What to expect with Prednisone?
June 19, 2019 6:27 PM Subscribe
What are the likely side effects of a 14 day course of Prednisone (40 mg first week, then 20 mg for a week)?
I’ve been prescribed Prednisone for a serious facial rash that hasn’t responded to months of other treatments: 40mg/day for 7 days, then 20mg/7 days.
Is this short enough of a term/dose to avoid weight gain and...moon face? What else should I expect?
37 year old female, 5’9, average weight. I do have mobility problems and cannot exercise.
Sorry if this has been addressed previously, I wasn’t able to find the answer myself.
I’ve been prescribed Prednisone for a serious facial rash that hasn’t responded to months of other treatments: 40mg/day for 7 days, then 20mg/7 days.
Is this short enough of a term/dose to avoid weight gain and...moon face? What else should I expect?
37 year old female, 5’9, average weight. I do have mobility problems and cannot exercise.
Sorry if this has been addressed previously, I wasn’t able to find the answer myself.
Sleep issues, irratiability are two of the big ones for me, it also is a double whammy thing longer I take it (less sleep plus more irritability as sleep directly effects how well I regulate). I try and cut out as much stress as possible.
I also get more anxious than usual.
posted by AlexiaSky at 6:40 PM on June 19, 2019 [1 favorite]
I also get more anxious than usual.
posted by AlexiaSky at 6:40 PM on June 19, 2019 [1 favorite]
I get the jitters..my hands shake.
posted by Ftsqg at 6:41 PM on June 19, 2019 [1 favorite]
posted by Ftsqg at 6:41 PM on June 19, 2019 [1 favorite]
The typical risk with occasional Prednisone is mood changes, like difficulty controlling anger or just plain moodiness. This is not usually a problem unless the dose is somewhat higher and for somewhat longer. But, the usual patient is not you, and you might be moody or angry.
You should definitely not have any kind of long-term symptoms, like moon face. That's the kind of thing kids with intractable asthma used to get when they took steroids for YEARS, before better treatments were developed, and more typically when the patients were children. Ditto bone problems - too short-term to be problematic. The downside symptoms generally only occur with long-term chronic use.
You might find you temporarily have more appetite, but that should be minor and depart shortly after your course is finished.
posted by citygirl at 6:44 PM on June 19, 2019 [5 favorites]
You should definitely not have any kind of long-term symptoms, like moon face. That's the kind of thing kids with intractable asthma used to get when they took steroids for YEARS, before better treatments were developed, and more typically when the patients were children. Ditto bone problems - too short-term to be problematic. The downside symptoms generally only occur with long-term chronic use.
You might find you temporarily have more appetite, but that should be minor and depart shortly after your course is finished.
posted by citygirl at 6:44 PM on June 19, 2019 [5 favorites]
When I have taken prednisone on a similarly short-term basis, I have gotten a lot of energy and odd joint pains go away. Other people seem to report getting temporarily irritable, but I can't say I became any more irritable from it (at least, no more than baseline).
posted by They sucked his brains out! at 6:47 PM on June 19, 2019 [4 favorites]
posted by They sucked his brains out! at 6:47 PM on June 19, 2019 [4 favorites]
You may find that you have difficulty sleeping. You will likely be short-tempered and agitated.
If you have diabetes or pre-diabetes, you will see your blood glucose levels rise. Within a few days of stopping, they'll go back to "your" normal. By the time the week is up and you taper down, you will likely see a reduction in symptoms.
You may be more hungry and gain a couple of pounds, but two weeks is not long enough (particularly with a reduction after one week) for "moon face." I don't remember my exact dosage, as it changed a few times, and I am old now, but I was on Prednisone when I was 12 for a kidney disease. It was a much higher dosage. After about 6 weeks, I had a puffy face and had gained about 10 pounds. (I also had been severely underweight due to the illness, so this was a good thing.) I eventually gained 40 pounds over six+ months on the meds, bringing me to a healthy weight for my height. You're not going to have to deal with this. Really.
