High doses of cortisone should be used only for short periods when used systemically, because long-term use above the so-called Cushing’s threshold (>7.5 mg/d) significantly increases the risk of massive and sometimes dangerous side effects. Short-term high-dose or local applications usually have no or much less pronounced side effects.
Typical side effects of prednisolone
Side effects of treatment with prednisolone include:
- Inhibition of the immune system carries with it an increased susceptibility to infection. Infections can be masked, go unnoticed for a long time, and then become particularly severe. Patients treated with prednisolone should therefore protect themselves from infection and avoid large gatherings of people.
- Due to the inhibition of inflammatory cells, wound healing is also disturbed.
- The endogenous hormone cortisol has an anabolic effect, so it serves to store energy. Just like cortisone, prednisolone also has effects on sugar and fat metabolism. High dosages thus cause a redistribution of fat and patients gain weight, especially in the trunk area. The so-called bull neck and the moon face are typical signs of a long-lasting high dosage of cortisone. This effect on the metabolism can even trigger diabetes mellitus.
- Long-term use can also cause thinning of the skin, you can then see the vessels in the subcutis more clearly. Acne of the skin, known as steroid acne, can also be triggered.
- A bone loss, called osteoporosis in technical language, is very common among the side effects of prednisolone.
- Another side effect is muscle weakness.
- Furthermore, treatment with prednisolone carries the risk of cataracts or glaucoma.
- Depression and mood swings can be exacerbated by taking cortisone medications. Some patients treated with prednisolone also have appetite changes.
- Stomach problems (for example, a stomach ulcer) or inflammation of the pancreas may be undesirable side effects of prednisolone.
- Prednisolone increases the risk of cardiac arrhythmias, hypertension, calcification of the arteries, thrombosis and vascular inflammation.
- During cortisone therapy, the absorption of iodine into the body may be decreased, so thyroid levels should be checked regularly during treatment with prednisolone.
If a disease requires long-term immunosuppressive treatment, cortisone should be combined with other immunosuppressive medications to avoid side effects.
