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Drug Info

Can prednisone help with the flu?

Prednisone is not typically used to treat the flu, here’s why
Taneia Surles, MPH
By | Jan. 10, 2025 Medically reviewed by Samantha Marr, DNP, APN, AGPCNP-BC, CCRN
Top view of an open Rx bottle: Can prednisone help with the flu?

Key takeaways

  • Prednisone is a prescription drug that healthcare providers prescribe to treat medical conditions like asthma, allergic reactions, arthritis, inflammatory bowel disease (IBD), and more.

  • Medical experts do not recommend the use of corticosteroids like prednisone because their anti-inflammatory properties weaken the immune system, making it harder to fight off the virus.

  • However, in some cases, healthcare providers may use prednisone for critically ill patients if there’s lung tissue damage.

  • If your healthcare provider deems it safe to take prednisone with the flu, please ensure you follow their dosage instructions and take the proper precautions to protect your immune system.

  • Several prednisone alternatives, including antiviral medications, inhaled corticosteroids, and pain relief medications, can be more effective in treating influenza.

In this article:

Prednisone is a corticosteroid that healthcare providers prescribe to treat medical conditions like asthma, allergic reactions, arthritis, inflammatory bowel disease (IBD), and adrenal, blood, and bone marrow conditions. “Its primary objective is to diminish the degree of inflammation and activity of the immune system,” says Shahinaz Soliman, MD, a board-certified family physician at Shantique Med Spa in Torrance, California. 

According to medical experts, taking prednisone for flu is not helpful, as the steroid medication can affect the body’s ability to fight the virus.

Does prednisone help with the flu?

According to the World Health Organization (WHO), the flu, or influenza, is a viral, contagious respiratory infection of the nose, throat, and lungs. It can cause mild to serious illness and, in some cases, death. 

The symptoms of flu include the following:

  • Fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Headaches
  • Muscle or body aches
  • Fatigue or tiredness

So, how does prednisone work in the body? “Prednisone is a synthetic drug that mimics the action of cortisol, a natural hormone in the body, and reduces the inflammatory response and activity of the immune system,” Dr. Soliman explains. “When stress is present, it does this by blocking pro-inflammatory mediators and dampening the activation of particular immune cells.” 

Dr. Soliman says prednisone should not be used to treat the flu. “As influenza is due to viral agents, the immune system must work actively for the virus,” she explains. “Prednisone acts by dampening the immune response, which could impede recovery from any subsequent viral infections. Although it may decelerate inflammation of some symptoms, it could also predispose people to some of the more serious complications of the flu virus.”

Researchers also advise against the use of prednisone for the flu. According to a systematic review of several observational studies, corticosteroids, such as prednisone, are associated with increased mortality (death) and hospital-acquired infections in influenza, especially when administered in high doses.

Another study found that the immunosuppressive effects of corticosteroids, such as prednisone, are typically not effective for treating respiratory illnesses like influenza or community-acquired pneumonia (CAP). However, researchers did find that the effects of steroid medications could be beneficial for other infectious diseases like COVID-19 and reduce the respiratory failure that can lead to acute respiratory distress syndrome (ARDS), sepsis, and even death.

ARDS is a life-threatening complication of influenza A/H1N1 that can develop when the virus damages your lungs. Sepsis is another serious medical condition that results from your body’s extreme inflammatory reaction to any type of infection. It is one of the most common flu complications that requires hospitalization.

The only situation where prednisone might help treat this viral infection is if someone has severe influenza. A systematic review and meta-analysis revealed that corticosteroids may improve the damage to lung tissue induced by influenza and decrease the risk of death in animal models. Researchers also found that many healthcare providers may administer corticosteroids as an anti-inflammatory treatment for adult patients in the intensive care unit (ICU) with severe influenza-related pneumonia to stop or slow the progression of the respiratory illness and improve clinical outcomes. 

However, despite the benefits of prednisone for treating the flu, Dr. Soliman thinks the risks outweigh the benefits. “While it is true that pulmonary inflammation can be reduced by the use of prednisone—which appears to be beneficial in flu symptoms—antiviral immune responses can also be suppressed by the use of the drug, making it less useful in treating the flu,” she explains.

How fast does prednisone work for the flu?

