Overview
If you’re trying to understand what are the worst side effects of prednisone, you’re not alone. Prednisone is a corticosteroid (steroid anti-inflammatory) that can quickly calm inflammation. It can also affect many body systems at once. That mix can feel confusing, especially during a short course.
This guide breaks down what prednisone is used for, which effects are common, and which deserve faster attention. You’ll also learn when reactions may start, how long they may linger, and how to prepare for follow-up conversations with your clinician or pharmacist.
A partner pharmacy dispenses only after confirming your prescription with the prescriber.
Throughout, you’ll see both medical terms and plain-language meanings. The goal is clarity, not alarm. Side effects can be manageable, but they are still real. You deserve information that respects your concerns.
Key Takeaways
- Common early effects: appetite, mood, sleep changes
- Serious risks: infection, severe mood shifts, high blood sugar
- Timing varies: some effects start within days
- Short courses: often intense but brief side effects
- Tracking helps: notes support safer follow-up
What are the worst side effects of prednisone
People often use “worst” to mean two things. First, symptoms that feel intolerable day-to-day, like insomnia or agitation. Second, less common but more medically serious reactions, like severe infection or extreme mood changes. Both deserve attention, but they call for different kinds of support.
Prednisone can lower inflammation by changing immune signals. That same immune shift can make it harder to fight germs, especially at higher doses or longer courses. It can also raise blood sugar, affect blood pressure, and change how your body holds salt and water. In some people, it can trigger significant mental health symptoms.
Why it matters: A “bad cold” can become serious faster when immunity is suppressed.
| Concerning symptom | What it could relate to | Reason to act |
|---|---|---|
| Fever, chills, worsening infection signs | Reduced immune response | Infections may progress quickly |
| Severe mood change, confusion, hallucinations | Neuropsychiatric effects | Safety and rapid evaluation matter |
| Very high thirst/urination, blurry vision | Hyperglycemia (high blood sugar) | Can be dangerous, especially with diabetes |
| Black stools, vomiting blood, severe stomach pain | GI bleeding/ulcer risk | Needs urgent assessment |
Most people will not experience the most severe outcomes. Still, knowing the red flags can reduce fear and speed up help when it’s needed. If you have a history of diabetes, ulcers, glaucoma, infections, or mood disorders, bring that context into every prednisone conversation.
Core Concepts
Online searches tend to mix many scenarios into one. A five-day “burst” for airway inflammation is not the same as months of treatment for an autoimmune disease. Still, the questions overlap. It helps to separate dose, duration, and your personal risk factors.
This section explains how prednisone works, when side effects may start, and why some people feel fine while others struggle. It also clarifies common questions about 20 mg tablets, 5-day courses, and withdrawal-like symptoms.
Prednisone basics: what it is and what it’s used for
Prednisone is a systemic corticosteroid, meaning it works throughout the body. Clinicians prescribe it for many inflammatory and immune-driven conditions. In plain terms, it can calm an overactive immune response and reduce swelling, redness, and irritation.
People sometimes ask what prednisone is used for when they only feel “sick” or short of breath. Prednisone isn’t a cough medicine by itself. But it may be used when cough is tied to airway inflammation, such as an asthma flare or severe allergic inflammation. Your prescriber’s goal is usually to reduce inflammation that is driving symptoms, not to “treat the cough” directly.
When do side effects start?
When do prednisone side effects start depends on the effect and the person. Some changes can show up quickly, sometimes within hours to days. Others take longer because they relate to gradual shifts in metabolism, skin, bone, or eye pressure.
Early-onset effects often include sleep disruption, feeling “wired,” increased appetite, indigestion, and mood changes. Some people notice flushing, sweating, or a racing mind at night. Later effects are more associated with prolonged exposure, such as thinner skin, bruising, acne, and bone loss (osteoporosis).
- Fast changes: sleep, appetite, mood, energy
- Variable timing: fluid retention, blood pressure
- Longer-term: bone, skin, eye effects
The most common short-term side effects
Short term prednisone side effects can feel intense because they affect daily routines. Insomnia is a big one. Prednisone can also increase appetite and cause temporary weight changes. Some people describe swelling in the face or hands from fluid retention. Others notice heartburn or stomach discomfort.
Mood and thinking changes are also common. That can look like irritability, anxiety, restlessness, or feeling unusually energetic. Less commonly, people experience depression or mood swings. These reactions can be distressing, especially if they feel out of character. If you already manage anxiety or depression, it helps to tell your clinician before starting.
Medications come from licensed Canadian pharmacies that follow their provincial rules.
Can prednisone make you feel weak and shaky?
Yes, prednisone can make you feel weak and shaky, and the reasons differ. For some, it’s related to sleep loss, anxiety, or feeling overstimulated. For others, it may tie to blood sugar swings, especially if meals change because appetite increases. A fast heartbeat or tremor can feel scary, even when it’s not dangerous.
There is also a recognized steroid effect on muscles, sometimes called steroid myopathy (muscle weakness). It is more associated with higher doses and longer exposure. But even short courses can leave people feeling “off,” especially if they were already ill, dehydrated, or not eating normally. If weakness is severe, one-sided, or paired with chest pain or shortness of breath, it needs prompt evaluation.
Dose and duration: 20 mg tablets and 5-day courses
Many prescriptions reference a strength like 20 mg, which leads to common questions such as “is prednisone 20 mg a steroid” and “is 20 mg of prednisone a low dose.” Prednisone is a steroid medication. Whether 20 mg is “low” depends on the condition being treated, your size, and how long you take it. A dose that is modest for one person may feel strong for another.