The best thing you can do is to take note of these annoying symptoms (crankiness, difficulty sleeping) and say, "Oh, yes, that's because of the Prednisone. Well, today is day 4. 10 more days." It's hard, but just stopping and recognizing the "why" will help.
posted by The Wrong Kind of Cheese at 6:48 PM on June 19, 2019 [1 favorite]
If you have diabetes or pre-diabetes, you will see your blood glucose levels rise. Within a few days of stopping, they'll go back to "your" normal. By the time the week is up and you taper down, you will likely see a reduction in symptoms.
You may be more hungry and gain a couple of pounds, but two weeks is not long enough (particularly with a reduction after one week) for "moon face." I don't remember my exact dosage, as it changed a few times, and I am old now
The best thing you can do is to take note of these annoying symptoms (crankiness, difficulty sleeping) and say, "Oh, yes, that's because of the Prednisone. Well, today is day 4. 10 more days." It's hard, but just stopping and recognizing the "why" will help.
posted by The Wrong Kind of Cheese at 6:48 PM on June 19, 2019 [1 favorite]
Prednisone chews through your vitamin D, which exacerbates all the above symptoms. Take a supplement while you're on it, and for a while after. If you still feel crappy a few weeks later, get your levels checked. I needed a mega dose of D following a 10 day course.
posted by ananci at 6:50 PM on June 19, 2019 [1 favorite]
posted by ananci at 6:50 PM on June 19, 2019 [1 favorite]
Response by poster: Thank you guys, I feeling better about it already. I forgot to ask- what about acne?
posted by dianeF at 7:05 PM on June 19, 2019
posted by dianeF at 7:05 PM on June 19, 2019
The weight gain happens really quickly. Not only do you retain water like a sponge, but I felt stomach-growling hungry literally all the time. If you can just, like, empty out all the food in your house and then limit yourself to a Freshly delivery or something where you just cannot get to a large stash of food, then maybe. But I’m not gonna lie, I packed on 10 pounds in two weeks, and that is a lot of weight for me. It did not come back off. Not tryin’ to scare ya, but.
I also experienced a 2-3 day period where I had an unbelievable amount of energy. I barely slept, and I got an incredible number of things done around the house. If you have any major projects that need doing, line them up for the first week of prednisone and you’ll probably get them done.
posted by Autumnheart at 7:26 PM on June 19, 2019 [4 favorites]
I also experienced a 2-3 day period where I had an unbelievable amount of energy. I barely slept, and I got an incredible number of things done around the house. If you have any major projects that need doing, line them up for the first week of prednisone and you’ll probably get them done.
posted by Autumnheart at 7:26 PM on June 19, 2019 [4 favorites]
I had severe terror and anxiety and mental fog and had to stop taking it after 3 days because I was scared to fucking death about what my brain was telling me to feel and do. I had never felt anything even remotely like that before and it ended as soon as I stopped taking it, and I will never take it again for any reason. However, I am unfortunately prone to severe side effects with pretty much all medications so most certainly ymmv.
posted by poffin boffin at 8:05 PM on June 19, 2019 [2 favorites]
posted by poffin boffin at 8:05 PM on June 19, 2019 [2 favorites]
Response by poster: Thank you guys, again. This face rash already gave me moon face and I’d like to avoid additional moons. I’ll definitely be prepared for the psychological stuff now and watch my food intake. If anyone has further advice, I welcome it!
posted by dianeF at 8:05 PM on June 19, 2019
posted by dianeF at 8:05 PM on June 19, 2019
To provide a counterpoint to all the folks mentioning negative side effects: I absolutely LOVE LOVE LOVE being on prednisone and never experience anything but positive side effects in the short term. The only reason I don't beg to take it more often is because the negative effects are cumulative, in my understanding, and I want to save the option to have it again in the future if I really need it.
The last time I was on it was 2 years ago, for bad allergies. I had a 10-day prescription, that tapered off, although I don't remember the exact dosages. I had ENERGY and OPTIMISM for once, instead of being my usual depressed and lethargic self. I got shit done. I Got. Shit. Done. And felt freaking awesome.
I am already fat, but don't experience weight gain on prednisone, nor moon face or anything bad.
