The Good and Bad Side of Prednisone

By Andrea M. Jensen CHES AE-C

2 min read

I have mentioned this once or twice over the years (actually I mention it all the time...note the sarcasm). But I really hate wildfire smoke.

A year ago, Middle Son ended up in the intensive care unit (ICU) during a local forest fire that filled the valley with wildfire smoke. Watching his little body struggle and seeing all the wires and monitors (especially the heart monitor) is something I can never forget.

This time, it was my turn to end up in the hospital from wildfire smoke. Luckily I was not as bad as he had been all those years ago, but I did spend a long day in the emergency room (ER) and was pretty sick. Not to mention scared!

Should I go to the hospital?

I always teach those with asthma to listen to their body and remember when they should go to the hospital. Suddenly, I could hear my own words echoing in my head. I could hear myself repeating "Go to the hospital if:"¹

Your albuterol doesn't seem to be helping
You cannot say a phrase or full sentence without stopping and gasping for breath
You see a blue tint to your fingernails or lips
You are breathing fast (panting)
You have extreme shortness of breath (can't breathe in or out all the way)

Months before, I had listened to a webinar from Allergy and Asthma Network, and the doctor focused on a couple more emergency symptoms to watch for:²

Feeling too exhausted to breathe
Increased work to breathe

I realized that I had almost all of the signs of an asthma emergency! I also knew I was working way too hard to breathe. That's all I could focus on – trying to breathe in and out.

The other thing I have heard in countless webinars from doctors is "If you think you should...and the next word is go to the hospital...the answer is yes!" Listen to your body and that nagging voice. If you wonder if you are sick enough to go to the hospital, you probably are.

I managed to gasp out a sentence to my husband that I needed to go to the hospital. Once we arrived, they quickly took me back, started albuterol treatments, and gave me a liquid steroid. It is a really strong medicine, but I knew I would need a week's worth of prednisone pills to pull out of this asthma flare.

The good and bad side effects of prednisone

On the drive home, I warned my husband that I was going to be mean. Of course, every mom is mean, right?! But you can also have other "fun" side effects:³

Rapid heart beat
Mood changes
Agitation
Aggression
Irritability
Headache
Increased appetite
Weight gain
And many more!

My kids were on prednisone a lot when they were younger. They were in the hospital 12 times for asthma, and I remember the doctor warning me that prednisone can also suppress the immune system.

Not a great thing to happen during a pandemic, but I did not have a choice to not have prednisone.

The bad side of prednisone is that there are a lot of temporary side effects. The good side of prednisone is it can literally save your life during an asthma flare.

Who else has had "fun" on prednisone? Did your family go into hiding? Did your co-workers avoid you? Did you stay up all night and eat everything in the fridge? Did you yell at every driver on the road?

Share your story!

