Risks Associated With Taking Prednisone And Alcohol

Prednisone And Alcohol

Prednisone is an adrenocortical steroid that doctors can prescribe to treat several different conditions such as balancing hormones in people whose adrenal glands do not produce enough corticosteroids or helping treat diseases that cause inflammation, such as lupus, multiple sclerosis, and arthritis. Prednisone can also alter the function of the immune system and is also a powerful anti-inflammatory tablet. 

As it is used to treat hormones and genetic diseases, it acts as a long term medication making people often wonder if they can take prednisone and alcohol together. In this article, we take a look at the side effects and risks of doing so: 

Side Effects Of Taking Prednisone And Alcohol

Alcohol and Prednisone:

In general, speak to a doctor before drinking alcohol and when taking prednisone. They might tell you that it depends on several factors, including:

  • how large the dosage of prednisone is
  • whether it is a short- or long-term course of treatment
  • how much alcohol the person drinks

Therefore only a doctor can best determine whether mixing prednisone with alcohol will be safe. The main issue about using prednisone and alcohol is that alcohol can make the side effects of prednisone much worse.

Side Effects and Risks:

The risks of taking prednisone and alcohol together include:

  1. Weakened immune system

A major side effect of prednisone is a weakened immune system, which can make people more vulnerable to infections.

The body may have more trouble fighting off diseases than it usually would. Exposure to measles or chickenpox can cause more severe infection in people taking steroids.

Alcohol also weakens the immune system. Chronic alcohol use can make it easier for people to become ill with pneumonia or tuberculosis, for example. Anyone who consumes prednisone and drinks alcohol frequently has a higher risk of developing an infection.

  1. Gastrointestinal problems

Prednisone can increase the risk of gastrointestinal disturbance. Long-term use of alcohol causes inflammation of the stomach lining, which can lead to stomach ulcers, heartburn, and malnutrition.

People with existing stomach issues, such as heartburn, should avoid using prednisone and alcohol together.

  1. Weight gain

While multiple factors are involved, research suggests that alcohol intake can lead to weight gain as a possible side effect of prednisone.

  1. Brittle bones

Long-term prednisone use can make the bones weaker and more brittle, leading to osteoporosis. Drinking alcohol is also a risk factor for osteoporosis, due to loss of nutrients. Having osteoporosis puts a person at risk of severe bone fractures.

  1. Blood sugar changes

Alcohol can cause blood sugar levels to drop, which can be problematic for a person with diabetes. Patients with diabetes also need to be aware that drinking alcohol can create inflammation of the pancreas and lead to complications.

Prednisone can increase blood sugar levels. Patients with diabetes who are taking prednisone could need more insulin or medication to lower their blood sugar.

How Long Does Prednisone Stay in Your System?

Prednisone has a half-life (the amount of time it takes for the drug level in the body to decrease to 50 percent of what it was when a person first took it)  of about 2 to 3 hours. 

Other studies place its half-life closer to 3 to 4 hours. 

For example, if a person took 5 mg of prednisone, the dose remaining in the body after three hours would be about 2.5 mg.

It takes about seven half-lives for a drug to leave the body. So based on a half-life time of 2 to 3 hours, it would take 14 to 21 hours for prednisone to leave the body. This is just an average and may be different depending on a person’s age, weight and general health.

Who Shouldn’t Use Prednisone

People who are allergic to prednisone or have a systemic fungal infection should not use this drug. Anyone who’s medically receiving immunosuppressive doses of prednisone should not receive live or live-attenuated vaccines. Inactivated vaccines may be used, but the patient’s response to these vaccines is unpredictable. 

Prednisone interacts with a rather giant list of drugs. This isn’t a complete list of all possible drug interactions. Patients should tell their health care provider about all the medicines they take and may start taking.

  1. Pregnancy and Breastfeeding: 

Studies have shown that steroids, including prednisone, can harm an unborn baby (in human and animal studies) when taken during pregnancy, according to the drug’s label.

Some studies have shown a small increase in the risk of cleft palate and other orofacial clefts when prednisone is taken during the first trimester. There are also reports of decreased birth weight and intrauterine growth restriction — a condition where the baby doesn’t grow at the right rate during pregnancy.

