Prednisolone and Alcohol

Estimated reading time: 31 minute(s)

Prednisolone is a versatile and highly potent form of steroid prescribed to millions of people for various purposes. It is primarily a short-term treatment for inflammatory and allergic conditions, but many people use it to keep their chronic illnesses under control. Despite being an extremely beneficial drug, prednisolone has its side effects and drug interactions. Many of these side effects can get worse, especially when people combine it with alcohol, especially in high doses.

People who occasionally consume a drink or two while taking prednisolone are very unlikely to experience any side effects. However, frequent or heavy drinkers can very quickly develop severe effects on their prednisolone treatment and the body on the whole.

What is Prednisolone and Why Do We Use it?

Prednisolone is a glucocorticoid medication that is categorized as a broader group of drugs called corticosteroids. These corticosteroids are the manmade version of the natural steroid hormone that the human body produces. As a steroid medication, prednisolone helps manage inflammation and keep its associated symptoms in check.

People may take prednisolone for various reasons. For example, it is primarily used for managing inflammatory conditions like multiple sclerosis, lupus erythematosus, and rheumatoid arthritis. Some people also use it to treat certain types of cancer, serious allergic reactions, and inflammatory conditions of the eyes, lungs, intestines, and skin. Some people naturally have low levels of natural corticosteroids in the body and may require prednisolone replacement to cover the gap.

Prednisolone comes in the form of an oral tablet, a liquid solution, and a delayed-release tablet. The dose for this medication may vary depending on its dosage form and the condition it is treating. Regular prednisolone tablets can be taken several times a day according to the severity of the symptoms it is treating. Some brand names of prednisolone commonly available in the market include Deltasone and Rayos.

What Happens if You Take Alcohol and Prednisolone?

Many people are unsure if they should be drinking on prednisolone. The truth is there is no definite answer to this question, as the consequences that may occur by combining prednisolone and alcohol can vary in different people. Like other steroids, prednisolone on its own can cause different mental and physical side effects, and alcohol can very much increase its severity, especially if you consume it in larger quantities.[1]

Mentioned below are some prednisolone and alcohol interactions and possible side effects that may occur if you combine both:

Increased Risk of Infections

The anti-inflammatory effects of prednisolone can significantly lower immunity. This makes it difficult for the body to fight off infections as its immune system is not up to the mark. Alcohol also weakens the immune system, sometimes up to 24 hours following a heavy binge drinking session. Mixing prednisolone and alcohol can significantly reduce the body’s immune activity, increasing the risk of infections due to fungi, viruses, parasites, and bacteria.

Gastrointestinal Problems

Prednisolone is also capable of causing gastrointestinal issues, such as internal bleeding and peptic ulcers. Some symptoms of ulcers in the stomach include indigestion, heartburn, and discomfort. Just like prednisolone, alcohol can also irritate the stomach, and even though it doesn’t directly cause ulcers, it significantly increases the risk, especially when combined with certain drugs like NSAIDs and prednisolone.

Mood Changes

Corticosteroids like prednisolone can also negatively impact mental health and trigger sudden and rapid shifts in mood. Its long-term use is also associated with problems like depression and insomnia. People who have been using prednisolone for a long time are at a higher risk of developing these symptoms than those who are only on a short course.

Similarly, long- and short-term use of alcohol has also been linked to low mood and depression. It is also not uncommon for heavy drinkers to experience mood disorders and anxiety. Hence, those using prednisolone for a long time or are heavy drinkers may wish to avoid combining both as it may potentially trigger a mental health crisis.

High Blood Pressure

Prednisolone and other types of corticosteroids increase fluid retention in the body. Ir also causes the pooling of electrolytes, such as sodium which, together with fluid retention, increases the total volume of blood and boosts blood pressure. Drinking alcohol, on the other hand, causes a decrease in blood pressure, particularly 12 hours after consumption, followed by a rapid increase. The exact effects on blood pressure depend on how much a person consumes. Combining prednisolone and alcohol can cause unpredictable blood pressure fluctuations, which may prove extremely dangerous.

Weakening of Bones

All types of corticosteroids, including prednisolone, can harm the bones. It can also decrease bone mineral density (BMD) by reducing calcium absorption and inhibiting the development of hone tissues. Many people who use prednisolone for a long time develop osteoporosis, a health condition characterized by weakened and brittle bones at a high risk of breakage. While people of all age groups using prednisolone can develop osteoporosis, those who have hit menopause, older adults, and long-term prednisolone users are more susceptible to developing it.

Alcohol has also been known to affect bone health, but some experts have conflicting opinions on the matter. Some studies on postmenopausal women have concluded that moderate alcohol consumption tends to lower the risk of fractures, whereas animal models suggest otherwise. Animals who consumed high levels of alcohol were found to have very low BMD and deteriorating bone health. Similarly, research also reveals that women with more than six drinks per day suffer greater bone loss than those who consume this beverage minimally.

