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Prednisone and Alcohol interaction

Last reviewed by Editorial Team on September 4th, 2018.

What is Prednisone?

Prednisone is a corticosteroid drug that is used as an anti-inflammatory or an immunosuppressant medication. It works by preventing the release of inflammatory substances in the body. However it also suppresses immune system.

Prednisone available dosages and forms

Prednisone is a prescription drug. It is available in following dosages forms: immediate-release tablet, delayed-release tablet, and liquid solution. All of these forms are taken orally.

Rayos is a Brand name for delayed-release tablet. The solution is available as a brand name drug called Prednisone Intensol and as a generic drug. The immediate-release tablet is only available as a generic drug. It is available in next doses: 1, 2, 5 and 50 mg.

Prednisone uses

Prednisone is approved for the treatment of:

  • endocrine disorders
  • rheumatic disorders such as: osteoarthritis, bursitis and rheumatoid arthritis
  • multiple sclerosis
  • skin diseases such as: psoriasis and dermatitis
  • allergies and asthma
  • eye diseases such as: ulcer, inflammation and optic neuritis
  • lung diseases
  • blood disorders: anemia and low platelet count (thrombocytopenia)
  • symptoms of lymphoma or leukemia
  • lupus and nephrotic syndrome
  • stomach diseases: colitis

Prednisone side effects

The most common side effects that occur with prednisone include:

  • Confusion
  • Restlessness
  • Excitement
  • Headache
  • Vomiting
  • Nausea
  • Trouble sleeping
  • Thinning skin or acne
  • Weight gain

Prednisone serious side effects

Patients should call their doctor right away if they experience any of following side effects:

  • Severe allergic reactions, such as: skin rash, itching or hives, swelling of lips, face, or tongue
  • Changes in moods or emotions including depression
  • Changes in vision
  • Eye pain
  • Infection
  • High blood sugar
  • Swelling of ankles or feet

Can you drink alcohol while taking Prednisone?

It is never advisable for patients to drink alcohol while they are on prednisone therapy. However, there is no proven direct interaction between prednisone and alcohol. But, their concomitant use, especially for a long-term may increase the risk for gastrointestinal side effects, because both substances may cause bleeding and especially stomach ulcers in predisposed patients.

Usually, small amounts of alcohol during low-dose-prednisone therapy should not cause any serious side effect on the patient. In fact, there are prednisone’s liquid preparations that already contain alcohol as an additive in formulation which may prove unlikely chemical reactions between small doses of alcohol and prednisone.

But, predisposed patients, especially those with underlying condition on prednisone therapy need to discuss with their doctors or pharmacists if drinking alcohol may cause some side effects while they are on prednisone therapy. For example, patients suffering from ulcerative colitis or Crohn’s disease, on a prednisone therapy must avoid alcohol in order to prevent their condition worsening.

This combination can lead to further intestinal irritation thus worsening the ulcerative colitis or Crohn’s disease symptoms. Also, there are some patients that can tolerate drinking alcohol while taking prednisone. Both, prednisone and alcohol are metabolized and eliminated by the liver, so taking them together may be too much for the liver function. Although if few drinks are taken, it shouldn’t cause adverse effect, but it still increases the risk for liver complications.

mixing prednisone and alcohol

Prednisone warnings and precautions. Who should avoid prednisone?

  • Patients with infections: Prednisone lowers immune system function and can make an existing infection worse. It also increases the risk for getting a new infection.
  • Patients with diabetes mellitus: Prednisone increases sugar levels in blood. Patients with diabetes on prednisone therapy might need to monitor their blood sugar levels more closely. If it goes up too much, doses of diabetes drugs might need to be changed.
  • Patients with heart or kidney disease: Prednisone retains salt and water, which can raise blood pressure. Patients with heart failure, hypertension, and kidney disease should avoid prednisone.
  • Patients Allergic to Prednison: Prednisone may cause a severe allergic reaction, causing following symptoms: trouble breathing, swelling of your throat or tongue, hives. Don’t take this drug if you’ve ever had an allergic reaction to it. Taking it again could be fatal.
  • Pregnant Woman: Prednisone is a category D in FDA pregnancy category list of drug. That means that: Studies show a risk of side effects to the fetus when the mother uses the prednisone. This drug should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother.
  • Breastfeeding Woman: Prednisone can pass through breast milk. However, no side effects have been found in infants exposed to prednisone through breast milk.
  • Children: If prednisone is used for a long time it may have effect on children growth. Your child’s doctor should monitor your child’s growth rate.
  • Seniors: Older persons have lower function of heart, liver and kidneys. Prednisone is metabolized by the liver and eliminated from the body through kidneys. This is something that makes these organs to work extra hard. Older adults should be started on a lower dose and may have dose increased slowly.

Prednisone and weight gain

One of the most common as well as most disturbing side effects of prednisone is weight changes. After long-term use, prednisone can cause a fat redistribution to the face, back of the neck, and abdomen, however these side effects may not be evident in some patients. Generally speaking, if the duration of the treatment is longer and the higher the dose is, the greater are the changes.

Weight gain during therapy with prednisone is related to two factors: increased calorie intake due to increased appetite and retention of fluids. In some cases, the medical condition of the patient can compound the weight changes.

Rapid weight loss may occur as part of withdrawal symptoms if patient discontinue treatment with Prednisone abruptly after long-term use.

Most common Prednisone drug interactions

  • Prednisone + Mifepristone: Mifepristone may prevent prednisone from working correctly, and thus reduce its efficacy. Patients should taking mifepristone if they’ve been taking prednisone regularly for a long time.
  • Prednisone + Bupropion: This combination may cause seizure attacks in some patients
  • Prednisone + Haloperidol: This combination may induce arrhythmia attacks in some patients.
  • Prednisone + Live Vaccines: Prednisone lowers immune system function. If a live vaccine is received while taking prednisone, immune system might not be able enough to handle it properly which may lead to an infection.
  • Prednisone + Fluoroquinolones antibiotics (ciprofloxacin, levofloxacin, ofloxacin): Concomitant administration of fluoroquinolones and corticosteroids may elevate the risk of tendinitis and tendon rupture.
  •  Prednisone + TNF blockers (adalimumab, natalizumab): The use of tumor necrosis factor – TNF blockers with other immunosuppressive or myelosuppressive agents such as prednisone may increase the risk of infections. Serious infections and sepsis, including fatalities, have been reported with the use of TNF blockers and immunosuppressive agents.

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