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ACTONE Member
Subsequent to a recent severe asthma attack & visit to the ER this past Sunday, Ive been put on on a week's worth of Prednisone tablets. Several days into taking the medicine Im not experiencing any of the side effects you describe. I am however experiencing gastro intestinal issues, including sour stomach & watery stool, both unusual for me. Also feeling a bit 'hyped up". Regardless, the positives far outweigh these few negatives, as the Prednisone has restored my breathing almost completely back to normal. A scant 3 day ago the slightest movement caused powerful wheezing & an inability to catch my breath. The improvement in such a short period of time is astonishing. So despite the minor side effects, Im a huge Prednisone fan. A lifesaver to be sure!
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="ACTONE" user-id="4256007"/> Hi again, ACTONE, and thanks for joining in this conversation about the pros and cons of using prednisone. I am glad to hear your experience (aside from the side effects you shared here), is a good one. When the steroid works over the short term to ease one's breathing, with only 'minor' tolerable side effects, that seems to be the optimum scenario. Please do check back and keep us apprised of how you're doing once you come off the medication. Wishing you well, Leon (site moderator asthma.net) 
2. Andrea M. Jensen CHES AE-C Contributor
 <inline-mention username="ACTONE" user-id="4256007"/> The side effects you described can also be normal on prednisone. It is a lifesaver for sure! But - be aware of that it can impair your immune system for up to 6 months. So take extra precautions against germs (like we're not already doing that during COVID....) There are times when I don't have a choice and need a steroid burst. But I take my controller inhaler every morning and every night. Sounds weird, but I actually get less medicine taking my controller inhaler (because it goes straight to my lungs), than if I take prednisone and swallow a pill that goes through all my organs, bloodstream, etc. For long term, I'm all about using a controller inhaler to prevent needing prednisone. But sometimes it can't be helped and is literally a lifesaver! I just don't want the long term side effects of using prednisone (like glaucoma, cataracts, weak bones, high blood pressure or causing diabetes). It's always a balancing act with asthma meds! Hope you recover quickly! Andrea, Author
ACTONE Member
Thanks Leon, will do. My last dose of the prednisone is this Tues, 10/12. After that fingers/toes will be tightly crossed that the outbreak does not return.
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="ACTONE" user-id="4256007"/> It's my pleasure, ACTONE. I'm hoping the very same outcome for you. Perhaps the prednisone will be sufficient to get you past this particular episode. Are you still taking your other (asthma) medications during this period of time. And, will you plan to continue taking them once the course of prednisone is over? Does your physician want to see you following all this for a status update? We are all with you on this, ACTONE - keep up the good work! And, if we can assist you with anything, please let me or any other moderator / team member know. Leon (site moderator <a href='http://asthma.net' target='_blank'>asthma.net</a>)
ACTONE Member
In addition to the prednisone, I also use the Advair Discus inhaler at least 1/day, as well as 1-2 daily nebulizer treatments. And of course, my trusty rescue inhaler is always by my side!😀 And yes, Ive also been advised to schedule a follow up with a pulmonary specialist to assess the current state of my condition & to adjust my medications accordingly. Incidentally, would love to hear any other responses/reactions/results to prednisone treatment following a severe outbreak such as I just experienced. And finally, thanks for all...much appreciate your support & concern!!
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="ACTONE" user-id="4256007"/> Hi again, ACTONE, and thanks for your response and further explanation. It sounds like, once the course of prednisone is completed, your treatment, medication regimen and follow-up visit with the pulmonologist will keep you on track. Like you, I will also keep my fingers crossed for your return to some normalcy with this. Please do check back and keep us apprised of your progress throughout. Warmly, Leon (site moderator asthma.net)
ACTONE Member
Following up as promised: it's now 1 week since finishing my course of prednisone following a most severe attack that required an ER visit. The improvement remains intact with breathing back to nearly 100%. Needless to say am more than happy with the results. Ive decided to discontinue the acupuncture (as well as the accompanying herbal treatment) as it didnt seem to help the condition at all. The prednisone was nothing short of a godsend & am so grateful they prescribed it at the ER. Currently I have my discus & rescue inhalers close by as well as my nebulizer, all ready to go into action should the condition reappear. But for now, have never felt better, so steady as she goes. Thanks so much for the comments & for this most helpful site!
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="ACTONE" user-id="4256007"/> Hi again, ACTONE - I'm so glad to hear back from you with this recent update and, especially with the excellent progress report!! You must be elated, as you said!! Sometimes, it takes that special one-course of steroids to 'knock out' the particularly severe asthma episode and, once the spasm is completely broken, the patient can return to more of a sense of normalcy. Perhaps, that is what has occurred for you. As you said - let's keep the course steady - stay on your routine medication regimen (diskus, rescue metered dose inhalers (MDI's), and nebulizer), and allow yourself time to recover from this challenging episode. Being kind and patient with yourself now can only serve you well. Please do stay in touch - we would appreciate your keeping us apprised of your continued progress. Good luck, ACTONE. Warm regards, Leon (site moderator asthma.net)

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