If the label on your steroid tablets says prednisone, tell your prescriber about all three changes, the hunger, the broken sleep and the higher blood sugar readings, because any change in your health during treatment is something to report. Sudden weight gain is among prednisone's serious side effects, which mean calling your prescriber's office immediately. You can then match each change to the person who hears about it, and tell the signs that mean calling the office from the ones that mean calling 911.
Which of the three changes is the steroid
Prednisone may cause difficulty falling asleep or staying asleep, along with other side effects including headache, extreme changes in mood, changes in personality, acne, heartburn and increased sweating. Steroids are also among the medicines that can cause your blood sugar to spike, and being sick with an illness can raise it as well.
Appetite is not on MedlinePlus's lists of prednisone's side effects, which leaves open whether the hunger comes from the tablets. Corticosteroids, also called steroids, are among the medicines that may contribute to weight gain (see Could your antidepressant be part of the weight gain?). Tell your prescriber about the hunger either way.
| What changed | Who to tell |
|---|---|
| Difficulty falling asleep or staying asleep | Your prescriber's office: mention it now, and call again if it is severe or does not go away |
| Hunger | Your prescriber's office, since any unusual problem while you are taking prednisone is a reason to call that office |
| Higher blood sugar readings | Your prescriber's office, with the readings you have taken since the course began, and if you have diabetes and often have high blood glucose levels or the symptoms of high blood sugar, the health care team that treats your diabetes too, because your diabetes meal plan, physical activity plan or diabetes medicines may need to change |
In case of an overdose, call Poison Help at 1-800-222-1222. If someone has collapsed, had a seizure, is having trouble breathing or cannot be awakened, call 911 immediately, whether it comes from an overdose or as a side effect of prednisone.
Call your prescriber's office immediately about any of these serious side effects, except where an item says 911:
- vision problems
- eye pain, redness, or tearing
- sore throat, fever, chills, cough, or other signs of infection
- seizures, which mean calling 911
- depression
- loss of contact with reality
- confusion
- muscle twitching or tightening
- shaking of the hands that you cannot control
- numbness, burning, or tingling in the face, arms, legs, feet, or hands
- upset stomach
- vomiting
- lightheadedness
- irregular heartbeat
- sudden weight gain
- shortness of breath, especially during the night, and 911 if it becomes trouble breathing
- dry, hacking cough
- swelling or pain in the stomach
- swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing, and 911 for trouble breathing
- rash
- hives
- itching
If you have diabetes, very high blood glucose can lead to diabetes-related ketoacidosis, which can be life-threatening and whose symptoms may include trouble breathing, nausea or vomiting, belly pain, confusion and feeling very tired or sleepy. Severe high blood glucose with symptoms of ketoacidosis needs treatment at the hospital, so head to an emergency room or phone 911. With type 1 diabetes, symptoms of diabetic ketoacidosis include decreased alertness, deep and rapid breathing, nausea and vomiting, and stomach pain, and any of them means going to the emergency room or calling 911 whatever your readings, not calling your prescriber's office.
Prednisone, the infection and your blood sugar
Prednisone is a corticosteroid, a medicine similar to hormones your adrenal glands make to fight stress associated with illnesses and injuries, and one of the hormones those glands make, cortisol, also helps regulate blood glucose, which is your blood sugar. Cortisol's other jobs include helping your body respond to stress, maintaining blood pressure, reducing inflammation and turning the food you eat into energy. For conditions such as those affecting the lungs, prednisone works by reducing swelling and redness and by changing the way the immune system works.
The infection can push your readings up as well. Sometimes high blood sugar occurs due to stress from surgery, infection, trauma or medicines, so on a course like yours the chest infection and the prednisone may both be behind the numbers. If you have diabetes, the questions to ask yourself when your blood sugar is high include whether you have a fever, cold, flu or another illness, and whether you have started any new medicines.
Ending the course, and stopping it early
When high blood sugar comes from the stress of surgery, infection, trauma or medicines, it returns to normal after the stress is over; if you have diabetes, ask the team that treats it what your readings should come back to. If the broken sleep or the hunger carries on after the last tablet, tell your prescriber's office. Steroids are strong medicines that can have side effects, including weakened bones and cataracts, and because of this you usually take them for as short a time as possible.
Talk to your prescriber before you stop taking prednisone, even if your chest feels better before the tablets run out. If you suddenly stop taking prednisone, your body may not have enough natural steroids to function normally, which may cause symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight loss, changes in skin color, sores in the mouth and craving for salt. Call your prescriber's office if these or other unusual symptoms appear after you stop; while you are still taking the tablets, an upset stomach is one of the serious side effects that mean calling that office immediately.
The people who need to hear about the course
Your prescriber needs to hear about your other conditions and everything else you take. Tell your doctor and pharmacist about every prescription and nonprescription medicine, vitamin, nutritional supplement and herbal product you take or plan to take with prednisone, since your doctor may need to change the doses of your medicines or monitor you carefully for side effects. The conditions to mention include diabetes, high blood pressure, osteoporosis, seizures, ulcers, mental illness, and liver, kidney, heart or thyroid disease. Ask your prescriber about grapefruit and grapefruit juice while you take it as well (see Check each medicine by name before you eat grapefruit).
According to MedlinePlus's prednisone information, tell your doctor if you are pregnant, are planning a pregnancy or are breast-feeding, and call your doctor if you become pregnant while taking it.
Prednisone may decrease your ability to fight infection and may prevent you from developing symptoms if you get an infection, which matters while you are being treated for one, so ask your prescriber which changes in your chest mean getting back in touch. Stay away from people who are sick and wash your hands often, and if you may have been near someone with chicken pox or measles, call your prescriber's office immediately.
If you need surgery, including dental surgery, or emergency treatment, tell the doctor, dentist or medical staff that you are taking prednisone or have recently stopped, and carry a card or wear a bracelet saying so in case you cannot speak in a medical emergency. Before any skin test, such as an allergy test or a tuberculosis test, tell the doctor or technician that you are taking prednisone.
You or your doctor may also send a report of a serious side effect to the Food and Drug Administration's MedWatch Adverse Event Reporting program, online or by phone at 1-800-332-1088 (see Reporting a side effect that has not gone away).
Where NicoCares handles your weight care, the care team there needs to hear about the course too. Write to them in Spruce, the app they reply in, that you are on a steroid course for your chest, and add any readings you have taken. Spruce messages carry no promised reply time, so keep that message for news that can wait. A serious side effect means calling your prescriber's office, a seizure, trouble breathing or someone who has collapsed or cannot be woken means calling 911, and ketoacidosis with diabetes needs an emergency room or 911.
