Can I drink when taking prednisone?

Prednisone is a potent and versatile steroid prescribed for different purposes. It is often prescribed for the short-term treatment of allergic and inflammatory conditions, although it can also be prescribed for chronic conditions. While it can be a useful drug, prednisone does not come without potential side effects and drug interactions. Some side effects of prednisone may be worsened with alcohol, depending on the amount of alcohol consumption.

Having an occasional drink or two while taking prednisone is unlikely to cause severe side effects. However, frequent or heavy drinking can have serious effects on prednisone treatment and the body. In this post, we’ll explore the use of prednisone, the potential side effects of mixing prednisone and alcohol, and whether it’s safe to drink alcohol with prednisone.  

What is prednisone?

Prednisone is a glucocorticoid drug that belongs to a broader group of drugs called corticosteroids, which are synthetic versions of natural steroid hormones. As a steroid drug, prednisone helps decrease inflammation in the body. 

You may be prescribed prednisone by a healthcare provider for various reasons. Prednisone is used to treat inflammatory conditions, such as rheumatoid arthritis, multiple sclerosis, and lupus. It may also be prescribed to treat serious allergic reactions, certain types of cancer, and inflammation from conditions of the eyes, skin, lungs, stomach, and intestines. For people with low corticosteroid levels, prednisone can help replace steroids naturally produced in the adrenal glands. 

Prednisone is available as an oral tablet, delayed-release tablet, and liquid solution. The dosage can vary based on the dosage form and treated condition. However, regular prednisone tablets may be taken multiple times per day. Brand names of prednisone include Rayos and Deltasone.

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Can you drink alcohol while taking prednisone?

Alcohol does not directly interact with prednisone. The main concern with drinking alcohol while taking prednisone is an increased risk of side effects. The outcome of drinking alcohol with prednisone depends on different factors, such as the level of alcohol intake and a history of alcohol abuse, alcohol addiction, or alcohol use disorder. Binge drinking (or drinking more than five drinks for men or more than four drinks for women within two hours) may pose more health risks while taking prednisone than drinking in moderation (or drinking no more than two drinks per day for men or no more than one drink per day for women). 

It’s best to wait until you have finished treatment with prednisone before drinking alcohol. People who drink alcohol with prednisone may have a higher risk of adverse effects than people who refrain from alcohol use during treatment. 

Prednisone and alcohol side effects

The side effects of prednisone and alcohol can overlap, making prednisone and alcohol a dangerous combination. Prednisone, like other steroids, can cause an array of physical and mental side effects. Alcohol can also cause side effects that can increase in severity as larger amounts are consumed. 

Increased risk of infections

Prednisone has anti-inflammatory effects that can lower the activity of the immune system. It can be hard for the body to fight off infections with a suppressed immune system. Frequent and heavy drinking may also weaken the immune system, and binge drinking for a night can suppress immune system activity for up to 24 hours. Mixing alcohol and prednisone may increase the risk of infections caused by bacteria, viruses, fungi, and parasites. 

Gastrointestinal issues

Prednisone use may cause gastrointestinal problems, such as peptic ulcers and gastrointestinal bleeding. Symptoms of peptic ulcers can include stomach discomfort, indigestion, and heartburn. Alcohol in large amounts can also irritate the stomach lining. Alcohol does not directly cause peptic ulcers, but excessive alcohol consumption may be a risk factor for peptic ulcers. The risk of digestive tract health problems may also be increased with smoking, stress, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Mental and mood changes

Corticosteroids, such as prednisone and prednisolone, can have an impact on mental health. People who take corticosteroids may experience mental and mood changes, including mood swings, insomnia, and depression. People who take prednisone long-term for chronic conditions have a higher risk of these side effects than people who only take prednisone for a short period. High doses of prednisone are also linked to mental and mood changes.

Chronic and short-term alcohol use can also lead to bouts of depression. It’s not uncommon for people who live with alcohol use disorder to also experience anxiety and mood disorders. People with alcohol use disorder may want to avoid long-term treatment with corticosteroids due to the risk of mental and mood changes. 

High blood pressure

Prednisone and other corticosteroids can increase the retention of fluid and electrolytes, such as sodium. Fluid retention can increase the total volume of the blood and lead to high blood pressure. 

