Prednisone

Generic name: prednisone · Brand names: Rayos (delayed-release tablet, not covered by this record), Sterapred, Sterapred DS, Prednisone Intensol (concentrated solution, not covered by this record), Deltasone, Orasone, Cortan (marked no longer on the market)

Quick facts

Drug class
Section
Description
Source
DailyMed label (Mylan)
Medlineplus text
Prednisone is in a class of medications called corticosteroids.
Medlineplus source
MedlinePlus Why is this medication prescribed?
Openfda pharm class epc
not queried
Source text (exact source wording)
Prednisone tablets contain prednisone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract.
Rx or otc
Value
Rx
Section
Principal Display Panel
Source
DailyMed label (Mylan)
Source text (exact source wording)
Rx only
Controlled schedule
Not a controlled substance (no schedule appears in the label text)
Forms and strengths
Section
How Supplied
Source
DailyMed label (Mylan); appearance is labeler-specific
Source text (exact source wording)
Prednisone Tablets, USP are available containing 5 mg, 10 mg or 20 mg of prednisone, USP. The 5 mg tablets are white, round, scored tablets debossed with M on one side of the tablet and PS above the score and 5 below the score on the other side. The 10 mg tablets are white, round, scored tablets debossed with M on one side of the tablet and PS above the score and 10 below the score on the other side. The 20 mg tablets are peach, round, scored tablets debossed with M on one side of the tablet and PS above the score and 20 below the score on the other side.
Generic available
Value
yes
Source
DailyMed label (Mylan) Marketing Information
Source text (exact source wording)
Marketing Category: ANDA (ANDA080292, ANDA088832, ANDA083677)
Common use one line
A corticosteroid used to treat many inflammatory, allergic, immune and hormone-related conditions.

What it is used for

Prednisone is used for a wide range of conditions, including adrenal gland problems, certain types of arthritis, lupus, skin diseases, severe allergic conditions, lung conditions such as sarcoidosis, kidney-related swelling (nephrotic syndrome) and ulcerative colitis. The label also lists eye, blood and cancer-related uses.
Section
Indications and Usage (headings: Endocrine, Rheumatic, Collagen, Dermatologic, Allergic, Respiratory, Edematous, Gastrointestinal; the Ophthalmic, Hematologic, Neoplastic and Miscellaneous groups in the label are not copied here)
Source
DailyMed label (Mylan)
Medlineplus text
Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels.
Medlineplus source
MedlinePlus Why is this medication prescribed?
Source text (exact source wording)
Prednisone tablets are indicated in the following conditions: Endocrine Disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice: synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance); congenital adrenal hyperplasia; hypercalcemia associated with cancer; nonsuppurative thyroiditis. Rheumatic Disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: psoriatic arthritis, rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy), ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, epicondylitis. Collagen Diseases: During an exacerbation or as maintenance therapy in selected cases of: systemic lupus erythematosus, systemic dermatomyositis (polymyositis), acute rheumatic carditis. Dermatologic Diseases: Pemphigus; bullous dermatitis herpetiformis; severe erythema multiforme (Stevens-Johnson syndrome); exfoliative dermatitis; mycosis fungoides; severe psoriasis; severe seborrheic dermatitis. Allergic States: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: seasonal or perennial allergic rhinitis; bronchial asthma; contact dermatitis; atopic dermatitis; serum sickness; drug hypersensitivity reactions. Respiratory Diseases: Symptomatic sarcoidosis; Loeffler’s syndrome not manageable by other means; berylliosis; fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy; aspiration pneumonitis. Edematous States: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus. Gastrointestinal Diseases: To tide the patient over a critical period of the disease in: ulcerative colitis, regional enteritis.

How it works

Prednisone is a man-made glucocorticoid. Synthetic versions like it are used mainly for their strong anti-inflammatory effects in many organ systems. Glucocorticoids have wide metabolic effects and change the body's immune responses.
Section
Clinical Pharmacology
Source
DailyMed label (Mylan)
Source text (exact source wording)
Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states. Their synthetic analogs are primarily used for their potent anti-inflammatory effects in disorders of many organ systems. Glucocorticoids cause profound and varied metabolic effects. In addition, they modify the body’s immune responses to diverse stimuli.

