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.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.