Things to avoid while taking prednisone

In this article:

• Things to avoid while taking prednisone
• Foods to avoid
• Drinks to avoid
• Medications and supplements to avoid
• Activities and exercises to avoid
• The bottom line

In this article

• Things to avoid while taking prednisone
• Foods to avoid
• Drinks to avoid
• Medications and supplements to avoid
• Activities and exercises to avoid
• The bottom line

Prednisone is a steroid drug that treats inflammation linked to inflammatory or autoimmune conditions like rheumatoid arthritis, lupus, multiple sclerosis, and Crohn’s disease. While it can help manage symptoms, it can also come with a long list of side effects, especially with long-term use. Avoiding certain foods, drinks, and lifestyle habits while taking prednisone may help protect your health during treatment.

Things to avoid while taking prednisone

Like any over-the-counter (OTC) or prescription medication, prednisone works best under certain conditions. “It is a powerhouse at relieving symptoms quickly, but you can pay the price later,” says board-certified rheumatologist Dr. Stella Bard, MD. “Taking it in short spurts for flares is okay, but taking it long-term comes with a slew of side effects.”

Some foods might worsen prednisone’s side effects, as can certain beverages like coffee. Some drugs might interact with prednisone, reducing its effects or increasing the risk of more serious side effects. Before taking any corticosteroid, talk to a healthcare provider about your current diet and any drugs you’re already taking. They can offer medical advice to help your treatment go as smoothly as possible. 

What foods should you avoid while taking prednisone?

Foods rarely interact directly with prednisone, but because the drug can cause weight gain, raise blood sugar, and change how the body absorbs certain nutrients, it’s important to watch what you eat. Whenever possible, try to limit the following foods:

• Sweets and simple carbohydrates: Things like cookies, cakes, and candy are already some of the most tempting foods on the shelves, and Dr. Bard says prednisone makes you crave them even more, so avoiding them is key. That’s because prednisone and sugary foods can both elevate blood glucose levels and lead to weight gain. 
• High-sodium, processed foods: According to Dr. Mary Greene, MD, a cardiologist with Manhattan Cardiology and contributor to Lab Finder, prednisone can cause high blood pressure. So she says patients should “avoid salty and processed foods while taking prednisone to avoid an unsafe increase in blood pressure.” However, adding a little table salt to a homemade meal is usually fine.
• Foods high in cholesterol and saturated fats: Prednisone may increase LDL and total cholesterol levels. You may be able to help manage this risk by limiting foods high in cholesterol and unhealthy fats. Avoid fried foods, oils, full-fat dairy, and other foods cooked in fat. 

On the flip side, there are some foods you should try to include in your diet while taking prednisone. They include:

• Calcium and Vitamin D-rich foods: Prednisone can decrease the body’s absorption of calcium, which could lead to bone loss (osteoporosis) over time. High-calcium foods like dairy, broccoli, spinach, kale, and sardines can help keep your bones strong. Vitamin D helps the body absorb calcium, so foods like salmon, tuna, egg yolk, mushrooms, and vitamin D-fortified foods are a good idea too. 
• Lean, high-protein foods: A high-protein diet is important since prednisone may increase the breakdown of protein. Foods high in protein include lean meats, fish, poultry, eggs, beans, tofu, and nuts. 
• High-potassium foods: Prednisone can increase how quickly the body gets rid of potassium, which may lead to lower potassium levels. Consider adding potassium-rich foods like bananas, oranges, apricots, prunes, cantaloupe, honeydew, and baked potatoes to your diet. These foods may help replenish potassium lost during treatment with prednisone.

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What drinks should you avoid while on prednisone?

Certain beverages can affect your prednisone treatment, too. A few of the most common culprits include:

• Alcohol: Dr. Greene recommends avoiding alcohol, since it can compound prednisone’s blood pressure effects. Drinking may also worsen some of prednisone’s other adverse effects, like gastrointestinal issues, mood swings, elevated blood sugar, and weight gain. In addition, both substances may suppress your immune system, making you more susceptible to infections. 
• Coffee: This hot morning pick-me-up doesn’t directly interact with prednisone, but the caffeine in coffee may worsen possible side effects, like insomnia, high blood pressure, and heartburn. It’s not a huge risk, but still something to consider. 
• High-sugar drinks: Soft drinks, sugary coffee drinks, certain fruit juices, and other sweetened drinks can raise blood sugar levels. Since prednisone can also raise blood sugar, it’s best to avoid them. 

It’s important to drink plenty of water while taking prednisone, since the medication can cause your body to hold onto sodium. In general, the recommended daily water intake is at least half an ounce per pound of body weight. 

Medications and supplements to avoid while on prednisone

Some of the most serious prednisone interactions don’t come from food or drinks but from other drugs. Always mention any prescription drugs, OTC medicines, or dietary supplements you take to a healthcare provider before starting a new prescription. Prednisone’s potential drug interactions include:

• NSAIDs: Nonsteroidal anti-inflammatory drugs and corticosteroids can both cause gastrointestinal side effects, such as stomach ulcers and bleeding. Taking them together could increase the risk of these effects. Tylenol (acetaminophen) might be a safer option, but talk to your healthcare provider first. 
• Other immunosuppressants: Because prednisone can suppress the immune system, taking other drugs with similar effects can increase the risk of infection. Talk to a healthcare provider about this. In many cases, prednisone will be prescribed for a shorter course while other immunosuppressant medications take effect. 
• Diabetes medications: The goal of diabetes drugs like metformin is to manage blood sugar levels. However, prednisone may cause high blood sugar, making the diabetes drugs less effective. 
• Blood thinners: Prednisone may increase or decrease the effects of anticoagulant medications. One study found that prednisone raised INR (a measure used to monitor blood clotting) in someone taking warfarin, which led to a high bleeding risk. 
• Diuretics: Both diuretics (water pills) and prednisone can decrease the body’s potassium levels, leading to an increased risk of low potassium levels (hypokalemia).
• Certain antibiotics and antifungals: Some antibiotics and antifungals can interact with prednisone. For example, macrolide antibiotics, such as clarithromycin and azithromycin, and the antifungal ketoconazole can slow the breakdown of prednisone in the body, leading to higher levels of prednisone and potentially increased side effects. In addition, taking prednisone with quinolone antibiotics like levofloxacin or ciprofloxacin may increase the risk of tendon problems.
• Live vaccines: Prednisone can increase the risk of infection, especially in high doses. Because live virus vaccines contain weakened forms of the actual virus, they can sometimes cause the illness they’re used to prevent in people with suppressed immune systems. Examples of live vaccines include those for chickenpox, measles, mumps, and rubella.

Activities and physical exercises to avoid while taking prednisone

If you’re worried about gaining weight while taking prednisone—or you’re just a fitness enthusiast—you’ll probably be looking to work out during your medical treatment. Good news: You don’t have to stop your exercise routine while taking prednisone. In fact, physical activity may even help mitigate some common side effects of prednisone. 

Regular exercise can help reduce inflammation and cut down the loss of protein that can occur during prednisone use. Studies also suggest that exercise can help regulate blood sugar and prevent bone loss. Most people can safely continue their normal daily activities, but be aware that prednisone can cause side effects like fatigue, dizziness, and muscle weakness, so you might not always feel at your best.

The bottom line

Prednisone can be a game-changer for managing inflammation, but it comes with risks. Avoiding sweets, processed foods, and alcohol—and being mindful of your activity level—can go a long way toward making your treatment safer and more effective.

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