Dosage: adults

The starting dose can range from 5 mg to 60 mg per day depending on the condition, and it must be individualized. After a response, the dose is lowered in small steps to the lowest dose that works. After long-term use it should be withdrawn gradually. Taking it with food or milk may reduce stomach irritation, and morning dosing before 9 am is recommended.
Section
Dosage and Administration (selected sentences in label order)
Source
DailyMed label (Mylan)
Source text (exact source wording)
The initial dosage of prednisone may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated. In situations of less severity lower doses will generally suffice, while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly. Gastric irritation may be reduced if taken before, during, or immediately after meals or with food or milk. Therefore, it is recommended that prednisone be administered in the morning prior to 9 am.

Dosage: children

Section
Precautions: Pediatric Use (selected sentences in label order)
Source
DailyMed label (Mylan)
Source text (exact source wording)
The efficacy and safety of corticosteroids in the pediatric population are based on the well-established course of effect of corticosteroids, which is similar in pediatric and adult populations. Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. In order to minimize the potential growth effects of corticosteroids, pediatric patients should be titrated to the lowest effective dose.

Dosage adjustments

Liver
In people with cirrhosis, corticosteroids have an enhanced effect because they are broken down more slowly. No numeric liver dose adjustment is given.
Section
Precautions: Gastrointestinal
Source
DailyMed label (Mylan)
Source text (exact source wording)
There is an enhanced effect due to decreased metabolism of corticosteroids in patients with cirrhosis.
Elderly
For older adults, dose selection should be cautious, usually starting at the low end of the range, and the higher risk of diabetes, fluid retention and high blood pressure should be considered.
Section
Precautions: Geriatric Use
Source
DailyMed label (Mylan)
Source text (exact source wording)
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. In particular, the increased risk of diabetes mellitus, fluid retention and hypertension in elderly patients treated with corticosteroids should be considered.

Missed dose

Ask your doctor at the start what to do about a missed dose and write it down. Call your doctor or pharmacist if you miss a dose and are unsure. Do not take a double dose.
Section
What should I do if I forget a dose?
Source
MedlinePlus (https://medlineplus.gov/druginfo/meds/a601102.html), Last Revised 06/20/2024. The tablet label has no missed-dose section.
Source text (exact source wording)
When you start to take prednisone, ask your doctor what to do if you forget to take a dose. Write down these instructions so that you can refer to them later. Call your doctor or pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make up for a missed dose.

Overdose

The label has no overdose section. MedlinePlus says to call poison control at 1-800-222-1222, or 911 if the person has collapsed, had a seizure, has trouble breathing or cannot be woken.
Medlineplus text
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Medlineplus source
MedlinePlus In case of emergency/overdose

Storage

Store at 20° to 25°C (68° to 77°F), protected from light and moisture, in a tight, light-resistant container with a child-resistant closure.
Section
How Supplied
Source
DailyMed label (Mylan); labeler-specific
Source text (exact source wording)
Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.] Protect from light and moisture. Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

Boxed warning

NONE (no boxed warning appears in the Mylan label text)

Contraindications

Do not use prednisone if you have a systemic fungal infection or a known allergy to any of its components.
Section
Contraindications
Source
DailyMed label (Mylan)
Source text (exact source wording)
Prednisone tablets are contraindicated in systemic fungal infections and known hypersensitivity to components.

