Side Effects Of Prednisone

Prednisone is a widely used medication that belongs to a family of drugs referred to as corticosteroids, which are very similar to the naturally-produced hormone called cortisol. Cortisol is produced by the adrenal glands and alters the way the immune system is functioning, helps the brain use glucose more efficiently, suppresses the digestive system, and slows growth processes. However, corticosteroids are used to decrease the action of the immune system when it is causing more harm than good. Numerous diseases and conditions can produce abnormalities of the immune system that may need treatment with corticosteroids such as prednisone. Prednisone helps stop the body from making the chemicals responsible for the inflammatory responses. Prednisone is most often used to treat rheumatoid arthritis, lupus, myositis, vasculitis, skin conditions, breathing disorders, ulcerative colitis, and allergic disorders.

Of course, prednisone comes with certain side effects. Get to know them now.

Fluid And Sodium Retention

An individual who takes prednisone may experience sodium and fluid retention. As mentioned, corticosteroids like prednisone are very similar to cortisone, which influences the way an individual's body manages its delicate balance between sodium, water, and other electrolytes. When the electrolyte and water balance is thrown off, an individual's body may be stimulated to retain more sodium than it is meant to. Excess sodium in a healthy individual's body is eliminated via the urine, stool, and sweat. Prednisone, like cortisone, can interfere with the normal elimination of sodium from the body. When sodium remains in an individual's body, fluid follows the sodium and also remains in the body. Sodium and fluid retention lead to weight gain, the buildup of excessive fluid in the cells outside of the bloodstream, and high blood pressure.

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High Blood Pressure

High blood pressure is a prevalent side effect of taking prednisone. Prednisone is one of many medications that cause an individual's body to be unable to eliminate sodium the way it should through sweat, stool, and urine. This malfunction causes the retention of more fluid than normal in the body because fluid follows sodium. Excess fluid in the body adds volume to the existing volume of the individual's blood in circulation. The individual's blood volume becomes higher than normal with excess fluid, which means more blood is being forced through their blood vessels as their heart is pumping it around their body. This mechanism is comparable to how water runs through a garden hose. The less water being forced through the garden hose, the lower the pressure will be inside of and on the garden hose walls. When a greater quantity of water is forced through the same garden hose, the pressure on the garden hose walls and inside of the garden hose increases. A greater volume of blood increases the amount of force being placed on the blood vessel walls as the heart is pumping it throughout the body. This increased force on the vessels is measured as an individual's blood pressure.

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Headaches

Headaches are a side effect that occurs in individuals who take prednisone for an extended period. Headaches are not caused by the mechanism of the medication itself but are more of a complication of the high blood pressure often induced by long-term use of prednisone. Headaches that occur due to high blood pressure caused by prednisone use tend to occur in a bilateral fashion, or on both sides of the head. High blood pressure produces adverse effects on an individual's blood-brain barrier and causes an accumulation of pressure in the brain. Blood can leak from the blood vessels in the brain because of high blood pressure, which produces inflammatory swelling inside of the skull. Because the skull is a bone that is not flexible and cannot expand, the swelling inside of an individual's skull causes the brain tissues to become compressed. The abnormal compression of the brain and surrounding tissues causes nearby nerve fibers to become irritated. These irritated nerves transmit signals of pain responsible for causing the patient to feel pain in their head, neck, and face.

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Nausea And Vomiting

Although they are not common side effects of prednisone, some individuals may experience nausea and vomiting. Prednisone and other corticosteroids are known to cause certain changes in the linings of a patient's stomach and small intestine. A process referred to as prostaglandin biosynthesis takes place in a healthy individual's stomach and small intestine when the contents of the organs reach a pH level that is too low. Prostaglandin biosynthesis induces a response that increases the alkalinity of the contents of the stomach and small intestine. Without this alkaline response, the mucosal barrier in the lining of an individual's stomach and small intestine can become increasingly eroded due to the high acidity of their contents. Moderate to high doses of prednisone over some time can cause the inhibition of prostaglandin biosynthesis, leading to increased acidity in the stomach and small intestine that produces significant damage to the tissues that should be protected by the mucosal layer in their linings. With a compromised mucosal layer and inflamed tissues, the stomach and small intestine are unable to digest and absorb food properly. Nausea and vomiting can occur due to the extensive inflammation of these digestive components, overgrowth of bacteria, or fermentation of stagnated food.

