Key takeaways
Prednisone 20 mg is a moderate dose of the generic oral systemic corticosteroid.
Prednisone 20 mg is sometimes prescribed as a five-day course, known as a “prednisone burst,” for certain conditions like asthma exacerbations.
Take prednisone in the morning with food and follow your healthcare provider’s instructions exactly to help minimize side effects.
Those who’ve just been prescribed prednisone 20 mg may wonder what it is, what this dosage is used for, any possible side effects, and the cost of their prescription. Prednisone is a generic prescription medication in the group of drugs called oral corticosteroids. It’s used for a variety of conditions, including controlling inflammation in arthritis, blood disorders, cancer, eye problems, and certain immune system disorders. In this article, learn about what 20 mg prednisone is used for, whether it’s considered a high dose, how to take it, what side effects to expect, and how much it costs.
What is prednisone 20 mg used for?
Prednisone 20 mg is used to treat a wide range of inflammatory and immune-related conditions. It can be used for certain autoimmune issues, inflammation from infections, polyp reduction, sudden hearing loss, and acute facial paralysis, says Matt Hershcovitch, MD, board-certified ear, nose, throat (ENT) specialist and founder of SoCal Breathe Free in Burbank, California. Prednisone is approved by the U.S. Food and Drug Administration (FDA) to treat conditions like rheumatoid arthritis, severe psoriasis, ankylosing spondylitis, ulcerative colitis, and acute exacerbations of multiple sclerosis. It can also be prescribed off-label for conditions such as a COVID-19 infection, giant cell arteritis, and kidney complications in people with lupus (lupus nephritis).
Prednisone is a generic glucocorticoid, a type of corticosteroid. The 20 mg dose of generic prednisone is an oral tablet taken by mouth, not an injection or topical form.
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Is 20 mg of prednisone a high dose or a low dose?
20 mg of prednisone is considered a moderate dose for adults based on clinical guidelines from different medical associations. “What is considered a high dose of prednisone will depend on the specific use of the medication and duration of treatment,” says Ayesha Bryant, MD, physician and clinical advisor at Alpas Wellness in Maryland. For example, according to the American College of Rheumatology (ACR) clinical guidelines, prednisone can be given at 0.5 mg/kg body weight/day (or less), up to a maximum of 40 mg/day for lupus nephritis. For off-label use for giant cell arteritis, the ACR recommends prednisone between 10 and 80 mg per day, depending on whether low-, moderate-, or high-dose steroids are needed.
Doses of 40 mg or higher per day are considered a high dose, while doses of 10 to 40 mg per day are considered moderate doses, and doses of 10 mg or less per day are low doses of prednisone.
Prednisone dose ranges |
||
|---|---|---|
| Dose category | Daily dose range | Common uses at this dose |
| Low dose | <10 mg/day | Rheumatoid arthritis, immune thrombocytopenia (ITP), Addison’s disease, and congenital adrenal hyperplasia |
| Moderate dose | 10–40 mg/day | Psoriatic arthritis, myasthenia gravis, lupus nephritis, osteoarthritis, gout, Crohn’s disease |
| High dose | ≥40 mg/day | Severe allergic skin reactions, asthma (acute exacerbation), tuberculosis, proteinuria, ulcerative colitis |
| Very high/pulse dose | ≥250 mg/day | Multiple sclerosis (acute exacerbation) |
This is a general guideline, as doses may vary. Always follow the instructions for dosing given by your healthcare provider.
How to take prednisone 20 mg
If you’re prescribed prednisone at 20 mg once daily, it’s best to take it with breakfast. “Morning with food is best,” says Dr. Hershcovitch. Taking prednisone with food can help reduce gastrointestinal irritation, and taking it early on in the day mimics your body’s natural cortisol cycles. “Prednisone gives a burst of energy,” he shares. Healthcare providers often recommend taking prednisone before 9 a.m.
Depending on your healthcare provider’s specific instructions, you may need to take prednisone 20 mg more than once daily. In this case, your healthcare provider will recommend how to take your dose, whether all at once or spaced throughout the day. They may also recommend antacids or other medications to help prevent stomach ulcers while you are taking prednisone.
It’s recommended that people on prednisone lower their dietary salt intake and avoid alcohol. Prednisone also has a few drug interactions, so reviewing your medications and supplements with your healthcare provider or pharmacist can help identify them before you start your medication.
It’s important to follow your healthcare professional’s instructions exactly. Prednisone dosing is individualized to the patient. Some people will require a tapering regimen (for example, when taking prednisone for longer periods of time or at higher doses), while others will not. If you have any concerns about your prednisone dose, how to take it, or possible side effects, contact your healthcare provider as soon as possible.
How to take prednisone 20 mg for 5 days
A five-day course of prednisone 20 mg is a commonly prescribed short-term regimen for certain conditions. Also called a “prednisone burst,” healthcare providers may recommend prednisone 20 mg for five days in certain patients with Bell’s palsy, gout, or an asthma exacerbation. However, a prednisone burst may vary in dose and duration.
To take prednisone 20 mg once daily for five days, start by taking your first dose with breakfast in the morning. Take one dose at the same time every day for five days. Follow your dosing instructions exactly.
For a short course of prednisone 20 mg once daily for five days, it’s typically not necessary to taper the dosage, but always follow your exact directions. You may still experience side effects.