Electrolyte Changes

Prednisolone can alter the electrolyte balance in the body, mainly hitting the sodium and potassium levels. The use of this medication retains sodium while getting rid of potassium. Low potassium levels, a condition called hypokalemia, can lead to issues with the heart rhythm, muscle weakness, and confusion. Similarly, more than half of people who drink also experience hypokalemia. Hence, people particularly sensitive to electrolyte changes must avoid combining prednisolone and beer.

Blood Sugar Fluctuations

Prednisolone can directly affect blood sugar levels while altering sugar tolerance. Those taking this steroid medication may experience a rapid increase in their blood sugar levels, leading to a dangerous condition called hyperglycemia. This effect happens as prednisolone blocks the body’s ability to transport sugar molecules into the cells. People who are diabetic and taking prednisolone at the same time may need to monitor their blood sugar levels more carefully for the same reason.[2]

Alcohol is also capable of causing blood sugar fluctuations in the blood; however, the effects are opposite to that due to prednisolone use. Alcohol consumption lowers blood sugar levels, increasing the risk of hypoglycemia in the long run. But because most alcoholic drinks are rich in carbohydrates, their immediate effect is a rise in blood sugar levels. Hence, people taking prednisolone must be careful while drinking alcohol.

Weight Gain

Weight gain and increased appetite are the most notorious side effects associated with prednisolone and other steroids. Prednisolone directly affects the metabolic processes in the body, leading to increased fat deposits. At the same time, it also increases the appetite, forcing the users to eat more and gain weight. The fluid and sodium retention secondary to prednisolone use also contributes to weight gain.

Alcohol is not usually associated with weight gain; however, those who drink heavily are at an increased risk for it. Alcohol is also rich in calories which promote weight gain and even increase the risk of obesity, according to some studies.

Increasing the Quality of Life With Prednisolone

Whether you drink or not with prednisolone, the side effects of using steroid drugs can be pretty detrimental. Follow the tips mentioned below to ease some of these discomforts:

• Take your prednisolone dose after having a meal, as this practice may protect your digestive system from sustaining any damage. Add an antacid to your daily diet to further increase the protective barrier.
• Eat your meals sensibly while ensuring they are not larger than you normally consume. Steroids like prednisolone can increase your appetite and decrease satiety, causing you to overeat and gain weight.
• Eat small-sized meals several times a day to maintain healthy blood sugar levels. You may consider following a diabetic meal plan to reduce the risk of acquiring steroid-induced diabetes.
• Avoid using any stimulants, like nicotine and caffeine that may make your sleep issues related to prednisolone even worse. 
• Reduce your salt intake to avoid water retention. While it may not be explicitly mentioned on the packaging, certain foods tend to have higher levels of salt, such as those that are pickled, packaged, frozen, or canned. 
• Steroids can easily affect the sense of taste, making everything seem bland, so do not start loading up your food on salt.

FAQs

Can you drink alcohol while taking prednisolone?

Fortunately, alcohol does not seem to directly interact with prednisolone to cause any side effects, but the combination may increase the risk of these effects. The outcome of combining alcohol and prednisolone may depend on several factors, such as:

• How much prednisone you are consuming
• Your previous and current medical conditions
• How much alcohol do you usually drink
• Whether your prednisolone treatment is long-term or short-term

In general, binge drinking while using prednisolone may cause more damage than the occasional use of alcohol. Nevertheless, it is still the best idea to hold off using alcohol until you have finished your course of prednisolone.

How can I categorize my prednisolone dose as low or high?

According to the Americal Osteopathic College of Dermatology, the following criteria determine whether a person is using prednisolone in high, moderate, or low doses.

• Low Dose: Less than 7.5 mg per day
• Moderate Dose: Between 7.5 mg and 40 mg per day
• High Dose: More than 40 mg per day

What should I do if I experience a bad reaction because of combining prednisolone with alcohol?

Both prednisone and alcohol may cause similar side effects, some more serious than others. You may require urgent medical attention if a combination of the two brings on the following side effects:

• Slow or irregular breathing
• Persistent vomiting 
• Uncontrollable shaking
• Drowsiness or loss of consciousness
• Aggression
• Increased paranoia

Always talk to a healthcare professional and tell them accurately about the substances you have taken along with these doses. Make sure to mention all other drugs and substances besides alcohol and prednisolone. The more honest and accurate information you provide, the more effectively a healthcare provider can manage your symptoms.

How long after taking prednisone can you drink alcohol?

It is best to refrain from consuming alcohol altogether until you are entirely off prednisolone. While the combination may not necessarily bring any side effects, a risk is always there, so it is better to minimize this risk as much as possible. 

References

1 Fukushima, W., Yamamoto, T., Takahashi, S., Sakaguchi, M., Kubo, T., Iwamoto, Y., & Hirota, Y. (2013). The effect of alcohol intake and the use of oral corticosteroids on the risk of idiopathic osteonecrosis of the femoral head: a case-control study in Japan. The bone & joint journal, 95(3), 320-325.

2 Tamez-Pérez, H. E., Quintanilla-Flores, D. L., Rodríguez-Gutiérrez, R., González-González, J. G., & Tamez-Peña, A. L. (2015). Steroid hyperglycemia: prevalence, early detection and therapeutic recommendations: a narrative review. World journal of diabetes, 6(8), 1073.