Long-Term Side Effects of Prednisone

By Canadian Pharmacist

2 min read

Most people with myasthenia gravis (MG) are familiar with prednisone, a common drug prescribed during flares. Prednisone belongs to the drug class called corticosteroids. This class of medications have been given a bad reputation over the years because of their unfavorable side effect profile.

However, when prednisone is prescribed, this typically indicates that the potential benefit of treatment – in this case, to reduce the immune response and therefore subside the flare – outweighs the potential negatives.

Overall, prednisone does come with side effects – some serious - but these should generally not deter most people from taking the drug when needed. Many of the side effects are dose and duration dependent and some can even be minimized.¹

Ultimately, your doctor will work with you to determine whether prednisone is an effective and safe option for you.

Physical changes

Steroids such as prednisone are known to cause a "cushingoid" appearance – also known as moon face. These typically develop within the first 2 months of being on prednisone, but it is less likely to occur on low doses of prednisone (less than 5 MG per day).¹

Some people also gain weight while on therapy. One study analyzed the use of prednisone in an autoimmune condition called rheumatoid arthritis (RA) and found that using 5-10 MG of prednisone per day over a period of 2 years resulted in a 4-8 percent weight increase.¹

Heart health

Prednisone has numerous effects on the heart. For example, it can result in accumulation of water in the body, which can be problematic if someone has a history of heart failure.¹¹

Eye problems

Prednisone can increase the risk of glaucoma and cataracts. If you already have one of these conditions, your doctor will discuss with you the best way forward.

Stomach issues

Prednisone can cause short-term nausea and stomach upset – that is why it is recommended to be taken with food. However, in the long-term, serious bleeding of the stomach can occur if prednisone is combined with other drugs such as ibuprofen (Advil) and blood thinners.¹

If you are going to be on prednisone for a long period of time, your doctor may prescribe you another medication to protect your stomach and inform of you of other medicines you should avoid.

Effect on bones

Perhaps one of the most well-documented long-term effect of prednisone is its effect on bones. Prednisone can increase the risk of a condition called osteoporosis, or thinning of the bones, which increases the risk of fractures.¹

Depending on how long your prednisone treatment is, your doctor may prescribe another medication to help protect your bones.

Blood sugars

Prednisone can increase blood sugar levels, which is particularly of concern for people with diabetes. Your doctor may monitor your blood sugar levels more often while on treatment.¹

Mood disorders

Prednisone can increase the risk of mood disorders, such as confusion, psychosis, and depression. These effects are often reversible, but caution may be used if there is a history of these mood disorders.¹

If you’ve taken prednisone for an extended period of time, did you experience any of these side effects? Share your experiences down below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Myasthenia-Gravis.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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CommunityMemberad5fbb Member
I was diagnosed with MG late February 2023, and also diagnosed with degenerative arthritis in my cervical spine C4,5-5,6-6,7. Went to ER about 3 weeks ago bc I didn't know about the chewing, swallowing, etc. and was then told I had a "flare". Since then it has been reoccurring more often. I'm finding I can't eat a lot of things I love. I was told while leaving the hospital to increase my dosage to 60 mg 3x/day and to include prednisone. So far I haven't wanted to take the prednisone bc I wasn't really sure what it was for. I was supposed to start on the lowest dosage of 10 mg/day for 5 days and increase by 5 mg/week until I get to 60 mg for 5 days and then do the reverse. My question: Does the prednisone help with the chewing, swallowing, etc.? Thank you in advance for your help. This is a whole new world for me. 
1. kaitlynsutton Community Admin
 <inline-mention username="CommunityMemberad5fbb" user-id="6796260"/> We aren't medical doctors so we are not able to provide medical advice but from reading other's experiences with Prednisone here, I believe it should help with those symptoms. I wanted to share a few articles about swallowing that you might find helpful: <a href='https://myasthenia-gravis.com/living/swallowing-safety' target='_blank'>https://myasthenia-gravis.com/living/swallowing-safety</a> and <a href='https://myasthenia-gravis.com/caregiver/meal-planning-tips' target='_blank'>https://myasthenia-gravis.com/caregiver/meal-planning-tips</a>. Best, Kaitlyn (Team Member)
Juliana Texley Moderator & Contributor
Prednisone was truly a mixed blessing for my hubby. He saw an improvement within days, but 3 hip fractures later (osteopenia) he had to reduce it to 5 mg. It has a lot of disadvantages. He also has an ulcer from those drugs and now needs gaviscon pretty regularly. These are tricky drugs and don't work quickly, so keep in close touch with your provider. Juliana (Myasthenia-gravis.com team)
Swright570 Member
Hi my friend, I too have been on Prednisolone for 20 years, but for chest and nasal issues, now I'm on a huge dose of 60mg daily, 240mg Mestinon, inhalers for COPD and nasal sprays for nasal polyps.My body has been hammered by Steroids, the cramps I suffer in arms and legs are debilitating, and MG has changed my life beyond recognition. I can no longer drive, work and only 56. But, before Prednisolone, I couldn't open my eyes, struggled to swallow, breath, talk without slurring or chew my food, so, for now, it's a necessary evil I have to endure. Keep safe, keep well my friend.
Maynard Johnson Member
When I was in my early 20's I was diagnosed with MG and put on Prednisone and Mestinon. I took 40 mg of Prednisone for 5 or 6 years and it was an interesting experience. My friends father, who had Lupus, told me you'll love that stuff it will make you feel great and you'll go out and buy yourself a Hawaiian shirt. He had a funny sense of humor but he was right. It gives you a false euphoria to the point of being a bit overboard. The combination of Mestinon, Prednisone and what turned out to be a dairy intolerance did a number on my stomach. I had a 40 lb weight swing due to the dairy which was figured out by an intern after 14 days of hospital stay. Yogurt is a must with Prednisone and learn to balance your Mestinon. Too much makes the stomach worse. The mood swings were out of control. I never had much of a temper until my time on Prednisone but I would get out of control if someone pissed me off. Road rage was another problem. I worked two full time jobs and worked on my house to offset all the energy that Prednisone gave me. I felt like the Hulk some days. Flash forward 38 years and I have been off Prednisone for most of this time and rarely take Mestinon even though it helps my eye and facial muscles. I'm so used to the double and tunnel vision at this point it just isn't worth the side effects. I prefer to hold off except on those days where I wake up cross eyed and droopy faced. I realize I am fortunate compared to what some of you have to go through on a daily basis. My thymus removal in my mid 20's made a big difference in my life. I have had weight issues, and have become type 2 diabetic, ever since my days on Prednisone no bone issues that I didn't earn. (dropped a 200 lb object on my toes). I recently had my annual eye check up and they told me I had the eyeballs of a 20 year old although I developed a lot of floaters from Prednisone which can be annoying when your tired.