You may also see discussions like “prednisone 20 mg for 5 days” or higher-dose bursts described as 40 mg or 50 mg for 5 days. In general, higher doses are more likely to cause noticeable short-term steroid side effects, including insomnia, jitteriness, mood changes, and higher blood sugar. Duration matters too. Longer courses raise the chance of adrenal suppression and infection risk.
Another frequent worry is whether 5 mg prednisone daily is harmful. A low daily dose taken for a long time can still carry meaningful risk, especially for bone health, blood sugar, skin, and eyes. That’s why clinicians weigh benefits against risks and monitor over time.
Withdrawal symptoms and “rebound” after stopping
Prednisone can affect your body’s natural cortisol system. Clinicians may call this hypothalamic-pituitary-adrenal (HPA) axis suppression (reduced natural cortisol production). It is more likely with higher doses and longer durations. When prednisone is stopped after prolonged use, some people experience prednisone withdrawal symptoms, like fatigue, body aches, lightheadedness, or nausea.
Even after short courses, some people feel a dip in energy or a return of the original inflammation. That can feel like “withdrawal,” even when true adrenal suppression is unlikely. The key point is that stopping plans should come from the prescriber, because tapering needs vary by situation and risk.
Practical Guidance
Side effects feel less overwhelming when you can name them, track them, and communicate them. You don’t need to power through symptoms alone. Small practical steps can make conversations with your care team more productive.
This section focuses on preparation and monitoring, not self-directed treatment changes. If something feels severe or unsafe, it’s appropriate to seek timely clinical guidance.
Quick tip: Write down the day and time each new symptom begins.
Before you start: set up safer follow-up
If you’re prone to side effects, planning helps. Gather a current medication list, including over-the-counter drugs and supplements. Prednisone can interact with other medicines, and some combinations increase stomach irritation or bleeding risk. If you use NSAIDs (like ibuprofen) often, mention it.
- Medication list: include supplements and PRN drugs
- Health history: diabetes, ulcers, glaucoma, infections
- Mood history: anxiety, depression, bipolar disorder
- Baseline numbers: blood pressure or glucose, if tracked
If you want examples of how other medicines can affect mood or sleep, see Zoloft Side Effects and Bupropion Side Effects. Different drugs work differently, but tracking patterns is a shared skill.
During treatment: reduce friction with daily life
How to reduce prednisone side effects often comes down to minimizing triggers and documenting changes. Sleep is a priority because poor sleep amplifies irritability, hunger, and shaky feelings. If your prescriber gave timing instructions, follow them. If they did not, a pharmacist can explain common timing approaches used to reduce insomnia.
Food choices can also influence how you feel. Prednisone can raise appetite and cause fluid retention. People often do better with regular meals, steady hydration, and a plan for snacks. If you have diabetes or prediabetes, discuss blood sugar monitoring expectations with your clinician.
- Sleep routine: protect a consistent bedtime window
- Meal plan: aim for regular, balanced meals
- Symptom notes: mood, sleep, swelling, heartburn
- Infection awareness: watch for fever or worsening sores
If blood pressure is part of your health picture, it may help to review Lisinopril 10 mg Tablet and Atenolol Side Effects as general medication education. Those articles are not prednisone-specific, but they can help you name symptoms clearly.
Cash-pay access may help when you’re navigating prescriptions without insurance.
After the last dose: what to track and report
Some prednisone side effects fade quickly, while others take longer to settle. Many people notice that appetite and sleep normalize within days. Fluid retention may also ease as your body readjusts. Mood can take a bit longer, especially if sleep was disrupted.
If you feel unusually tired, achy, or dizzy after stopping, document it and share it. If your original symptoms return, note the timing. That record helps your clinician decide whether the underlying condition is flaring again or whether you may be dealing with a medication effect.
For another example of tracking side effects over time, see Trulicity Side Effects and Oxybutynin 5 mg. Different therapies, same principle: specifics matter, and written notes help.
Compare & Related Topics
Reading about steroids can get confusing fast because “steroid” covers many routes and strengths. Prednisone is systemic, meaning whole-body exposure. Other corticosteroids may be inhaled, topical, or used locally in the gut. Those routes can change the side effect profile, but they can still cause side effects.
It also helps to separate prednisone from prednisolone. Prednisolone is a closely related corticosteroid and is often described as the “active” form. In adults, prednisolone side effects in adults are generally similar to prednisone’s, though formulations and clinical choices vary. Your prescriber picks based on the situation and practical factors like swallowing, liver function, or formulation needs.
When you’re weighing what are the worst side effects of prednisone, it’s fair to ask whether a more local option could meet the same goal. For example, some anti-inflammatory therapies are delivered to a specific area, which may limit systemic exposure for some people. Examples include inhaled medicines like Alvesco MDI, rectal therapies like Uceris Rectal Foam, or topical prescriptions such as Zoryve and non-steroid immune modulators like Tacrolimus HGC. These are not substitutes in every case, but they show how route can matter.
If you want broader medication education beyond steroids, you can browse General Health Articles for related topics.
Authoritative Sources
For the most reliable and up-to-date safety information, start with official labeling and major medical references. If you are researching what are the worst side effects of prednisone, use these sources to confirm details you see on social media or forums.
Recap: Prednisone can be very effective for inflammation, but it can also disrupt sleep, mood, appetite, and blood sugar. Serious risks are uncommon, yet important to recognize early. The best next step is to track symptoms and share them clearly with your care team.
This content is for informational purposes only and is not a substitute for professional medical advice.