I hope your experience is like mine.
posted by nirblegee at 8:16 PM on June 19, 2019 [6 favorites]
The last time I was on it was 2 years ago, for bad allergies. I had a 10-day prescription, that tapered off, although I don't remember the exact dosages. I had ENERGY and OPTIMISM for once, instead of being my usual depressed and lethargic self. I got shit done. I Got. Shit. Done. And felt freaking awesome.
I am already fat, but don't experience weight gain on prednisone, nor moon face or anything bad.
I hope your experience is like mine.
posted by nirblegee at 8:16 PM on June 19, 2019 [6 favorites]
I had a 10-day course (tapering dose) to treat hives last summer, and while it did help the hives go away, I had a pretty intense UTI or bladder infection as a result (a week of fever!) My doctor asked me to stop taking the prednisone before I finished them.
Afterwards, my periods were irregular for two or three months - but I am not sure if this was an aftereffect of the fever/infection or the drug. I can't remember the dosage.
posted by Lawn Beaver at 8:35 PM on June 19, 2019 [1 favorite]
Afterwards, my periods were irregular for two or three months - but I am not sure if this was an aftereffect of the fever/infection or the drug. I can't remember the dosage.
posted by Lawn Beaver at 8:35 PM on June 19, 2019 [1 favorite]
I was on it for 2 weeks over the winter, and it was a wild ride. I had SO much energy to do all the things, and was hungry all the time, so it ended up with me going on a baking / cooking project spree. I portioned and froze most of it , just so I didn't eat it all. (I ended up defrosting and eating most of it within the week, but hey, at least it wasn't immediate)
posted by Fig at 8:54 PM on June 19, 2019 [2 favorites]
posted by Fig at 8:54 PM on June 19, 2019 [2 favorites]
Eating every minute of the day. Waking up hangry.
My experience: be nice to yourself, it doesn’t last. I pretty much just eat really heavy foods too. I swear it goes away. I also get super bloated, just filled with water. That also goes away!
I have been on large daily doses of steroids for years, but still get some side effects when I need a temporary increase. (Strangely, I don’t get the emotional volatility.)
Insomnia can happen. Lots of weird shit. But it’s only temporary, so don’t try too hard to fight it.
posted by crankyrogalsky at 9:09 PM on June 19, 2019 [1 favorite]
My experience: be nice to yourself, it doesn’t last. I pretty much just eat really heavy foods too. I swear it goes away. I also get super bloated, just filled with water. That also goes away!
I have been on large daily doses of steroids for years, but still get some side effects when I need a temporary increase. (Strangely, I don’t get the emotional volatility.)
Insomnia can happen. Lots of weird shit. But it’s only temporary, so don’t try too hard to fight it.
posted by crankyrogalsky at 9:09 PM on June 19, 2019 [1 favorite]
If you want the full-immersion experience, you can watch the (pretty great) movie Bigger Than Life.
posted by rhizome at 11:24 PM on June 19, 2019 [1 favorite]
posted by rhizome at 11:24 PM on June 19, 2019 [1 favorite]
The doc I work for calls it "the devil's elixir."
It will often "cure" you of whatever you're taking it for, but the side effects....Christ!
I took Prednisone for 8 or 9 months. I think you probably won't observe a lot of what's mentioned here (maybe in small doses) on a 2-week taper.
posted by kuanes at 4:07 AM on June 20, 2019 [1 favorite]
It will often "cure" you of whatever you're taking it for, but the side effects....Christ!
I took Prednisone for 8 or 9 months. I think you probably won't observe a lot of what's mentioned here (maybe in small doses) on a 2-week taper.
posted by kuanes at 4:07 AM on June 20, 2019 [1 favorite]
My husband was on a high dose of prednisone for 5 months. It saved our marriage. Seriously, it was like a switch turned on: he was suddenly the cheerful, happy, easy-going guy I married. He didn't gain weight; he already had a pretty round face before the prednisone so no changes there. In our experience pred is a wonder drug: hope that it has a similar effect for you!
posted by tumbling at 4:12 AM on June 20, 2019 [3 favorites]
posted by tumbling at 4:12 AM on June 20, 2019 [3 favorites]
Prednisone is great for me. I have a ton of energy, can focus, and am motivated. I can feel more jittery if I don't eat, but properly nourished and rested, it's wonderful.
posted by quadrilaterals at 5:32 AM on June 20, 2019 [3 favorites]
posted by quadrilaterals at 5:32 AM on June 20, 2019 [3 favorites]
I sometimes have to take similar short courses of pred for asthma flares, as my normal asthma treatment is basically "all the drugs we have except for oral steroids" so that's really the only place to go if the normal course isn't cutting it for some reason.