Warnings and precautions

Prednisone suppresses the immune system and raises the risk of infections from many types of germs. Infections can be mild or severe and at times fatal, and the risk rises with higher doses. Monitor for infection.
Heading
Immunosuppression and Increased Risk of Infection
Section
Warnings: Immunosuppression and Increased Risk of Infection (selected sentences)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Corticosteroids, including prednisone tablets, suppress the immune system and increase the risk of infection with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic pathogens. Corticosteroid-associated infections can be mild but can be severe and at times fatal. The rate of infectious complications increases with increasing corticosteroid dosages. Monitor for the development of infection and consider prednisone tablets withdrawal or dosage reduction as needed.
In people with latent tuberculosis, tuberculosis may reactivate, so they need close monitoring.
Heading
Tuberculosis
Section
Warnings: Tuberculosis
Source
DailyMed label (Mylan)
Source text (exact source wording)
If prednisone tablets are used to treat a condition in patients with latent tuberculosis or tuberculin reactivity, reactivation of tuberculosis may occur. Closely monitor such patients for reactivation.
Chickenpox and measles can be serious or even fatal in non-immune people taking corticosteroids.
Heading
Varicella Zoster and Measles Viral Infections
Section
Warnings
Source
DailyMed label (Mylan)
Source text (exact source wording)
Varicella and measles can have a serious or even fatal course in non-immune patients taking corticosteroids, including prednisone tablets.
Hepatitis B can reactivate in carriers treated with immunosuppressive doses. Patients should be screened before prolonged treatment.
Heading
Hepatitis B Virus Reactivation
Section
Warnings (first sentence of paragraph 1; first sentence of paragraph 2)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Hepatitis B virus reactivation can occur in patients who are hepatitis B carriers treated with immunosuppressive dosages of corticosteroids, including prednisone tablets. Screen patients for hepatitis B infection before initiating immunosuppressive (e.g., prolonged) treatment with prednisone tablets.
Live or live-attenuated vaccines must not be given to people on immunosuppressive doses. Killed or inactivated vaccines may be given, but the response may be reduced.
Heading
Vaccination
Section
Warnings: Vaccination (first three sentences)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered. However, the response to such vaccines may be diminished and cannot be predicted.
Corticosteroids may cause cataracts, glaucoma with possible optic nerve damage, and secondary eye infections.
Heading
Ophthalmic
Section
Warnings: Ophthalmic (first sentence)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to bacteria, fungi or viruses.
Prednisone can suppress the body's own steroid production, which can cause insufficiency after stopping, especially if stopped too fast. This can last up to 12 months after stopping, so hormone therapy should be restarted during stress in that period.
Heading
Endocrine (adrenal suppression and withdrawal)
Section
Warnings: Endocrine (first three sentences of paragraph 1)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Corticosteroids can produce reversible hypothalamic-pituitary adrenal (HPA) axis suppression with the potential for corticosteroid insufficiency after withdrawal of treatment. Adrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for up to 12 months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted.
Corticosteroids can cause sodium retention with swelling and potassium loss, so use caution in heart failure, high blood pressure or kidney insufficiency.
Heading
Cardio-Renal
Section
Precautions: Cardio-Renal
Source
DailyMed label (Mylan)
Source text (exact source wording)
As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, or renal insufficiency.
Use caution with peptic ulcers, diverticulitis, fresh intestinal surgery and ulcerative colitis, because of a higher risk of perforation.
Heading
Gastrointestinal
Section
Precautions: Gastrointestinal (first sentence)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Steroids should be used with caution in active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since they may increase the risk of a perforation.
Corticosteroids reduce bone formation and increase bone loss, which can slow bone growth in children and cause osteoporosis at any age.
Heading
Musculoskeletal
Section
Precautions: Musculoskeletal (first two sentences)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation (i.e., decreasing absorption and increasing excretion) and inhibition of osteoblast function. This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism, and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age.
Mood and mental changes can occur, from euphoria, insomnia and mood swings to severe depression or psychosis, and existing emotional problems may get worse.
Heading
Neuro-Psychiatric
Section
Precautions: Neuro-Psychiatric (last two sentences)
Source
DailyMed label (Mylan)
Source text (exact source wording)
Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.

Pregnancy and breastfeeding

Corticosteroids caused birth defects in animal studies, and there are no adequate studies in pregnant women, so they should be used in pregnancy only if the benefit justifies the risk. Newborns exposed to substantial doses should be watched for low adrenal function. Corticosteroids pass into breast milk and could affect a nursing baby, so a decision should be made whether to stop nursing or stop the drug.
Section
Precautions: Pregnancy (Teratogenic Effects, selected sentences); Nursing Mothers
Source
DailyMed label (Mylan)
Medlineplus text
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking prednisone, call your doctor.
Medlineplus source
MedlinePlus What special precautions should I follow?
Source text (exact source wording)
Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Side effects

