Prednisolone (and prednisone, used more in the US) are corticosteroid medicines that reduce inflammation and calm the immune system. They’re used for asthma and COPD flare-ups, allergic reactions, inflammatory bowel disease, arthritis, skin conditions and many other illnesses. Short courses are usually well tolerated. Longer courses need careful monitoring, and they should not be stopped suddenly because the body may not make enough of its own steroid hormone.
How to take it
- Usually once a day in the morning, with food, to reduce stomach upset and sleep problems
- Follow the exact dose and schedule; some courses reduce gradually (taper)
- Carry a steroid card if you’re on long-term treatment, where your country uses them
Common short-term side effects
- Increased appetite
- Difficulty sleeping
- Mood changes: irritability, high mood, low mood or anxiety
- Indigestion
- Higher blood sugar, especially in people with diabetes
- Fluid retention
Long-term risks
- Weight gain and a rounder face
- Thinning bones (osteoporosis); bone protection may be prescribed
- Diabetes and high blood pressure
- Higher infection risk
- Muscle weakness
- Thin skin and easy bruising
- Cataracts and glaucoma
- Adrenal suppression
Why you mustn’t stop suddenly
After more than a few weeks of steroids, the adrenal glands may stop producing enough natural cortisol. Stopping suddenly can cause an adrenal crisis: severe weakness, vomiting, low blood pressure and collapse. Your healthcare provider will reduce the dose gradually.
Sick day rules and emergencies
- If you’re unwell with fever, vomiting or diarrhoea while on long-term steroids, contact your care team; your dose may need increasing
- If vomiting and unable to keep tablets down, seek urgent care
- Tell health professionals before surgery or procedures
Seek medical help if you have
- Signs of infection (fever, sore throat that won’t go away)
- Severe mood changes, confusion or thoughts of self-harm
- Black stools or vomiting blood
- Very high blood sugar readings
- Contact with chickenpox or shingles if you’ve never had chickenpox
Frequently asked questions
Is prednisolone the same as anabolic steroids?
No. Corticosteroids are different from the anabolic steroids misused for muscle building.
Can I drink alcohol on prednisolone?
Small amounts are usually fine, but alcohol can increase stomach irritation.
Related reading: Adrenal crisis and steroid safety · Arthritis guide
Checked against NHS guidance on prednisolone. Updated 5 November 2026.
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