Prednisolone side effects

High doses of  cortisone  should only be used for a short period of time when used systemically, since long-term use above the so-called Cushing threshold (> 7.5 mg/d) significantly increases the risk of massive and sometimes dangerous side effects. Short-term high-dose or local applications usually have no or much less pronounced side effects.

Typical side effects of prednisolone

Side effects of treatment with prednisolone include:

• The inhibition of the immune system harbors an increased susceptibility to infections. Infections can be disguised, go unnoticed for a long time and then become particularly severe. Patients treated with prednisolone should therefore protect themselves from infection and avoid large crowds.
• Due to the inhibition of inflammatory cells, wound healing is also disturbed.
• The body’s own hormone cortisol has an anabolic effect, so it serves to store energy. Like cortisone, prednisolone also has an effect on sugar and fat metabolism. High dosages thus cause a redistribution of the fat and the patients gain weight, especially in the area of ​​the trunk. The so-called bull neck and the moon face are typical signs of a long-lasting high dose of cortisone. This effect on the metabolism can even   trigger diabetes mellitus.
• Long-term use can also lead to thinning of the skin, and the vessels in the subcutaneous tissue can then be seen more clearly. Acne of the skin, the so-called steroid acne, can also be triggered.
• Bone loss, technically called osteoporosis, is a very common side effect of prednisolone.
• Another side effect is muscle weakness.
• Furthermore, treatment with prednisolone carries the risk of cataracts or glaucoma.
• Depression  and mood swings can be exacerbated by taking cortisone preparations. Some patients being treated with prednisolone also have changes in appetite.
• Stomach problems (such as a stomach ulcer) or inflammation of the pancreas can be unwanted side effects of prednisolone.
• Prednisolone increases the risk of  cardiac arrhythmias ,  high blood pressure , calcification of the arteries, thrombosis and vascular inflammation.
• The absorption of iodine into the body can be reduced during cortisone therapy, which is why the thyroid gland values ​​should be checked regularly during treatment with prednisolone.

If an illness requires long-term immunosuppressive treatment, cortisone should be combined with other immunosuppressive drugs to avoid side effects.