Common
The label does not state which side effects are most common or how often they occur.
Less common
The label gives no incidence table.
Serious
The label's reaction list includes allergic reactions, heart problems, high blood sugar and diabetes, ulcers and perforation of the stomach or bowel, bone loss and fractures, tendon rupture, seizures, depression, psychosis, cataracts and glaucoma. MedlinePlus says to call your doctor right away for vision problems, signs of infection, seizures, depression, loss of contact with reality, confusion, irregular heartbeat, sudden weight gain, trouble breathing or swallowing, swelling, rash or hives.
Label section
Adverse Reactions (selected terms from each body-system list, in label order; the label's full list is longer)
Label source
DailyMed label (Mylan)
Medlineplus source
MedlinePlus What side effects can this medication cause?
Label source text (exact source wording)
The following adverse reactions have been reported with prednisone or other corticosteroids: Allergic Reactions: anaphylactoid or hypersensitivity reactions, anaphylaxis, angioedema. Cardiovascular System: bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, edema, hypertension or aggravation of hypertension, myocardial rupture following recent myocardial infarction, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis. Endocrine: Adrenal insufficiency, development of cushingoid state, diabetes mellitus (new onset or manifestations of latent), hyperglycemia, moon face, suppression of growth in pediatric patients. Gastrointestinal: pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease). Musculoskeletal: aseptic necrosis of femoral and humeral heads, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture (particularly of the Achilles tendon), vertebral compression fractures. Neurological/Psychiatric: convulsions, depression, hallucinations, mania, psychiatric disorders including steroid psychoses or aggravation of pre-existing psychiatric conditions. Ophthalmic: cataracts (including posterior subcapsular cataracts), central serous chorioretinopathy, glaucoma, increased intraocular pressure, optic nerve damage.
Medlineplus source text (exact source wording)
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: vision problems; eye pain, redness, or tearing; sore throat, fever, chills, cough, or other signs of infection; seizures; depression; loss of contact with reality; confusion; muscle twitching or tightening; shaking of the hands that you cannot control; numbness, burning, or tingling in the face, arms, legs, feet, or hands; upset stomach; vomiting; lightheadedness; irregular heartbeat; sudden weight gain; shortness of breath, especially during the night; dry, hacking cough; swelling or pain in the stomach; swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs; difficulty breathing or swallowing; rash; hives; itching
Medlineplus common text
Prednisone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: headache; dizziness; difficulty falling asleep or staying asleep; inappropriate happiness; extreme changes in mood; changes in personality; bulging eyes; acne; thin, fragile skin; red or purple blotches or lines under the skin; slowed healing of cuts and bruises; increased hair growth; changes in the way fat is spread around the body; extreme tiredness; weak muscles; irregular or absent menstrual periods; decreased sexual desire; heartburn; increased sweating
Medlineplus common source
MedlinePlus (milder symptoms to report if severe; not an incidence list)

