What Prednisolone Is Used For
| Condition | Duration |
|---|---|
| Asthma exacerbation | 5 days (short course: safe to stop abruptly) |
| COPD exacerbation | 5 days |
| Rheumatoid arthritis | Weeks to months, at low dose |
| Polymyalgia rheumatica | 1–2 years, slow taper |
| Inflammatory bowel disease (Crohn's/UC) | Weeks, then taper |
| Transplant rejection prevention | Long-term, low dose |
| Temporal arteritis / GCA | 1–2 years |
Adrenal SuppressionIf you've taken prednisolone for more than 3 weeks, your adrenal glands may have stopped making cortisol. Stopping suddenly can cause an 'adrenal crisis' (collapse, vomiting, shock). Always taper slowly and carry a Steroid Emergency Card.
Blood Tests to Monitor on Steroids
| Test | Frequency | Why |
|---|---|---|
| Blood glucose | Every 1–3 months | Steroids cause steroid-induced diabetes |
| Blood pressure | Every visit | Steroids raise BP |
| Bone density (DEXA scan) | At start, then 1–2 yearly | Prevent osteoporosis |
| Full blood count | Every 3–6 months | Immune suppression monitoring |
| Electrolytes (potassium) | Every 3–6 months | Hypokalaemia risk |
| Cholesterol | Annually | Steroids raise lipids |
Bone ProtectionIf taking prednisolone >7.5 mg for >3 months, you should be prescribed calcium + vitamin D supplements and possibly a bisphosphonate (e.g. alendronate) to protect your bones. Ask your doctor if you haven't been prescribed these.
Common Long-Term Side Effects
- Weight gain and increased appetite, especially abdominal fat
- 'Moon face' and 'buffalo hump' (fat redistribution)
- Raised blood sugar (steroid-induced diabetes)
- High blood pressure
- Osteoporosis (bone thinning)
- Cataracts and glaucoma (eye pressure)
- Skin thinning and easy bruising
- Mood changes: euphoria or depression
- Increased infection risk
Do I need to take extra steroids during illness?
Yes. This is the 'sick day rules'. If you have a fever or significant illness while on maintenance steroids, you may need to double your dose. Carry a steroid card. Seek emergency help if vomiting prevents taking your dose.
Can I get vaccinations on steroids?
Live vaccines (e.g. MMR, yellow fever, varicella) are generally avoided if on high-dose steroids. Flu and pneumococcal vaccines are strongly recommended. Discuss with your doctor.
Will my face go back to normal after stopping?
Yes. Moon face and weight gain from steroids usually reverse gradually after stopping or reducing the dose.
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Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.