High doses of cortisone should only be used for a short time when used systemically, since the risk of massive and sometimes dangerous side effects is markedly increased with long-term use above the so-called Cushing threshold (> 7.5 mg / d). Short-term high-dose or local applications usually have no or less pronounced side effects.
Typical side effects of Prednisolone
Side effects of Prednisolone treatment include:
- The inhibition of the immune system has an increased susceptibility to infection. Infections can be obscured, go unnoticed for a long time and then become particularly severe. Patients treated with prednisolone should therefore protect themselves from infection and avoid large crowds.
- The inhibition of inflammatory cells also hampers wound healing.
- The endogenous hormone cortisol has an anabolic effect, so it is used for energy storage. Like cortisone, prednisolone has effects on sugar and fat metabolism. High dosages thus cause a redistribution of the fat and the patients increase especially in the area of the body trunk. 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.
- In addition, dilation of the skin may occur after prolonged use, and the vessels in the subcutaneous tissue can be seen more clearly. Also, an acne of the skin, the so-called steroid acne, can be triggered.
- A bone loss, termed osteoporosis in the jargon, is very common among the side effects of prednisolone.
- Another side effect is muscle weakness.
- Furthermore, treatment with prednisolone carries the risk of gray or green stars.
- Depression and mood swings can be exacerbated by taking cortisone supplements. Some patients treated with prednisolone also have an appetite change.
- Gastric distress (for example, gastric ulcer) or inflammation of the pancreas may be undesirable side effects of prednisolone.
- Prednisolone increases the risk of cardiac arrhythmias, high blood pressure, calcification of the arteries, thrombosis and vascular inflammation.
- During therapy with cortisone, the absorption of iodine in the body may be reduced, therefore during treatment with prednisolone the thyroid levels should be checked regularly.
If a disease requires long-term immunosuppressive treatment, cortisone should be combined with other immunosuppressive drugs to avoid side effects.