Prednisone 20 mg side effects
Some common side effects of prednisone 20 mg include:
- Increased appetite and weight gain
- Trouble sleeping (insomnia)
- Mood changes or irritability
- Fluid retention and mild swelling (edema)
- Delayed wound healing and fragile skin
- Elevated blood sugar (hyperglycemia)
- Upset stomach
- Increased sweating
Even taking short courses of prednisone can carry a risk of side effects. “Generally, short courses of prednisone tend to be well-tolerated,” Dr. Bryant says. “However, even short-term prednisone ‘bursts’ can result in sleep disturbances, mood swings, increased hunger, fluid retention, and temporary increases in blood glucose,” she shares. According to an analysis of children and adolescents taking corticosteroids for fewer than 14 days, patients on the medication had a risk of developing hyperglycemia and sleep disturbances.
Serious side effects can occur with longer use or higher doses of prednisone. Serious side effects of prednisone 20 mg include the development of high blood pressure (hypertension), osteoporosis, muscle weakness, increased infection risk, stomach ulcers, cataracts, and elevated eye pressure (glaucoma). Adrenal suppression is also a serious side effect that can occur with prednisone use.
If you’re on prednisone 20 mg and experiencing severe mood changes, vision problems, discolored stool, signs of infection, or any other concerning side effects, contact your healthcare provider for medical advice as soon as possible.
RELATED: Prednisone side effects and how to avoid them
Prednisone 20 mg interactions and warnings
There are a few interactions and warnings to be aware of if you’re prescribed prednisone 20 mg. Some common risks associated with taking prednisone include:
- Increased risk of infection (e.g., fungal infections or reactivating hepatitis B infections)
- Risk of developing or worsening diabetes and high blood pressure
- Risk of developing osteoporosis
- Risk of developing stomach ulcers
It’s not recommended to combine alcohol with prednisone as they both can irritate the gastrointestinal tract. In addition, factors like frequent alcohol consumption and low vitamin D can worsen the risk of developing osteoporosis.
Common drug interactions with prednisone 20 mg include:
- Nonsteroidal antiinflammatory drugs (NSAIDs, e.g., ibuprofen) which increase the risk of stomach ulcers and gastrointestinal bleeding
- Diabetes medications: Prednisone raises blood sugar and may reduce the effectiveness of insulin or diabetes medications (e.g., metformin)
- Blood thinners (e.g., warfarin): Prednisone can change (increase or decrease) the effects of blood thinners
- Live vaccines: Prednisone may suppress the immune response needed to respond to certain vaccines and have effective immunity. If you’re getting a vaccine while taking prednisone, be sure to tell the immunizing healthcare professional that you are taking prednisone.
- Cytochrome P450 (CYP) 3A4 inducers and inhibitors: Drugs that affect the CYP3A4 enzyme can change the rate at which prednisone is metabolized, which can result in too much or too little drug
- Diuretics (e.g., hydrochlorothiazide): “Mixed with prednisone, can lead to electrolyte abnormalities (hypokalemia),” Dr. Herschkovitch says.
Always discuss your full medical history and medication list with your healthcare provider before taking prednisone 20 mg.
How much does prednisone 20 mg cost?
Prednisone is available as an affordable generic. The average retail price is $13 for 10 tablets of 20 mg prednisone without insurance. Cash prices at retail pharmacies vary widely based on factors such as location, pharmacy, dose, and quantity. A SingleCare discount card can significantly reduce the out-of-pocket cost compared to paying the retail price without insurance. With SingleCare, it could cost $3 for 10 tablets of 20 mg prednisone.
Learn more about the cost of prednisone and how to get prednisone affordably in our article: How much is prednisone without insurance?
Expert takeaway
“When taking prednisone, it’s very important to follow the prescribed regimen exactly,” says Karen Berger, Pharm.D., member of the SingleCare Medical Review Board. “If you have any questions about how or when to take it, be sure to check with your healthcare provider or pharmacist.”
Frequently asked questions
How long does prednisone take to work?
Prednisone reaches peak blood concentration about 2 hours after taking it, but it may take some time to start to notice an improvement in symptoms. Take your prescribed regimen exactly as directed by your healthcare provider.
Can I drink alcohol while taking prednisone 20 mg?
You should not drink alcohol if you’re taking prednisone 20 mg. Combining alcohol and prednisone can increase the risk of certain side effects, such as gastrointestinal bleeding and ulcers.
Does 20 mg of prednisone make you tired?
Though tiredness is not a listed side effect of prednisone 20 mg, it can indirectly cause tiredness in some patients.
Can you buy prednisone over the counter?
No. Prednisone can’t be bought over the counter; it should be prescribed by a licensed healthcare provider.
The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Aug. 13, 2026. Prices vary by pharmacy. Visit our coupon page for updated drug prices at pharmacies near you.
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- Prednisone, StatPearls (2025)
- 2024 American College of Rheumatology (ACR) guideline for the screening, treatment, and management of lupus nephritis [PDF], Arthritis Care & Research (2024)
- 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of giant cell arteritis and takayasu arteritis [PDF], Arthritis Care & Research (2021)
- Short-course systemic corticosteroids in asthma: Striking the balance between efficacy and safety, European Respiratory Review (2020)
- Adverse events following short-course systemic corticosteroids among children and adolescents: A systematic review and meta-analysis, JAMA Network Open (2025)
- Adrenal suppression, Endotext [Internet] (2018)
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