Can you drink coffee while taking prednisone?

If you start your day with a cup of coffee, you’re in good company. The National Coffee Association reports that more Americans (up to 63%) drink coffee daily than any other beverage—including water. For a good reason—the caffeine it contains is good for an energy boost, and there are some notable health benefits. However, like most substances, there are health risks, such as anxiety and trouble sleeping, when consumed in excess. And it can interact with or worsen the side effects of certain medications, including the popular steroid prednisone.

Prednisone is a corticosteroid—just like hydrocortisone and cortisone. “It is used to control inflammation by suppressing the immune system,” says Jelena Radan, Pharm.D., BCPS, Lead Clinical Pharmacy Specialist at KSP Specialty Pharmacy. Doctors prescribe this medication for treating inflammatory conditions such as arthritis, allergies, inflammatory bowel disease (IBD), lung disorders, and autoimmune diseases. If you have been prescribed prednisone, it may be best to avoid or limit coffee consumption, as the caffeine in coffee may worsen your medication’s side effects.

Does coffee interact with prednisone?

“Caffeine does not reduce the effect of prednisone in patients. Patients taking steroids can consume coffee or caffeinated products,” says Yusra Shao, MD, a medical oncologist who works at the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan. “However, caution may be advised when consuming both due to overlapping side effects such as insomnia and heartburn. Patients who experience these symptoms may benefit from minimizing their caffeine intake.”

If you are taking prednisone, here are some things to keep in mind about drinking coffee with your medication:

It may have immunosuppressing effects

Although conflicting, some studies suggest that coffee is an immunosuppressant. According to a 2017 study, the beverage acts in an anti-inflammatory manner on different components of the immune system, such as natural killer (NK) cells, monocytes, and neutrophils. While there is no available study on how this effect of coffee may impact people taking immune-suppressing medications, insights suggest that coffee may amplify the immunosuppressive effects of prednisone.

It may worsen the side effects of prednisone

One study published in 2020 showed that consuming caffeine, especially in high amounts, can cause sleep disturbances and sleep disorders like insomnia, while another 2020 study indicated that caffeine may play a role in migraine headaches. Sleep disturbances and headaches are common side effects of prednisone. It’s important to keep in mind that taking this drug along with coffee may worsen these side effects.

Caffeine may also increase blood pressure, and an increase in blood pressure is one of the primary adverse effects of prednisone. Other “common side effects that a co-consumption of caffeine and prednisone can exacerbate include anxiety and an irregular heartbeat,” Dr. Radan points out.

It may worsen the symptoms of your medical condition

Coffee may also worsen the symptoms of certain medical conditions treated with prednisone, such as IBD. Diarrhea is a hallmark symptom, and some available evidence suggests coffee may have significant effects on digestive function, including laxative effects. For instance, a 2022 review of studies indicates that both regular and decaffeinated coffee may stimulate and increase the movement of bowel content through the large intestine, thereby facilitating the emptying of the bowels. This means consuming coffee while taking prednisone for IBD may worsen symptoms like diarrhea.

Decaffeinated coffee is a safer option for people on medication since it contains little to no caffeine, the major controversial ingredient in coffee. However, it still contains other ingredients that may interact with your medication or its effects. For instance, similar to regular coffee, decaffeinated coffee may also have stimulatory effects on colon bowel movement, indicating that caffeine is not the causative ingredient in this case.

RELATED: Is coffee good for constipation?

It may help with inflammation

A review of 15 studies suggests that coffee consumption is associated with anti-inflammatory action. However, this does not mean you have the green light for unlimited coffee consumption if you have an inflammatory condition. The effect of coffee on inflammation depends on genetics and other individual differences. A study published in Molecular Nutrition and Food Research observed contradictory effects of coffee on inflammation, with the beverage causing significant pro-inflammatory impact on the study participants.

Best practices for taking prednisone 

To ensure you are taking prednisone safely and to maximize its effects, here are some general helpful practices you may want to adopt:

• Take the medication with food. This can reduce stomach upset unless your medication is labeled “enteric coated” or “gastro-resistant.” These may be taken without food. 
• Take it in the morning. If your prednisone dosage is once daily, consider taking the pills in the morning to reduce its likelihood of affecting your sleep. If your dosage is twice daily, take the second dose for the day no later than mid-afternoon.
• Swallow the pill whole. Prednisone in tablet form is best ingested whole without crushing, breaking, chewing, or dividing it. Solutions are available for those unable to take pills.
• Avoid taking certain medications with prednisone. Tell your healthcare provider if you are taking medicines like diuretics (water pills), non-steroidal anti-inflammatory drugs (NSAIDs), estrogen pills (including birth control pills), blood thinners (such as warfarin), and diabetes medications. These medications may interfere with prednisone.
• Protect yourself against infections by adopting good hygiene practices. Prednisone can make you vulnerable to infections like COVID-19. Keep up-to-date on vaccines as recommended by your provider.
• Do not stop your prednisone therapy suddenly. This can cause withdrawal symptoms, especially if you are taking a high dose. Your healthcare provider can guide you on how to quit taking prednisone medication safely.
• Do not take prednisone with certain supplements. Herbal supplements are not regulated by the FDA, so the full extent of interactions with drugs like prednisone is unknown. On the other hand, long-term prednisone consumption can reduce calcium absorption and activation of vitamin D to aid in calcium absorption; therefore, you may be told to take calcium and vitamin D supplements while taking steroids.
• Avoid foods with a high amount of salt or sugar. Since high blood sugar (hyperglycemia) and high blood pressure (hypertension) are side effects of prednisone, it makes sense to limit your intake of foods with high amounts of refined sugar and salt, which can contribute to hyperglycemia and hypertension, respectively.

Bottom line: Drinking coffee with prednisone is low risk

Coffee is safe to consume in moderate amounts while taking prednisone, though there are some potential risks, including immune suppression, increased side effects, or worsened symptoms. If you are a coffee lover, cutting it out entirely may be difficult. Instead, try drinking less coffee and ensuring you don’t take it close to your medication time to minimize potential risks.