Prednisone Side Effects
Complete list of drugs used to
treat arthritis.
Summery of prednisone side effects
- upset stomach
- stomach irritation
- vomiting
- headache
- dizziness
- insomnia
- restlessness
- depression
- anxiety
- acne
- increased hair growth
- easy bruising
- irregular or absent menstrual periods
If you experience any of the following symptoms, call your doctor
immediately:
- skin rash
- swollen face, lower legs, or ankles
- vision problems
- cold or infection that lasts a long time
- muscle weakness
- black or tarry stool
Prednisone side effects - Weight Gain
Weight gain is usually the most
dreaded side–effects of steroid use, incurred to some degree by nearly all patients
who take them. The amount of weight gain varies from individual to individual. In addition
to causing weight gain, prednisone leads to a redistribution of body fat to places
that are undesirable, particularly the face, back of the neck, and abdomen. Pictured
below is a example of redistribution of body fat to the back of the neck. Accumulation
of fat in this area is sometimes referred to as a “buffalo hump”.
Prednisone side effects - Increased risk for Infetions
Patients are at increased risk
for many types of infections, from minor fungal infections in the mouth (“thrush”,
caused by Candida) to life–threatening infections such as Pneumocystis
carinii pneumonia. The higher the steroid dose and the longer the duration of therapy,
the greater the risk of infection. The risk is also increased when patients receive
combinations of immunosuppressive medications, such as cyclophosphamide (cytoxan) and
prednisone. The risk of some infections can be greatly reduced by taking specific types of
antibiotics prophylactically.
Other prednisone side effects
Bone thinning (osteoporosis)
Prednisone may cause thinning
of the bones even in people who are not usually at high risk for osteoporosis (for
example: males, young people). In people susceptible to osteoporosis, prednisone may
accelerate the process of bone loss. Fortunately, in the past few years, excellent
treatments and preventive measures have become available for osteoporosis. All
patients on prednisone for prolonged periods are candidates for these medicines.
Easy Bruising
Prednisone also
causes “thin skin”. Patients on moderate to high doses of prednisone often
notice that they bruise easily, even with only slight trauma. Pictured below is a
patient with giant cell arteritis who suffered a skin laceration after she struck her leg
against a chair.
Avascykar Necrosis of Bone
For reasons that
are not known, high dose prednisone (for example, greater than 20 milligrams a day)
predisposes some patients to joint damage, most often of the hips. In avascular necrosis
(or osteonecrosis, meaning “bone death”) of the hip, the part of the leg bone
that inserts into the pelvis dies, resulting in pain with weight–bearing and some
loss of joint function. Many patients with avascular necrosis require joint replacements.
Steroid–induced diabetes
High blood sugar, or steroid–induced diabetes. This usually resolves when the
steroids are decreased or discontinued.
High blood pressure
High blood pressure. This usually improves as the corticosteroid dose is reduced.
Mood Swings/Insomnia
Many patients find it difficult to sleep when taking high doses of steroids. Many also
find that they are more irritable than usual. Steroids sometimes even induce depression,
which improves when the drug is decreased or discontinued.
Cataracts
Long–term steroid use may lead to cataract development in the eyes, which
frequently require surgical removal.
Acne
High dose prednisone predisposes some patients to acne, especially facial acne, as
pictured below. The facial acne developed after several weeks of high steroid doses
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