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Weight Gain

A common adverse side effect of taking prednisone for extended periods is unexpected weight gain. Corticosteroids like prednisone can influence the way an individual's body naturally uses up calories and the way it manages fat deposition. These interferences have been known to cause a patient taking prednisone for an extended period to have an increased appetite. With an increased appetite, someone taking prednisone is inclined to consume more calories than they would otherwise. The consumption of a greater number of calories than the number of calories the body is burning off is referred to as a positive energy balance. When an individual has a positive energy balance, the excess calories not being burned off are stored in the body as fat tissue. Over time, the fat tissue accumulates in the individual's body and causes weight gain or a net increase in total body mass. Prednisone can also result in weight gain because of its tendency to cause the body to hold onto more sodium and fluid that would otherwise be eliminated through sweat, urine, and stool.

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Mood Changes

Many patients experience mood changes during treatment with prednisone. One patient's mood swings may vary considerably compared to another. For example, some individuals report feelings of euphoria while on the medication, and others have experienced depression, anxiety, and anger. Patients might have very quick shifts in mood during prednisone use, and mood changes often develop without provocation and for no apparent reason. Individuals who use prednisone could feel extremely sad or angry without knowing why. Prednisone is sometimes associated with more severe mental health changes, including the development of psychosis, delusions, and dementia. Mood changes are more likely to occur when prednisone is taken in higher dosages, and reducing the dose could reduce or eliminate mood swings. Patients often find their mood returns to normal once they stop taking prednisone. If mood changes are disruptive, patients should check with their doctor about switching to a different medication.

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Decrease In Urine Production

A decrease in urine production is common with prednisone use. The patient may notice they do not use the bathroom as often as normal, and urination could be painful. It might be difficult to start the urine stream, and patients might feel they are unable to completely empty the bladder. Decreased urine production can cause the body to retain fluids, and this may lead to weight gain and increased fullness and roundness in the face and neck. Patients might want to monitor their urine production and color, and they should let their doctor know if they experience pain while urinating, and it is especially important to keep drinking fluids to prevent dehydration. Since problems with urination may lead to kidney issues, patients may need to have their kidney health monitored during treatment with this medication. Emergency medical care is necessary if the patient becomes unable to urinate at all.

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Irregular Heartbeat Or Pulse

Patients who take prednisone frequently report experiencing an irregular heartbeat or pulse. They may notice their heartbeat is faster or slower than usual, and the sensation of a pounding heartbeat could be present. Individuals who take this medication may want to check their pulse at home regularly. This can be done with an automatic blood pressure machine or pulse oximeter; many automatic blood pressure machines will detect an irregular heartbeat and notify the patient immediately. Since an irregular heartbeat could indicate a more serious medical issue and increase the patient's risk of certain heart conditions, it should always be checked by a physician. The doctor will check the patient's heartbeat by listening with a stethoscope, and an electrocardiogram may be completed. Patients who experience an irregular heartbeat might benefit from switching to another medication if possible. Many individuals find their heart rate becomes regular again after they stop taking prednisone. Patients who have certain cardiac risk factors may need to have their heart health checked with frequent follow-up visits during treatment with prednisone.

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Blurry Vision

Individuals who experience blurry vision during their treatment with prednisone should speak to their doctor right away. Blurry vision decreases visual sharpness, and patients could notice objects and individuals appear hazy. They might see halos around lights, and their eyes may water or become painful. Patients with these symptoms will generally need to have an eye health exam with an ophthalmologist, who will check their eye pressure, visual acuity, and eye muscle health. The doctor will need to know the patient is taking prednisone, and they will ask questions about when the eye symptoms began, how long they last, and if anything makes them worse or better. Patients who regularly experience blurry vision while on prednisone may find it difficult to perform daily activities such as reading, driving, writing, or using the computer. To reduce blurry vision and other side effects, the prescribing physician might choose to lower the patient's dose of prednisone, and alternative medications may be considered. Any vision changes that occur with prednisone generally resolve after the medicine is discontinued.

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Breathing Issues

Prednisone is used to treat many types of respiratory disorders, and patients who experience breathing issues while taking this medication could be having an allergic reaction. If shortness of breath occurs, emergency medical care should be obtained immediately. Breathing issues associated with prednisone are more common in female patients over sixty years old, and patients with high blood pressure are at an increased risk of experiencing breathing difficulties while on prednisone as well. Breathing issues typically begin during the first month of prednisone use, and taking this medication together with tiotropium bromide could also increase the likelihood of this side effect. To determine the cause of breathing difficulties, doctors will first check for signs of an allergic reaction, including facial swelling and skin rashes. If an allergic reaction is ruled out, a physical examination and imaging studies may be needed to detect underlying medical conditions. Pulmonary function tests may be performed, and the patient may need to take additional medications to reduce breathing trouble while on prednisone. Activity modification could ease this side effect, and patients will need to be regularly monitored by their healthcare providers.