First, the good: Prednisone is SO EFFECTIVE. I feel notably and amazingly better within a day, usually. Also, any side effects I have usually go away even before the end of the course, once my taper gets below a certain dose. I'm already fat and round-faced but I never notice any particular increase in those traits from pred. Or acne, or anything else. I think there's likely a fair bit of variability in people's responses.
The less good: I guess maybe this is related to the mood thing but pred tends to make me feel... weird. Not really angry or cranky or manic or whatever, just... weird. Like I'm a half degree off from normal life, maybe. Just a little off. It's not really negative, just strange. I haven't noticed appetite changes but I do get leg cramps (prednisone makes your body flush potassium.) I'd suggest a potassium supplement or just make sure you eat a lot of bananas. My doctor actually gives you a handout with your prescription suggesting foods you should eat more of while you're on it.
But basically, a short course will likely help a lot and the side effects will be manageable and temporary.
posted by oblique red at 6:40 AM on June 20, 2019 [1 favorite]
First, the good: Prednisone is SO EFFECTIVE. I feel notably and amazingly better within a day, usually. Also, any side effects I have usually go away even before the end of the course, once my taper gets below a certain dose. I'm already fat and round-faced but I never notice any particular increase in those traits from pred. Or acne, or anything else. I think there's likely a fair bit of variability in people's responses.
The less good: I guess maybe this is related to the mood thing but pred tends to make me feel... weird. Not really angry or cranky or manic or whatever, just... weird. Like I'm a half degree off from normal life, maybe. Just a little off. It's not really negative, just strange. I haven't noticed appetite changes but I do get leg cramps (prednisone makes your body flush potassium.) I'd suggest a potassium supplement or just make sure you eat a lot of bananas. My doctor actually gives you a handout with your prescription suggesting foods you should eat more of while you're on it.
But basically, a short course will likely help a lot and the side effects will be manageable and temporary.
posted by oblique red at 6:40 AM on June 20, 2019 [1 favorite]
When my husband was put on a short course of Prednisone, he basically woke up fully refreshed after four hours. I really clearly remember him waking me up at 5 am after an hour of lying awake in bed and him being like, "Well, I guess this is how Napoleon felt."
When I get put on a short course of Prednisone, I get a small energy bump, but mostly eat everything in sight. I have memories of buying (and eating) in rapid succession four servings of mango sorbet from a food truck in front of a Home Depot when I was on a two week course for allergies about a decade ago. And the vendor was just like O_o o_O but too polite to say anything.
posted by joyceanmachine at 7:02 AM on June 20, 2019 [1 favorite]
When I get put on a short course of Prednisone, I get a small energy bump, but mostly eat everything in sight. I have memories of buying (and eating) in rapid succession four servings of mango sorbet from a food truck in front of a Home Depot when I was on a two week course for allergies about a decade ago. And the vendor was just like O_o o_O but too polite to say anything.
posted by joyceanmachine at 7:02 AM on June 20, 2019 [1 favorite]
Response by poster: I took my first dose a few hours ago and I have a smile on my face that I haven’t had for awhile. I also feel like dancing at 7am but we’ll see. I’m really grateful for your answers since I’m pretty isolated and going through this alone. Thank you guys again.
posted by dianeF at 7:18 AM on June 20, 2019 [3 favorites]
posted by dianeF at 7:18 AM on June 20, 2019 [3 favorites]
My ADHD went through the roof on prednisone: I had SO MANY ideas and SO MANY urges to do things that I just could not do ANYTHING and sat there frustrated and upset and yet jittery and NEEDING to create stuff. Because I started several projects with people online that week that fell through the cracks, the next time I needed to take it I posted on my blog that if I offered to do projects with people or tried to recruit anyone during the next week, not to take me up on it until after I was off the stuff.
This may not be related to the prednisone, but the last time I took it, a couple of years ago, I got an ocular migraine for about 30 minutes. The migraine has not recurred since. The doc had me get an at-home blood pressure kit to monitor my blood pressure, which was slightly elevated at the time, possibly due to the prednisone, but nothing bad happened other than me being weirded out and fascinated by it.
I'd still take prednisone again if I needed to, but I'd be alert for signs of another ocular migraine if I were driving somewhere and always have my Kindle charged up and be loaded up on audiobooks in case I needed to pull over and wait for a while until it went away.
posted by telophase at 8:10 AM on June 20, 2019 [1 favorite]
This may not be related to the prednisone, but the last time I took it, a couple of years ago, I got an ocular migraine for about 30 minutes. The migraine has not recurred since. The doc had me get an at-home blood pressure kit to monitor my blood pressure, which was slightly elevated at the time, possibly due to the prednisone, but nothing bad happened other than me being weirded out and fascinated by it.
I'd still take prednisone again if I needed to, but I'd be alert for signs of another ocular migraine if I were driving somewhere and always have my Kindle charged up and be loaded up on audiobooks in case I needed to pull over and wait for a while until it went away.
posted by telophase at 8:10 AM on June 20, 2019 [1 favorite]
when i take prednisone, on about day 3 or 4, i get incredible pain in my joints. feels like my ankles will shatter with each step, and it is hard to type and impossible to knit or do anything like that. it is not amazing. but goes away a few days after the pills are done.
posted by misanthropicsarah at 8:52 AM on June 20, 2019 [1 favorite]
posted by misanthropicsarah at 8:52 AM on June 20, 2019 [1 favorite]
Nthing being aware that you might emotionally process things differently. I had a slight uptick in energy, combined with being delighted that it worked FAST -- noticeable improvement in a day or so. I have been on two-week courses of prednisone quite a few times, and never had noticeable weight gain or acne issues.
However, for me, it is important to make sure that I have been prescribed prednisone and not prednisolone. Some docs consider them fairly interchangeable for some conditions, but prednisolone fucked me up. Similar to what poffin boffin reports above, with the terror and anxiety and mental fog. I literally screamed in rage at my spouse over a minor spat and could not calm down for hours.
When I tell a doc that I don't tolerate prednisolone but I do fine on prednisone, they usually look at me funny and murmur that there really shouldn't be a difference, but I am quite confident that my existing anecdata is valid for myself. YMMV, obviously.
posted by desuetude at 8:56 AM on June 20, 2019 [1 favorite]
However, for me, it is important to make sure that I have been prescribed prednisone and not prednisolone. Some docs consider them fairly interchangeable for some conditions, but prednisolone fucked me up. Similar to what poffin boffin reports above, with the terror and anxiety and mental fog. I literally screamed in rage at my spouse over a minor spat and could not calm down for hours.
When I tell a doc that I don't tolerate prednisolone but I do fine on prednisone, they usually look at me funny and murmur that there really shouldn't be a difference, but I am quite confident that my existing anecdata is valid for myself. YMMV, obviously.
posted by desuetude at 8:56 AM on June 20, 2019 [1 favorite]
Just gently reminding you that other people's experiences will not be yours. I refer to Prednisone as "Satan's Steroid" and people will LINE UP to tell you how shit it is, because it is shit, but when I have to take it at that dosage for that amount of time, my side effects are exactly zero. Yours might be as well!
posted by DarlingBri at 9:35 AM on June 20, 2019 [1 favorite]
posted by DarlingBri at 9:35 AM on June 20, 2019 [1 favorite]
I think mine was 10 days and it was for a crazy cough/infection I couldn't get rid of. I took it over Christmas and WOW, I secretly wish I could take it every Christmas. I mean, maybe I was jittery, but I slept fine and... I had so much energy. I helped clear the table and washed the dishes on Christmas Day in such an impressive fashion, that people noticed how energetic I was. I kind of felt like I could've accomplished a lot of random tasks due to the energy, but it was sort of bright, happy energy and not frantic jittery. I lean toward being anxious so I was worried I'd have full-on anxiety attacks b/c of it, but it didn't happen.
posted by jdl at 9:49 AM on June 20, 2019 [1 favorite]
posted by jdl at 9:49 AM on June 20, 2019 [1 favorite]
I took a short-term dose for a systemic skin rash and had zero side effects, aside from super dry skin on my hands where the rash had been (which I'm pretty sure was a side effect of fixing the allergic reaction, rather than the prednisone, because my skin was fine everywhere else).
posted by serelliya at 12:39 PM on June 20, 2019 [1 favorite]
posted by serelliya at 12:39 PM on June 20, 2019 [1 favorite]
Something I haven't seen mentioned: Prednisone is an immunosuppresant, that's the point, but it also makes you more likely to catch a cold or whatever else people are spreading around. Make sure to wash your hands, etc, to avoid catching anything.
posted by epanalepsis at 5:32 PM on June 20, 2019 [1 favorite]
posted by epanalepsis at 5:32 PM on June 20, 2019 [1 favorite]
Yes, immunosuppresant! I think that's how I ended up with a UTI, my body just didn't have any defenses.
posted by Lawn Beaver at 5:34 PM on June 20, 2019 [1 favorite]
posted by Lawn Beaver at 5:34 PM on June 20, 2019 [1 favorite]
Prednisone is far better than any antidepressant I've ever taken. I was happy, motivated and energetic. My joints didn't hurt and I felt great.
posted by pushing paper and bottoming chairs at 7:15 PM on June 20, 2019 [1 favorite]
posted by pushing paper and bottoming chairs at 7:15 PM on June 20, 2019 [1 favorite]
Prednisone is a miracle drug. But side effects: insane heartburn and other digestive woes. But I have IBS so I’m prone to that stuff anyway.
Last time I took it, I paid close attention to what I ate so I wouldn’t gain ridiculous amount of weight (which I did before on it). Thought I was fine with it. Then one morning, I was walk walking into my work building and this man walks by with a huge pastry in hand. I have never felt more irrationally angry at someone in my life. I felt attacked. Bahahhhahaha! Just saying, the hunger is real.
There are some psychological highs and lows. Keep that in mind when the lows hit.
posted by Neekee at 6:01 AM on June 21, 2019 [1 favorite]
Last time I took it, I paid close attention to what I ate so I wouldn’t gain ridiculous amount of weight (which I did before on it). Thought I was fine with it. Then one morning, I was walk walking into my work building and this man walks by with a huge pastry in hand. I have never felt more irrationally angry at someone in my life. I felt attacked. Bahahhhahaha! Just saying, the hunger is real.
There are some psychological highs and lows. Keep that in mind when the lows hit.
posted by Neekee at 6:01 AM on June 21, 2019 [1 favorite]
I had bad GI symptoms on Prednisone. Prednisolone is much better for me. I didn't notice psych side effects or increased energy. Well, maybe my energy did increase a little bit, but I was taking it for severe asthma exacerbations. It could be I could just breathe better.
I also would have had a rough time with a taper like that. I definitely needed to go slower or my symptoms would rebound.
posted by kathrynm at 9:06 AM on June 21, 2019 [1 favorite]
I also would have had a rough time with a taper like that. I definitely needed to go slower or my symptoms would rebound.
posted by kathrynm at 9:06 AM on June 21, 2019 [1 favorite]
Response by poster: Update: I am allergic to Prednisone- broke out in hives (on my ‘trunk’ and arms) so I’m off it. Too bad- I was convinced it would heal my rash and that I’d clean my apartment. Thank you all again for your comments.
posted by dianeF at 10:09 AM on June 21, 2019 [3 favorites]
posted by dianeF at 10:09 AM on June 21, 2019 [3 favorites]
Oh gods, I am so sorry. Medication-induced hives feel like such a betrayal anyway, but et tu, Brute! Prednisone! Which can miraculously clear up (some) hives!
posted by desuetude at 9:05 PM on June 21, 2019 [2 favorites]
posted by desuetude at 9:05 PM on June 21, 2019 [2 favorites]
Response by poster: That is exactly how I feel, desuetude.
posted by dianeF at 2:54 AM on June 22, 2019 [1 favorite]
posted by dianeF at 2:54 AM on June 22, 2019 [1 favorite]
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