higher if you’re taking other medications alongside prednisone, such as certain heart medications and diuretics (water pills), and medications that reduce your absorption of vitamin B12.
Potassium-rich foods
If your blood potassium levels are lowered while taking prednisone, you can help replenish potassium by eating foods like:
- Dried fruits (raisins, apricots)
- Beans and lentils
- Potatoes
- Winter squash (acorn, butternut)
- Spinach, broccoli
- Beet greens
- Avocado
- Bananas
- Cantaloupe
- Oranges, orange juice
- Tomatoes
- Yogurt
- Nuts (cashews, almonds)
Foods high in vitamins B6 and B12
B vitamins help you use the energy from food. They can also help transport nutrients and oxygen throughout your body and help you feel more energized.
Some foods rich in vitamins B6 and B12 to eat while taking prednisone (to prevent possible deficiencies) include:
Vitamin B6
- Beef liver
- Tuna
- Salmon
- Fortified cereals
- Chickpeas
- Poultry
- Some vegetables and fruits such as leafy green vegetables, bananas, papayas, oranges, and cantaloupe
Vitamin B12
- Meat
- Fish
- Milk
- Cheese
- Eggs
- Some fortified breakfast cereals (suitable for vegans or vegetarians)
- Nutritional yeast (fortified with vitamins B6 and B12 and is great for vegans/vegetarians)
Folic acid
Taking prednisone might deplete levels of folic acid (vitamin B9). Some foods naturally rich in folate/folic acid include:
- Dark green leafy vegetables (turnip greens, spinach, romaine lettuce, asparagus, Brussels sprouts, broccoli)
- Beans
- Peanuts
- Sunflower seeds
- Fruit and fruit juices
- Whole grains
- Liver
- Seafood
- Eggs
- Fortified foods and supplements
Vitamin D
Prednisone can impair your immune system’s ability to fight off illness and infections. According to a study, vitamin D might help offset some of these impacts and benefit your immune system.
Some of the best sources of vitamin D include:
- Fortified milk, both dairy and plant-based
- Cod liver oil
- Salmon
- Swordfish
- Tuna fish
- Fortified products like cereals
- Sardines
- Beef liver
- Egg yolks
If you don’t eat vitamin D-rich foods regularly (this can happen if you follow a vegan or vegetarian diet), you might consider a vitamin D supplement.
Vitamin C-rich foods
Another nutrient known to help support your immune system is vitamin C. Vitamin C also aids in wound healing, which can be delayed by taking prednisone.
The best sources of vitamin C are in plant foods like:
- Citrus (oranges, kiwi, lemon, grapefruit)
- Bell peppers
- Strawberries
- Tomatoes
- Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower)
- White potatoes
Conclusion
Prednisone is a type of corticosteroid medication used to treat a variety of health conditions. Prednisone is administered in oral form, including tablets and a liquid solution.
Certain medications can interact with prednisone and increase your risk of bleeding, such as blood thinners and some types of anti-inflammatory medications.
While taking prednisone, you might consider limiting or avoiding concentrated sweets, high-sodium foods, and large amounts of alcohol and caffeine.
Prednisone can impact your immune system, so eating vitamin D- and vitamin C-rich foods can help support your immune system.
Certain nutrient deficiencies might arise from taking prednisone long-term; eating foods rich in potassium, folic acid, vitamin B6, and vitamin B12 can help offset these potential deficiencies.
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