In the US, millions of patients each year are prescribed corticosteroids, one of the most common being prednisone [1]. Prednisone is used to treat a variety of medical conditions by suppressing the immune system and the body’s natural inflammatory response.
Many who are on prednisone wonder: Is it safe to take with alcohol? Prednisone and alcohol are not safe to mix together and can cause increased adverse side effects such as liver toxicity, severe immune suppression, and impaired cognitive functioning.
What is Prednisone and What is it Used For?
Prednisone is a steroid used to reduce inflammation and suppress the immune system to treat conditions such as asthma, allergies, and autoimmune diseases such as rheumatoid arthritis and lupus.
Prednisone is converted by the liver into its active form, prednisolone, and binds to glucocorticoid receptors in cells to reduce inflammation and suppress the immune system. It also alters gene expression to stop the production of inflammatory-causing chemicals such as prostaglandins and leukotrienes.
These mechanisms of action make it a powerful medication for treating health problems associated with inflammation and immune suppression [2].
The Effects of Prednisone
Prednisone provides quick relief from inflammation and immune responses, but is also associated with several side effects. Speak with your doctors if any symptoms become severe or do not subside.
Short Term Use
Short-term use can impair mood, cause weight gain, and make it difficult to fall asleep. Other side effects include [2]:
- Increased anxiety, depression, irritability
- Insomnia
- Weight gain and increased appetite
- Headache and dizziness
- Muscle weakness, cramping
- Nausea, heartburn
- Sweating, hot flashes
- Increased blood pressure and blood sugar levels
Effects of Long-Term Prednisone Use
Long-term use is often associated with increased health risks such as osteoporosis, cataracts, and a weakened immune system. Other risks of long-term prednisone use include [2]:
- Changes in metabolism, fat distribution, and increased blood sugar levels. Fluid retention can lead to weight gain around the face and lower belly.
- Increased blood pressure
- Higher risk of infections
- Vision problems from cataracts or glaucoma
- Muscle weakness, muscle mass loss, bone thinning, increased risk of fractures, even within weeks of beginning treatment
- Increased risk of depression, anxiety, and, in severe cases, psychosis
- Acne, easy bruising, or slow wound healing
- Delayed growth in children
Can You Drink On Prednisone? Understanding The Risks
No, mixing corticosteroids such as prednisone with alcohol is dangerous and increases the risk of severe side effects. Alcohol is a central nervous system (CNS) depressant, which means it slows down activity in the body through the release of the neurotransmitter GABA.
Prednisone, like other corticosteroids, also affects the CNS by impacting chemicals such as corticotropin, norepinephrine, and beta-endorphins. When these are combined, the effects on the CNS intensify each other, leading to increased dizziness, sedation, and impaired coordination.
Why Do People Mix Prednisone with Alcohol?
Understanding these risks can help people on prednisone avoid alcohol. Some of the reasons why people report mixing alcohol and prednisone include:
- Not aware of the risks
- Think alcohol will help with side effects such as mood swings or insomnia
- They may drink alcohol while on prednisone because they struggle with alcohol addiction
- Intentionally mixing the two to increase the sedative effects of alcohol, although this is less common
Medical Interactions and Best Practices for Prednisone Use
Besides alcohol, prednisone interacts with over 600 drugs and needs to be taken under strict medical supervision to avoid potentially harmful interactions. Some of the most common interactions prednisone has include [3]:
- NSAIDS (ibuprofen, naproxen)
- Blood thinners (warfarin)
- Certain antibiotics (ciprofloxacin)
To reduce the risk of interactions, adverse side effects, and increase the effectiveness, follow these best practices for prednisone use:
- Take exactly what you are prescribed. Do not increase or reduce doses without speaking to your doctor.
- Be honest with your doctor about your symptoms, if you struggle with an alcohol addiction, and any adverse side effects, as they can adjust the dose based on your condition or symptoms.
- Take steroids with food, water, or a glass of milk to avoid nausea and stomach lining irritation.
- Take prednisone in the morning to reduce the risk of sleep disturbances.
- Report any unusual, persistent, or severe side effects to your doctor. Watch for high blood pressure, risk of infection, or elevated blood sugar.
- Calcium and Vitamin D supplements may be recommended by your doctor to strengthen and protect bone health.
- Inform your other healthcare providers that you are taking prednisone to avoid medication interactions.
- Do not stop taking prednisone cold turkey. Speak with your doctor who can safely taper you off gradually to avoid withdrawal symptoms or adrenal issues.
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Sources
[1] Prednisone Market Size and Share. 2025. Research Nester.
[2] Puckett, Y. et al. 2025. Prednisone. StatsPearl. National Library of Medicine.
[3] Prednisone Interactions. Drugs.Com.
