Prednisone is a commonly prescribed corticosteroid medication used to treat a variety of inflammatory conditions. It is often prescribed in a tapered dosage, where you start with a higher dose that is gradually reduced over days or weeks as the condition improves. This helps avoid side effects that can occur with long-term prednisone use.
However, some people wonder if they can take just a single dose of prednisone when needed rather than following a full tapered schedule. There are a few things to consider when deciding if a one-time dose of prednisone is appropriate.
What is prednisone?
Prednisone is a synthetic corticosteroid medication that mimics the effects of cortisol, a hormone naturally produced by the adrenal glands. It works by reducing inflammation and suppressing the immune system. Some conditions prednisone is commonly used to treat include:
- Asthma attacks
- Allergic reactions
- Rheumatoid arthritis
- Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
- Certain cancers
- Multiple sclerosis flare-ups
It comes in tablet form and is usually taken once or twice per day, often for several weeks or months. The dosage is often tapered, meaning you start with a higher dose which is gradually lowered over time.
Why is prednisone usually tapered?
Taking prednisone long-term, especially at higher doses, can cause side effects. The body becomes used to having extra cortisol around when you take prednisone regularly. If you suddenly stop prednisone, the body can’t resume making enough cortisol quickly enough. This can cause symptoms of cortisol withdrawal, such as:
- Fatigue
- Joint pain
- Body aches
- Low blood pressure
Tapering the dosage gives your adrenal glands time to steadily resume their normal cortisol production. This prevents withdrawal symptoms. It also minimizes other side effects that can occur with longer term use, such as:
- Increased appetite and weight gain
- Mood changes, such as depression or irritability
- Muscle weakness
- High blood sugar
- Bone loss (osteoporosis)
- Cataracts
- Glaucoma
- High blood pressure
- Impaired wound healing
- Thinning skin
Can I just take one dose of prednisone?
While prednisone is usually prescribed in a tapered dosage schedule, it is possible in some cases to take a single, one-time dose. Here are some factors to consider:
Severity of your condition
For quick relief of a sudden flare-up or attack of an inflammatory condition like asthma, allergies, or arthritis, a single dose of prednisone may be fine. It can help bring severe symptoms under control while other medications take effect or while you wait to see your doctor.
However, for chronic inflammatory conditions that require long-term management, a single dose of prednisone is not recommended. These diseases tend to need consistent doses of corticosteroids to keep inflammation in check over weeks or months.
Your previous prednisone use
If you have taken prednisone regularly in the past, even for a short time, you are more likely to experience withdrawal symptoms if you abruptly stop. Your adrenal glands may need the taper to adjust. People who have never taken prednisone likely have a lower risk of adrenal insufficiency or withdrawal after one dose.
Dosage amount
The risk of side effects and the impact on your adrenal glands depend partially on the strength of the prednisone dose. Low single doses of 5-10 mg are less concerning than a single dose of 60 mg, for example. Lower doses are less likely to cause significant adrenal suppression after just one use.
Your underlying health
If you have other health conditions that affect your adrenal glands, like Addison’s disease or other endocrine disorders, even small amounts of prednisone could potentially cause problems. People who are otherwise healthy are less prone to complications from isolated prednisone use.
| Factor | More Likely to Be OK with One Dose | More Likely to Need Tapered Doses |
|---|---|---|
| Condition Severity | Mild flare-up of asthma, allergies, arthritis | Severe, chronic inflammatory disease |
| Past Prednisone Use | No regular prior use | History of taking prednisone regularly |
| Dosage Amount | Under 10 mg | Over 40 mg |
| General Health | Otherwise healthy | Adrenal disorders like Addison’s |
Side effects of one-time use
A single, low dose of prednisone is unlikely to cause significant side effects. However, some people do report:
- Upset stomach
- Increased appetite
- Trouble sleeping
- Flush face
- Change in mood – some people report feeling agitated or having increased energy
These effects should go away within 1-3 days after taking the medication. Contact your doctor if side effects don’t resolve or if you experience more severe reactions like changes in vision, fever, chest pain or difficulty breathing.
Dangers of frequent or long-term use
While the occasional use of a single dose of prednisone is unlikely to be harmful in many cases, it is important not to make a habit of taking prednisone without medical oversight. Using prednisone too often, even in low doses, can cause side effects over time. Some problems associated with longer-term prednisone use include:
Adrenal suppression
Prednisone suppresses your body’s natural production of cortisol. If used for more than a week or two, the adrenal glands can start to atrophy and shrink. Over time, they may produce less cortisol even after you stop the prednisone. Significant suppression can take weeks or months to recover from.
Withdrawal symptoms
If you use prednisone regularly and then suddenly stop or significantly reduce the dosage, you are at risk for withdrawal effects like fatigue, nausea, low blood pressure, and body aches. Tapering is necessary after more than a brief course.
Weakened immune system
Long-term prednisone use can make it harder for your body to fight off infections. Being on prednisone for weeks or longer term lowers your resistance to illness.
Bone loss (osteoporosis)
Prednisone can interfere with new bone formation and accelerate bone breakdown, eventually leading to bone weakening, increased fracture risk, and osteoporosis. The risk increases with higher total doses over time.
Weight gain
Prednisone often prompts the body to store more fat and lose muscle mass. It stimulates appetite while also affecting how nutrients are metabolized and stored. Weight gain is common with long-term use.
Diabetes risk
Prednisone can make cells less sensitive to insulin and drive up blood sugar levels. With prolonged use, it can promote insulin resistance and increase the risk of developing diabetes, especially if you have other diabetes risk factors.
Eye problems
Using prednisone for many months or years can increase the risk of cataracts, glaucoma and damage to the optic nerve. Eye exams are important for long-term users.
Mood effects
Irritability, anxiety and depression are possible side effects of chronic prednisone use. Mood changes may persist even after the drug is stopped.
Key takeaways on single dose use
To summarize key points about taking one single dose of prednisone:
- A single, low dose can provide quick relief for a sudden flare-up of symptoms from an inflammatory condition like asthma or arthritis.
- People who have never taken prednisone before are unlikely to experience significant side effects or adrenal suppression from one dose.
- Those with a history of regular prednisone use, adrenal disorders or very high dose requirements are more prone to complications.
- Frequent or long-term use of prednisone without medical oversight can cause significant side effects.
- Work closely with your doctor to determine if a tapered dosing schedule or alternative medication may be a better option for your situation.
When to see your doctor
Be sure to consult your physician in these situations:
- If you experience concerning side effects after taking prednisone.
- If your condition doesn’t improve with one dose or worsens again shortly after taking it.
- If you feel you need to take prednisone regularly without a doctor’s input.
- If you have been on prednisone long-term and need to stop – tapering may be required.
With your doctor guiding your treatment plan, prednisone can help control inflammatory conditions. But use caution with frequent or long-term use if it is not under medical supervision. Be aware of the potential for side effects, especially with higher doses. Check in with your physician if you have any concerns about prednisone use.