Interactions

Drugs
With amphotericin B or diuretics, watch closely for low potassium.
Name
Amphotericin B and potassium-depleting agents
Section
Precautions: Drug Interactions
Source text (exact source wording)
When corticosteroids are administered concomitantly with potassium-depleting agents (e.g., amphotericin B, diuretics), patients should be observed closely for development of hypokalemia.
Macrolide antibiotics can significantly slow the clearance of corticosteroids.
Name
Macrolide antibiotics
Section
Precautions: Drug Interactions: Antibiotics
Source text (exact source wording)
Macrolide antibiotics have been reported to cause a significant decrease in corticosteroid clearance.
Neostigmine or pyridostigmine with corticosteroids may cause severe weakness in people with myasthenia gravis.
Name
Anticholinesterases
Section
Precautions: Drug Interactions
Source text (exact source wording)
Concomitant use of anticholinesterase agents (e.g., neostigmine, pyridostigmine) and corticosteroids may produce severe weakness in patients with myasthenia gravis.
Corticosteroids usually reduce the response to warfarin, so coagulation tests should be monitored frequently.
Name
Oral anticoagulants (warfarin)
Section
Precautions: Drug Interactions
Source text (exact source wording)
Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.
Corticosteroids can raise blood sugar, so diabetes medicines may need dose changes.
Name
Antidiabetics
Section
Precautions: Drug Interactions
Source text (exact source wording)
Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.
Isoniazid levels may be lower.
Name
Antitubercular drugs (isoniazid)
Section
Precautions: Drug Interactions
Source text (exact source wording)
Serum concentrations of isoniazid may be decreased.
Both can lower the seizure threshold, so use together only with extreme caution.
Name
Bupropion
Section
Precautions: Drug Interactions
Source text (exact source wording)
Since systemic steroids, as well as bupropion, can lower the seizure threshold, concurrent administration should be undertaken only with extreme caution; low initial dosing and small gradual increases should be employed.
Cholestyramine may speed up the clearance of corticosteroids.
Name
Cholestyramine
Section
Precautions: Drug Interactions
Source text (exact source wording)
Cholestyramine may increase the clearance of corticosteroids.
Activity of both drugs may increase, and convulsions have been reported.
Name
Cyclosporine
Section
Precautions: Drug Interactions
Source text (exact source wording)
Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with this concurrent use.
People on digitalis glycosides may have a higher risk of heart rhythm problems from low potassium.
Name
Digitalis glycosides
Section
Precautions: Drug Interactions
Source text (exact source wording)
Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.
Estrogens may increase the effect of some corticosteroids.
Name
Estrogens, including oral contraceptives
Section
Precautions: Drug Interactions
Source text (exact source wording)
Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.
The risk of tendon rupture may be higher with fluoroquinolones such as ciprofloxacin or levofloxacin, especially in older adults.
Name
Fluoroquinolones
Section
Precautions: Drug Interactions
Source text (exact source wording)
Post-marketing surveillance reports indicate that the risk of tendon rupture may be increased in patients receiving concomitant fluoroquinolones (e.g., ciprofloxacin, levofloxacin) and corticosteroids, especially in the elderly.
Barbiturates, phenytoin, carbamazepine and rifampin can speed up corticosteroid breakdown and may require higher doses. Ketoconazole, itraconazole, ritonavir, indinavir and erythromycin-type antibiotics may raise corticosteroid levels.
Name
CYP 3A4 inducers and inhibitors
Section
Precautions: Drug Interactions: Hepatic Enzyme Inducers, Inhibitors and Substrates (first two sentences)
Source text (exact source wording)
Drugs which induce cytochrome P450 3A4 (CYP 3A4) enzyme activity (e.g., barbiturates, phenytoin, carbamazepine, rifampin) may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. Drugs which inhibit CYP 3A4 (e.g., ketoconazole, itraconazole, ritonavir, indinavir, macrolide antibiotics such as erythromycin) have the potential to result in increased plasma concentrations of corticosteroids.
Aspirin or other NSAIDs with corticosteroids increase the risk of stomach and bowel side effects.
Name
NSAIDs and aspirin
Section
Precautions: Drug Interactions
Source text (exact source wording)
Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects.
Use with thalidomide cautiously, because toxic epidermal necrolysis has been reported.
Name
Thalidomide
Section
Precautions: Drug Interactions
Source text (exact source wording)
Co-administration with thalidomide should be employed cautiously, as toxic epidermal necrolysis has been reported with concomitant use.
Vaccine responses may be reduced during corticosteroid therapy.
Name
Vaccines
Section
Precautions: Drug Interactions: Vaccines (first sentence)
Source text (exact source wording)
Patients on corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response.
Food and alcohol
Taking prednisone with food or milk may reduce stomach irritation.
Name
Food and milk
Section
Dosage and Administration
Source text (exact source wording)
Gastric irritation may be reduced if taken before, during, or immediately after meals or with food or milk.
MedlinePlus says to talk to your doctor about grapefruit and grapefruit juice. The tablet label does not mention grapefruit.
Name
Grapefruit (MedlinePlus)
Section
MedlinePlus What special dietary instructions should I follow?
Source text (exact source wording)
Talk to your doctor about eating grapefruit and drinking grapefruit juice while you are taking this medication.
The label's bone-health advice includes limiting alcohol. It has no specific alcohol interaction statement.
Name
Alcohol
Section
Precautions: Musculoskeletal
Other
St. John's wort, cimetidine and aspirin may interact with prednisone. Do not start them without talking to your healthcare provider.
Name
St. John's wort, cimetidine, aspirin (nonprescription/herbal)
Section
MedlinePlus What special precautions should I follow?
Source text (exact source wording)
the following nonprescription or herbal products may interact with prednisone: St. John's wort, cimetidine (Tagamet), aspirin.
Corticosteroids may suppress reactions to skin tests.
Name
Skin tests
Section
Precautions: Drug Interactions: Skin Tests
Source text (exact source wording)
Corticosteroids may suppress reactions to skin tests.
Liverpool checkers
Label mentions ritonavir and indinavir (antiviral protease inhibitors) as CYP 3A4 inhibitors/substrates in the interaction section; Liverpool HIV checker: not checked in this run.