Prednisone can travel to the baby through breast milk, but there haven’t been any reports of adverse events. But high doses of prednisone consumed over long periods of time could potentially cause growth problems in breastfed infants.

  1. Abelcet AND Ambisome (AMPHOTERICIN B INJECTION):

There have been reports that using these drugs with hydrocortisone, a corticosteroid similar to prednisone, may increase the risk of heart failure and cardiac enlargement.

  1. ARICEPT (DONEPEZIL), RAZADYNE (GALANTAMINE), EXELON (RIVASTIGMINE) AND OTHER ANTICHOLINESTERASE AGENTS:

Using these drugs with prednisone may cause severe weakness in patients with myasthenia gravis. Providers should have patients stop anticholinesterase therapy at least 24 hours before starting prednisone, if possible.

Using warfarin with prednisone may cause warfarin not to work as well. Providers should monitor patients frequently to make sure the anticoagulation effect is working.

  1. DIABETES DRUGS

Prednisone can increase blood sugar levels. People taking diabetes medications may need increased doses.

  1. Aplenzin, Forfivo XL, Wellbutrin (Bupropion)

Both bupropion and corticosteroids can make people more susceptible to seizures, so using them together may increase the risk of seizures.

  1. ANTIBIOTICS FOR TUBERCULOSIS

Isoniazid may not work as well when taken with prednisone.

  1. PHENYTOIN, BARBITURATES, RIFAMPIN, CARBAMAZEPINE AND OTHER CYTOCHROME (CYP) 3A4 ENZYME INDUCERS

These drugs may enhance prednisone metabolism. Providers may need to increase the dose of prednisone.

  1. MACROLIDE ANTIBIOTICS, KETOCONAZOLE AND OTHER CYP 3A4 ENZYME INHIBITORS

Ketoconazole may cause certain corticosteroids to linger in the body longer. Ketoconazole can decrease drug metabolism by as much as 60 percent. This can increase the risk of corticosteroid side effects.

  1. Fluoroquinolone Antibiotics

A certain type of antibiotic called fluoroquinolones can cause damage to tendons. People who take corticosteroids while also taking fluroquinolones, or after taking fluoroquinolones, may be at higher risk for tendon damage.

  1. PREVALITE (CHOLESTYRAMINE)

Clearance of corticosteroids — the rate at which the drug is processed and leaves the body — is increased with cholestyramine.

  1. GENGRAF, NEORAL, SANDIMMUNE (CYCLOSPORINE)

Using prednisone with cyclosporine may cause convulsions.

  1. LANOXIN (DIGOXIN)

Patients on digoxin — a drug used for heart failure — may be at increased risk of low potassium levels or hypokalemia. This can lead to heart rhythm problems.

  1. ESTROGEN DRUGS AND ORAL CONTRACEPTIVES

Drugs with estrogen hormones such as birth control pills (oral contraceptives) may reduce the metabolism of the drug in the liver and increase the effect of corticosteroids.

  1. CERTAIN PAIN RELIEVERS

Using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and salicylates such as aspirin may increase the risk of toxicity and gastrointestinal side effects when taken with corticosteroids.

  1. DIURETICS AND OTHER POTASSIUM-DEPLETING AGENTS

Using corticosteroids with diuretics and other potassium-depleting medications may increase the risk of low potassium levels, or hypokalemia.

  1. Seroquel (Quetiapine)

Taking prednisone may decrease the effect of quetiapine, so higher quetiapine doses may be needed.

  1. SKIN TESTS

Taking prednisone while having a skin test may reduce reactions to the test.

  1. Thalomid (Thalidomide)

Taking thalidomide with prednisone can lead to a serious skin reaction (toxic epidermal necrolysis).

  1. LIVE OR LIVE-ATTENUATED VACCINES

People taking prednisone should avoid the drug before receiving a live or live-attenuated vaccine. Prednisone has the ability to increase the replication of some organisms in live-attenuated vaccines. Patients taking immunosuppressive doses of prednisone should not use live or live-attenuated vaccines.

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