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Prednisone dosage for sinus infection: Uses, dosages, and side effects

Prednisone may help with sinusitis. Learn when it’s prescribed, the dosage guidelines, and key side effects to consider.
Gerardo Sison medical writer headshot
By | Oct. 30, 2024
Kleenex and a Rx pill respresenting Prednisone for sinusitis

Key takeaways

    • Prednisone can help reduce swelling and relieve symptoms of severe sinus infections, but it won’t cure the infection.
    • Doctors usually start with a higher dose of prednisone and lower it gradually over several days.
    • The dosage and duration of treatment depend on the severity of the infection and treatment response.
    • Possible side effects of prednisone include weight gain, mood changes, and weaker bones, especially with long-term use.
In this article:

Prednisone is a corticosteroid commonly prescribed to treat inflammatory conditions, such as asthma, chronic obstructive pulmonary disease (COPD), and arthritis. It’s typically prescribed as an oral tablet or liquid solution taken multiple times daily. Prednisone is the generic name for medications like Rayos and Deltasone.

Sinus infections can be uncomfortable, causing symptoms like congestion, headaches, and pressure around the nose and eyes. In some cases, particularly severe ones, a doctor or healthcare provider might consider using prednisone to help manage symptoms. However, compared to other treatments, prednisone might not offer huge benefits for mild sinus infections, and its side effects could outweigh the potential advantages.

Always consult a healthcare provider on the most appropriate sinus infection treatment. Continue reading to learn more about the potential use of prednisone for infections and its prescribed dosage. 

Can prednisone treat a sinus infection?

Prednisone may help treat sinus infections by reducing inflammation in the nasal passages. When someone has sinusitis, the lining of the sinuses or nasal cavities gets inflamed and swollen, leading to nasal congestion and sinus pressure.

Prednisone works by suppressing the immune system and lowering the levels of chemicals in the body that cause inflammation. Therefore, it can help open up the nasal passages, making it easier to breathe and allowing mucus to drain properly. As a result, people may feel less pressure in their sinuses, which can relieve symptoms like headaches and stuffiness.

High inflammation can leave a person feeling tired and unwell. By controlling the swelling, prednisone allows the body to focus on fighting the infection. However, while oral corticosteroids may offer relief, they don’t treat the underlying infection. In other words, prednisone won’t get rid of a bacterial, viral, or fungal infection causing sinusitis.

Viral sinus infections typically do not require specific treatment and must simply run their course. However, antifungal and antibiotic medications are effective options for treating fungal or bacterial infections.

When is prednisone prescribed for sinusitis?

Although prednisone is not the first choice for most sinus infections, it may be recommended in certain cases. For instance, a short course of steroids like prednisone may be beneficial if a person experiences severe sinusitis symptoms or if they recently had surgery affecting the sinuses. 

For example, a short course of prednisone may be recommended for chronic sinusitis, or sinus inflammation that occurs for more than 12 weeks at a time. A study looked at eight trials with 474 adults who had chronic sinus problems and nasal polyps, comparing the effects of short courses of oral steroids to placebo or no treatment.

After two to three weeks, the participants taking the steroids reported improvements in their symptoms. However, the benefits didn’t last long, as follow-up results showed little improvement after three to six months.

One review found that while corticosteroids helped improve symptoms in patients with chronic rhinosinusitis and nasal polyps, they didn’t provide much benefit when used alone for acute sinusitis. Therefore, oral corticosteroids by themselves aren’t used regularly for mild sinus problems but could be helpful for severe symptoms when combined with other treatments. In many cases, nasal steroid sprays may be recommended over oral corticosteroids. 

Prednisone dosage for sinus infections

The usual starting dosage of prednisone is anywhere from 5 to 60 mg per day. For sinus infections, prednisone is generally started at a higher dosage and slowly tapered or gradually decreased over time. 

For mild to moderate sinus infections, healthcare providers might prescribe a daily dose ranging from 20 to 40 mg. In contrast, severe cases might require higher doses of 60 to 80 mg per day. The dosage may then be tapered over seven to 14 days. 

Examples of prednisone dosages used in clinical trials have included the following:

Use Prednisone dosage
Chronic sinusitis without nasal polyps  20 mg twice daily for 5 days, then 20 mg once daily for 5 days
Chronic sinusitis without nasal polyps  60 mg for 3 days, 40 mg for 3 days, 20 mg for 3 days, and then 10 mg for 3 days
Chronic sinusitis with nasal polyps 30 mg daily for 4 days and then 25 mg for 2 days

The typical dosage of prednisone for sinus infections varies based on several factors, such as the severity of the infection and the person’s overall health. The dosage may also depend on the person’s response to treatment and other prescription medications they are taking. Oral prednisone should always be taken as directed to avoid serious side effects.

How long does it take prednisone to start working for sinusitis?

It’s possible to experience symptom relief relatively soon after starting prednisone. The drug starts working within a few hours after taking it. Some people may experience reduced inflammation and pressure within a day. However, for many, it may take a few days to feel the maximum effects of the medication.

Keep in mind that after ingestion, the body metabolizes prednisone in the liver, converting it into its active form, prednisolone. This conversion is key for the medication to have its desired effect. Depending on how their body processes the drug, some people might need a longer time before noticing significant changes.

Another important factor is food. When prednisone is taken with food, especially a high-fat meal, the time it takes for the drug to release into the body may be delayed. This means that it takes longer to reach its highest level in the bloodstream, which can delay how quickly a person feels better. 

On the other hand, if prednisone is taken on an empty stomach, it may be absorbed more quickly, leading to faster relief. Still, for some people, taking prednisone with food may help prevent an upset stomach. Therefore, it’s important to follow a healthcare provider’s instructions. 

Side effects and warnings of prednisone

Prednisone may cause various side effects, which can differ in severity. The risk of serious side effects generally increases with long-term use. That’s why it’s typically prescribed as a short-term treatment option, with the dosage slowly tapered off.

Potential side effects of prednisone may include:

  • High blood pressure 
  • Difficulty sleeping 
  • Muscle weakness
  • Fluid retention leading to a “moon face” 
  • Stomach issues like ulcers or irritation
  • Mood swings and psychological changes 
  • Increased appetite and weight gain 
  • Bone loss
  • Blood sugar changes
  • Increased sweating
  • Dry scalp

Prednisone may also come with serious warnings and precautions. For example, prednisone may cause elevated blood pressure or changes in electrolyte balance. Therefore, people with heart problems should use prednisone with caution. 

Prednisone may also interrupt the function of the adrenal glands, which may lead to Cushing’s syndrome or adrenal insufficiency. Abruptly stopping prednisone can worsen adrenal insufficiency by not giving the adrenal glands enough time to resume their normal cortisol production. Gradually reducing the dosage is often necessary to avoid worsening these effects.

In addition, long-term use of prednisone can disrupt growth and development in children, potentially leading to stunted growth if not carefully monitored. The use of prednisone should be monitored closely in growing children, as the medication can affect their height and how their bones develop.

Discuss any worsening or persistent side effects with a healthcare provider. Dosage adjustments may be recommended to manage side effects. 

Bottom line:

Prednisone is not usually the first choice for treating sinus infections. However, doctors might prescribe it for sinusitis to help reduce swelling and ease symptoms, especially when it’s combined with antibiotics or other medicines that treat the underlying infection. Studies show that using prednisone by itself doesn’t help as much. 

The amount of prednisone given for sinusitis can vary depending on the severity of the infection. Typically, treatment starts with a higher dose and then decreases over several days. Before taking this medication, it’s important to talk to a healthcare provider about possible side effects, as the side effects may outweigh the potential benefits.