Drinking alcohol may also have an effect on blood pressure. Studies suggest that alcohol can decrease blood pressure up to 12 hours after consumption and then increase blood pressure after that. However, the amount of alcohol consumed can make a difference. For example, one glass of alcohol should have little to no effect on blood pressure for most people (although heart rate may still be increased). After one glass, alcohol may start to influence changes in blood pressure.  

Weakened bones

Prednisone, like other corticosteroids, can affect the health of bones. By decreasing the absorption of calcium in the bones and blocking the development of bone tissue, prednisone can decrease bone mineral density (BMD). Osteoporosis, a health condition characterized by weakened bones, can arise from the use of prednisone at any age. However, postmenopausal women, older people, and people prescribed long-term use of corticosteroids are most at risk of developing osteoporosis from prednisone. 

While alcohol is known to affect bone health, studies are conflicting on the exact effects of alcohol on the bones. Some studies have found that postmenopausal women who consume alcohol may experience a lower risk of fractures with moderate alcohol consumption. Animal studies, on the other hand, have shown the opposite effects of heavy alcohol use. Animals that have heavily consumed alcohol were found to have low BMD levels and compromised bone health. In addition, studies showed that older postmenopausal women who consumed an average of six drinks per day were more likely to have greater bone loss than women with minimal alcohol intake. 

Electrolyte changes

Prednisone can cause changes in the electrolytes of the body, including sodium and potassium. The use of prednisone can cause sodium retention and potassium loss. Low levels of potassium (hypokalemia) can lead to muscle weakness, heart rhythm problems, and confusion. Potassium levels can vary in people who drink alcohol.  However, around half of all people with chronic alcohol use disorder experience hypokalemia. People who are sensitive to electrolyte changes should be wary of mixing prednisone and alcohol. 

Changes in blood sugar levels 

Prednisone can affect blood sugar (glucose) levels and alter the body’s sugar tolerance. People who take prednisone may experience increased blood sugar levels, which can lead to dangerously high blood sugar or hyperglycemia. This effect occurs because prednisone can block the body’s ability to transport glucose into the cells for energy. People with diabetes may need to monitor their blood sugar levels regularly or have their medications adjusted while on treatment with prednisone. 

The effects of alcohol also include changes in blood sugar levels. Drinking alcohol can lower blood sugar levels and increase the risk of hypoglycemia. However, alcoholic drinks may contain carbohydrates, which can increase blood sugar levels, and long-term alcohol consumption has been shown to be linked to low or high blood sugar levels. People with diabetes may need to be extra careful about monitoring their alcohol use while taking prednisone. 

Weight gain

An increased appetite and weight gain are common side effects of prednisone and other corticosteroids. Prednisone can affect the metabolism or the processing of different nutrients in the body, which can lead to increased fat deposits. An increased appetite can cause you to eat more while on prednisone and cause weight gain. In addition, sodium and fluid retention can contribute to weight gain with prednisone. Following a healthy lifestyle with regular exercise could help decrease the risks of weight gain while on prednisone. 

Moderate alcohol consumption is not usually linked to weight gain. However, people who drink heavily are more likely to experience weight gain than people who rarely drink. Alcoholic drinks can also contain calories that can promote weight gain. Some studies suggest that heavy alcohol intake may even play a role in obesity risk. 

The bottom line

There is no direct prednisone and alcohol interaction indicated on the FDA label for prednisone. Despite the absence of an explicit warning against mixing alcohol and prednisone, there is still a risk of serious side effects from drinking alcohol with prednisone. Combining alcohol and prednisone may increase the risk of physical and mental side effects, including a weakened immune system, stomach ulcers, bone loss, depression, changes in blood sugar levels, and weight gain. 

Always speak with a healthcare provider for medical advice about how to take your medications. Whether you’re concerned about side effects or drug interactions, you can discuss all of your treatment options with a healthcare provider. 

You should also be sure to tell your healthcare provider about other medical conditions you have and other medications you may be taking before starting treatment with prednisone. Some medications, including prescription drugs, over-the-counter medicine, and herbal supplements, may interact with prednisone and cause side effects.