Short term side effects of prednisone

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Short-Term Side Effects of Prednisone

Introduction to Prednisone and Its Uses

Prednisone is a glucocorticoid commonly prescribed for its anti-inflammatory and immunosuppressive properties. It is used to treat a variety of conditions, including autoimmune diseases, allergic reactions, and inflammatory disorders. While effective, prednisone is known to cause a range of side effects, even with short-term use.

Common Short-Term Side Effects

Metabolic Effects: Glucose Intolerance and Diabetes Risk

One of the most significant short-term side effects of prednisone is its impact on glucose metabolism. Studies have shown that even short-term use can impair beta-cell function, leading to increased blood glucose levels and a higher risk of glucose intolerance and diabetes 29. Prednisone can acutely increase postprandial glucose levels and inhibit insulin's effectiveness, contributing to its diabetogenic effects .

Fluid Retention and Weight Gain

Fluid retention and weight gain are frequently reported side effects of short-term prednisone use. These effects are often due to the drug's influence on electrolyte balance and water retention in the body 45. In a study involving patients with myasthenia gravis, weight gain was one of the most commonly reported intolerable side effects, particularly among women .

Insomnia and Nervous System Disorders

Insomnia is another common side effect associated with short-term prednisone treatment. This can significantly affect the quality of life, especially in patients who are already dealing with other health issues . Additionally, nervous system disorders, primarily headaches, have been frequently reported during short-term prednisone use .

Blood Pressure and Cardiovascular Effects

Short-term prednisone use can also affect cardiovascular health. For instance, a study on patients with subacute thyroiditis found that those on short-term prednisone had significantly lower systolic blood pressure compared to those on a longer regimen . This suggests that while short-term use may have fewer cardiovascular side effects, it still warrants monitoring.

Bone Metabolism: Increased Bone Resorption

Prednisone can negatively impact bone health even in the short term. It has been shown to increase markers of bone resorption and decrease markers of bone formation, leading to a higher risk of osteoporosis and fractures 910. These changes can occur within days of starting treatment and are dose-dependent .

Immune System and Inflammatory Response

Prednisone's immunosuppressive effects can also lead to changes in white blood cell counts and a reduced inflammatory response. This can be beneficial for treating inflammatory conditions but may also increase the risk of infections 39. Studies have shown significant changes in peripheral white blood cell counts and a reduction in inflammatory markers within hours of prednisone administration .

Conclusion

While prednisone is effective for treating various inflammatory and autoimmune conditions, its short-term use is associated with several side effects, including glucose intolerance, fluid retention, insomnia, cardiovascular changes, and impacts on bone metabolism. These side effects highlight the importance of careful monitoring and consideration of the risk-benefit ratio when prescribing prednisone, even for short durations.

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Most relevant research papers on this topic

Short-term versus 6-week prednisone in the treatment of subacute thyroiditis: a randomized controlled trial

Short-term prednisone treatment for subacute thyroiditis has fewer side effects and similar efficacy and recurrence rates compared to 6-week treatment.

RCT

2020·

14citations

·L. Duan et al.

Acute and 2-week exposure to prednisolone impair different aspects of beta-cell function in healthy men.

Prednisolone exposure both acutely and short-term impairs beta-cell function, contributing to its diabetogenic effects in healthy men.

RCTHighly Cited

2010·

164citations

·D. V. van Raalte et al.

Safety and pharmacodynamic dose response of short-term prednisone in healthy adult subjects: a dose ranging, randomized, placebo-controlled, crossover study

Short-term prednisone treatment is safe and effective for acute inflammatory and allergic conditions, with nervous system disorders being the most common adverse effects.

RCTVery Rigorous Journal

2016·

35citations

·D. Fleishaker et al.

Adverse side effects associated with prednisone in the treatment of patients with oral inflammatory ulcerative diseases.

Prednisone effectively reduces oral inflammation in patients, with fluid retention and insomnia being common side effects, but side effects can be minimized by reducing dosage.

Observational StudyHighly Cited

1984·

75citations

·F. Lozada et al.

Prednisone Side Effects are Common and Associated with Unwillingness to Accept a Dose Increase: Survey Result from MGFA Registry (P6.443)

Prednisone use in myasthenia gravis is common, but variable dosage and dosing frequencies lead to intolerable side effects, particularly weight gain, which often hinder treatment acceptance.

Observational StudyVery Rigorous Journal

2018·

0citations

·Ikjae Lee et al.

First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallel-group, open-label randomised trial

First-line rituximab combined with short-term prednisone significantly improves the proportion of patients achieving complete remission off-therapy in pemphigus patients, while decreasing treatment side-effects.

RCTRigorous JournalHighly Cited

2017·

451citations

·P. Joly et al.

Short-term prednisone use antagonizes insulin's anabolic effect on muscle protein and glucose metabolism in young healthy people.

Short-term prednisone use in healthy individuals causes muscle insulin resistance, leading to blunted protein anabolism and potentially leading to muscle atrophy with continued use of glucocorticoids.

RCT

2009·

47citations

·K. Short et al.

Prednisone side-effects and serum-protein levels. A collaborative study.

Hypoalbuminaemia increases free prednisolone levels in the body, partly explaining the increased frequency of side-effects in patients receiving prednisone.

Observational StudyHighly Cited

1971·

206citations

·GeorgeP. Lewis et al.

Prednisone affects inflammation, glucose tolerance, and bone turnover within hours of treatment in healthy individuals.

Prednisone treatment significantly affects glucose tolerance and bone formation markers within hours of treatment in healthy young adults, paralleling its anti-inflammatory effects.

RCT

2012·

56citations

·E. Kauh et al.

Bone turnover during short course prednisolone treatment in patients with chronic obstructive airways disease.

Short courses of prednisolone increased bone resorption and inhibited bone formation after two and four weeks in patients with chronic obstructive airways disease.

RCTHighly Cited

1992·

78citations

·D. Morrison et al.

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