Prednisone — synthetic corticosteroid for inflammatory and immune conditions

How it works

Prednisone binds to intracellular glucocorticoid receptors and alters gene expression. This leads to decreased production of inflammatory cytokines and immune mediators, stabilization of cell membranes, and reduced migration of inflammatory cells. The net effect is suppression of many components of the inflammatory and immune response.

Common uses

• Acute allergic reactions and severe asthma exacerbations.
• Autoimmune diseases such as rheumatoid arthritis and systemic lupus — see general information on autoimmune disease: Autoimmune disease.
• Inflammatory conditions of the lungs and organs, including sarcoidosis: Sarcoidosis.
• Inflammatory bowel disease, dermatologic disorders, and prevention of transplant rejection in combination with other agents.

Precautions and notable effects

Short courses are often well tolerated, but prolonged use increases risk of side effects. Common adverse effects include weight gain, elevated blood sugar, thinning of skin, mood changes, and increased susceptibility to infection. Long-term risks include osteoporosis, adrenal suppression on withdrawal, and cataracts. Clinicians typically taper doses to allow recovery of the body’s own cortisol production and monitor patients for metabolic and bone effects.

History and clinical importance

Introduced in the mid-20th century alongside other corticosteroids, prednisone transformed treatment of inflammatory and immune-mediated disorders. It remains widely used because of its effectiveness, availability, and familiarity to clinicians. For general context about corticosteroids: Corticosteroid class.