Corticosteroids are a class of hormone-like drugs that signal the body's immune system to halt inflammatory reactions. They are part of a group of molecules known as steroids. Corticosteroids differ in function from anabolic steroids used by some athletes to build muscle. Prednisone, a corticosteroid, works to alleviate symptoms of inflammatory bowel disease, lupus, asthma, arthritis and allergic reactions. It may be used to prevent the rejection of transplanted tissues. Many problematic side effects are associated with this class of medications, especially in oral forms. Doctors generally prescribe these drugs in the lowest effective dose for the shortest possible time.
Susceptibility to Infections
Prednisone and other corticosteroids relieve symptoms of autoimmune conditions because these medicines suppress the immune system. Corticosteroids inhibit the production of white blood cells and make it harder to fight off yeast, viral and bacterial infections. Doctors sometimes prescribe antibiotics with prednisone to reduce the risk of bacterial infection. Live vaccines are contraindicated for those taking prednisone.
Weight Gain
Predisone can cause edema, or swelling, of the lower extremities. This contributes to weight gain, as does increased hunger urges that occur even with short-term corticosteroid use. Fat cells accumulate in certain areas of the body such as the back of the neck, face and abdomen, while the arms and legs may remain thin. People who take prednisone may develop a characteristic "moon face." Corticosteroid use causes a rise in blood pressure and increases fluid pressure in the eyes.
Reduced Adrenal Function
Normally, the adrenal glands, which are located atop the kidneys, secrete cortisol to reduce inflammation. Prednisone provides the body with cortisone, a synthetic cortisol, causing the adrenal glands to slow down or stop secreting this hormone in as little as four weeks, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Depending on the length of therapy, weaning slowly off prednisone can give the adrenal glands time to recover. Side effects of rapid withdrawal are fatigue, dizziness, muscle aches, and slow recovery from colds and flu.
Long-Term Effects
In some serious conditions, the benefits of corticosteroid therapy outweigh the risks. Long-term use of prednisone causes skin to become thin and easily bruised and impairs wound healing. Other long-term side effects include the development of osteoporosis due to bone loss and the development of diabetes due to increased blood sugar and insulin resistance. Reduced vision may be the result of cataracts or glaucoma. Cardiovascular changes that increase the heart's workload can lead to eventual heart failure.
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