Prednisolone (Prednisone) — NZ Medication Guide | KiwiMeds
✅ Reviewed by a Registered Pharmacist NZ | Last updated: May 2026 | This information is for educational purposes only and does not replace advice from your doctor or pharmacist.
What is Prednisolone (Prednisone)?
Prednisolone (also known as prednisone in its prodrug form) is a corticosteroid — a medicine that mimics cortisol, the body’s natural stress hormone. It is a powerful anti-inflammatory and immunosuppressant medicine used for a wide range of conditions.
What is it used for?
Prednisolone is used to treat inflammatory conditions including asthma flares, rheumatoid arthritis, inflammatory bowel disease (Crohn’s, UC), severe eczema and psoriasis, allergic reactions, COPD exacerbations, and autoimmune conditions. It is also used in cancer treatment regimens. Fully funded by Pharmac.
How does it work?
Prednisolone works by suppressing the immune system and reducing inflammation. It does this by blocking the production of inflammatory chemicals (prostaglandins, cytokines) and suppressing immune cell activity. Its effects are very broad, which is why it is effective across so many conditions but also causes a range of side effects.
How to take it
Prednisolone is taken once daily in the morning with food (to reduce stomach irritation) — as directed by your doctor. Short courses (5–10 days) are common for flares. Never stop prednisolone suddenly after more than 2–3 weeks of use — the dose must be gradually tapered to allow the adrenal glands to recover their own cortisol production.
Common side effects
Short-term side effects include insomnia, increased appetite and weight gain, mood changes (euphoria, irritability), fluid retention, raised blood sugar (especially in people with diabetes), and increased infection susceptibility. Long-term side effects include osteoporosis, cataracts, skin thinning, weight gain, diabetes, and adrenal suppression.
Serious side effects
Signs of infection requiring urgent care (prednisolone masks fever so infections may be more advanced than they appear), adrenal crisis if stopped suddenly (severe fatigue, weakness, dizziness — seek emergency care), and mental health effects (rarely, high doses can cause psychosis or severe mood changes).
Drug interactions
NSAIDs (ibuprofen, aspirin) combined with prednisolone greatly increase stomach ulcer risk — use a proton pump inhibitor (omeprazole) to protect the stomach. Blood sugar monitoring is important in people with or at risk of diabetes. Some antibiotics and antifungals affect prednisolone levels.
Things to avoid
Avoid NSAIDs without stomach protection. Avoid live vaccines while on immunosuppressive doses. Carry a steroid card or medical ID if on long-term prednisolone. Avoid contact with people who have chickenpox or shingles if you are not immune.
NZ-specific information
Prednisolone is fully funded by Pharmac. For long-term use, ask your doctor about bone protection (calcium, vitamin D, bisphosphonate) and carry a steroid emergency card. The “sick day rules” for prednisolone are important — if you are unwell, you may need to double your dose temporarily.
Frequently asked questions
Can I stop prednisolone early if I feel better? For short courses (under 2 weeks), usually yes as directed. For longer courses, always taper — never stop suddenly. Does prednisolone cause weight gain? Yes, especially with longer courses. This is partly due to increased appetite and fluid retention and is dose- and duration-dependent.
💬 Always talk to your pharmacist or doctor for advice specific to you.
Related medications
Related: Dexamethasone, Budesonide. Condition: Asthma, Rheumatoid Arthritis.
References & Further Information
The following New Zealand and international resources were used to inform this page: