A corticosteroid tablet that suppresses inflammation and the immune system, used in asthma flare-ups, arthritis, inflammatory bowel disease and many autoimmune conditions.
Tablets 1, 5, 25 mg taken once in the morning with food; soluble tablets; intravenous hydrocortisone and methylprednisolone; joint injections; creams, inhalers, eye drops for local use
Onset and duration
Anti-inflammatory effect within hours; symptom relief in asthma and arthritis within a day or two.
Autoimmune disease, severe allergic reactions, some cancers and transplant rejection
Replacing cortisol in adrenal insufficiency (hydrocortisone); dexamethasone in brain swelling and severe COVID-19
How it works in the body
A synthetic version of cortisol, the adrenal stress hormone, at doses far above what the body makes. It enters cells and binds glucocorticoid receptors that switch off genes for inflammatory cytokines and switch on anti-inflammatory ones, shrinking the whole inflammatory response, whatever its trigger: it does not treat the cause. The same receptors in liver, muscle, bone, skin and brain produce the side effects, and prolonged dosing suppresses the pituitary-adrenal axis so the body's own cortisol production shuts down.
Common side effects
Increased appetite and weight gain, fluid retention, mood change, insomnia
Raised blood glucose (new or worsened diabetes), raised blood pressure
Indigestion; thin skin, bruising, acne
Serious: seek help
Adrenal suppression: after more than 3 weeks the dose must be tapered, and extra cover is needed for illness and surgery; abrupt stopping can cause an adrenal crisis
Osteoporosis and fractures (bone protection with bisphosphonates for long courses), avascular necrosis of the hip
Infections (masked and more severe: chickenpox, shingles, TB reactivation), peptic ulcer with NSAIDs, cataract and glaucoma
Psychosis, severe mood disturbance; growth suppression in children; muscle wasting
Cautions and interactions
Carry a steroid emergency card on courses longer than 3-4 weeks
Never stop long-term steroids suddenly; sick-day doubling rules
Check for TB, hepatitis, diabetes and blood pressure before long courses; consider PPI and bone protection
Live vaccines avoided on high doses; report exposure to chickenpox if not immune
Interactions
Check interactions
Taking Prednisolone and steroids with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
Medicines that share the class of Prednisolone and steroids. They are separate medicines with their own licences, doses and interactions, not alternative names for Prednisolone and steroids.
Medicines often discussed alongside Prednisolone and steroids: used together, compared with it, or acting on the same problem by a different route.
Educational content. Anatomy Nexus provides medical education and does not replace professional medical advice, diagnosis, treatment, prescribing or pharmacist review. Doses, choices and monitoring are decided by a prescriber for an individual; never start, stop or change a medicine on the basis of this page.