Patient tips

Do not stop prednisone suddenly or without medical supervision. Tell any medical staff that you take corticosteroids, and get advice quickly if you get a fever or other signs of infection. Avoid chickenpox and measles and seek advice right away if exposed. Do not have vaccinations without talking to your doctor, and wash your hands often.
Label source
DailyMed label (Mylan) Precautions: Information for Patients (the label has no separate Medication Guide in the captured text)
Medlineplus source
MedlinePlus (https://medlineplus.gov/druginfo/meds/a601102.html)
Label source text (exact source wording)
Patients should be warned not to discontinue the use of corticosteroids abruptly or without medical supervision. As prolonged use may cause adrenal insufficiency and make patients dependent on corticosteroids, they should advise any medical attendants that they are taking corticosteroids and they should seek medical advice at once should they develop an acute illness including fever or other signs of infection. Persons who are on corticosteroids should be warned to avoid exposure to chickenpox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay.
Medlineplus source text (exact source wording)
Continue to take prednisone even if you feel well. Do not stop taking prednisone without talking to your doctor. do not have any vaccinations (shots to prevent diseases) without talking to your doctor. Stay away from people who are sick and wash your hands often while you are taking this medication. Be sure to avoid people who have chicken pox or measles.

Alternatives

Class per label and medlineplus
glucocorticoid / corticosteroid

Frequently asked questions

Question
What is prednisone used for?
Answer
It is used for many conditions, including adrenal problems, certain types of arthritis, lupus, skin diseases, severe allergic conditions, some lung conditions and ulcerative colitis.
Source section
Indications and Usage
Source
DailyMed label (Mylan)
Question
Should I take prednisone with food?
Answer
Taking it before, during or right after meals, or with food or milk, may reduce stomach irritation. The label recommends morning dosing before 9 am.
Source section
Dosage and Administration
Source
DailyMed label (Mylan)
Question
What should I do if I miss a dose?
Answer
Ask your doctor at the start what to do and write it down. Call your doctor or pharmacist if you miss a dose and are unsure. Do not take a double dose.
Source section
What should I do if I forget a dose?
Source
MedlinePlus
Question
Can I drink grapefruit juice with prednisone?
Answer
MedlinePlus says to talk to your doctor about grapefruit and grapefruit juice. The tablet label does not mention grapefruit.
Source section
What special dietary instructions should I follow?
Source
MedlinePlus
Question
What are the common side effects?
Answer
The label does not say which are most common or how often they happen. MedlinePlus lists milder effects to report if severe, such as headache, dizziness, trouble sleeping, mood changes, acne, thin fragile skin, increased hair growth, tiredness, weak muscles, heartburn and increased sweating.
Source section
Adverse Reactions; MedlinePlus What side effects can this medication cause?
Source
DailyMed label (Mylan); MedlinePlus
Question
Is prednisone safe in pregnancy or while breastfeeding?
Answer
Corticosteroids caused birth defects in animal studies and there are no adequate studies in pregnant women, so they should be used in pregnancy only if the benefit justifies the risk. They pass into breast milk, so a decision should be made whether to stop nursing or stop the drug.
Source section
Pregnancy; Nursing Mothers
Source
DailyMed label (Mylan)
Question
What should I not combine with prednisone?
Answer
Live vaccines are contraindicated at immunosuppressive doses. The label also warns about warfarin, diabetes medicines, NSAIDs and aspirin, fluoroquinolones such as ciprofloxacin, bupropion, cyclosporine, thalidomide and drugs that affect CYP 3A4 such as ketoconazole and rifampin.
Source section
Warnings: Vaccination; Precautions: Drug Interactions
Source
DailyMed label (Mylan)
Question
Can I stop prednisone when I feel better?
Answer
Do not stop without talking to your doctor. Stopping suddenly can cause adrenal insufficiency, and after long-term use the drug should be withdrawn gradually.
Source section
Dosage and Administration; Information for Patients; MedlinePlus How should this medicine be used?
Source
DailyMed label (Mylan); MedlinePlus

Sources

  • DailyMed label, Prednisone tablets, Mylan Pharmaceuticals Inc. (PRIMARY)
    Set id: fec09050-5ac2-451b-a2b9-5a21b2def212 · Label effective or revised date: Revised: 9/2026 · Dailymed version date: Oct 01, 2026 (DailyMed published date) · Fetched at: 2026-11-03 · Sections used: Description, Clinical Pharmacology, Indications, Contraindications, Warnings, Precautions, Adverse Reactions, Dosage and Administration, How Supplied (whole label text captured)
  • MedlinePlus Prednisone
    Set id: n/a · Label effective or revised date: Last Revised - 06/20/2024 · Fetched at: 2026-11-03 · Sections used: indications, side effects, precautions, diet, forget a dose, overdose, brand names

Information is taken from the cited sources and is for general reference only. It is not medical advice. Report side effects to FDA MedWatch at 1-800-FDA-1088. For a poison emergency call 1-800-222-1222. See prices for this drug