Monelle Burrus, FNP, a nurse practitioner and health expert at Verve Health in Bend, Oregon, says that prednisone typically starts working within a few hours of the first dose for flu relief. However, she adds that certain factors can impact how soon the steroid drug works in your body.

“Age, chronic illnesses, such as diabetes or hypertension, and the overall immunity level of the individual can determine the metabolism rate of prednisone and its effects,” she explains.

Dr. Soliman says that if a healthcare provider prescribes prednisone to treat the flu, it would only address the inflammation caused by the virus. “Conversely, the anti-inflammatory action does not treat the viral infection on its own, thus leaving the problems with the flu intact but lessening inflammation,” she says.

If your healthcare provider deems it safe for you to take prednisone to reduce inflammation from influenza, here are best practices for taking this corticosteroid therapy:

  • Take it with food: “It should be taken with food to alleviate the chances of causing an upset stomach,” Dr. Soliman says. 
  • Adopt a healthy diet: It is important to consume a diet high in lean protein and potassium and low in salt. A dietitian or nutritionist can help guide you if needed. 
  • Avoid NSAIDs and alcohol: To avoid an upset stomach, avoid mixing non-steroidal anti-inflammatory aids (NSAIDs) and alcoholic beverages. 
  • Take the steroid drug in the morning: Take prednisone in the morning with breakfast. Because prednisone imitates a stress hormone called cortisol, it can affect your circadian rhythm (sleep-wake cycle), so there’s an increased risk of insomnia. To avoid this, don’t take prednisone in the late afternoon or right before you go to bed.
  • Finish the course of medication: “Be sure to complete the dosing schedule, refraining from abrupt cessation,” Dr. Soliman says. If you need to stop taking prednisone, your healthcare provider will guide you through the process safely.
  • Avoid potential exposures: Since prednisone may weaken your immune system and cause you to get sick more easily, avoid contact with people who are sick, wash your hands often, and wear a mask. “Stay away from any additional exposure as prednisone weakens the body‘s immune system and makes it susceptible to other infections,” Dr. Soliman says. 

If you have any questions or concerns about taking prednisone, please contact your healthcare provider directly. 

Prednisone dosage for the flu

According to Burrus, there are no specific guidelines on prednisone dosage for the flu, as the steroid has not been approved for managing the flu. Dr. Soliman says your healthcare provider can adjust your dosage appropriately if you are prescribed prednisone.

Potential side effects and complications

Knowing the potential side effects of taking prednisone for the flu is crucial. “Steroids suppress the immune system and therefore the body’s ability to fight off illnesses such as the flu,” Burrus says. “This can lead to other complications and a slow rate of healing.”

Here are some of the most common side effects of prednisone:

  • Stomach pain
  • Nausea
  • Vomiting
  • Changes in appetite
  • Mood swings
  • Agitation
  • Weight gain
  • Hives
  • Rash

Corticosteroids like prednisone could also lead to more serious side effects, such as:

  • Steroid psychosis (range of psychiatric symptoms that can occur after prolonged use of steroid medications)
  • Muscle damage
  • Congestive heart failure
  • Diabetes mellitus
  • Bone tissue death
  • Severe or life-threatening allergic reactions
  • High blood pressure
  • Infection
  • Seizures
  • Peptic ulcer or gastrointestinal perforation

If you’re experiencing severe side effects from taking prednisone, please seek immediate medical attention from your healthcare provider or call 911. 

Because prednisone is not typically prescribed to treat viral infections like the flu, there are some serious risk factors associated with taking this steroid drug.

“It is worth noting that the use of steroids (i.e., prednisone) in patients with viral infections will alter the immune response to the infection, which may lengthen the course of the infection as well as increase the risk of subsequent bacterial infections such as pneumonia,” Dr. Soliman says. “Furthermore, they can include psychological changes, elevated blood pressure, blood sugar levels, and gastrointestinal adverse effects more so if they are used for long periods of time.”

If you get your annual flu vaccination, it’s important to understand the effects corticosteroids can have on this vaccination. According to research, high-dose corticosteroids can weaken your immune system, making the flu shot less effective. The Centers for Disease Control (CDC) recommends waiting at least three months after stopping prednisone before getting a flu vaccine. 

You can ask your healthcare provider for further information on the potential risks of taking prednisone for the flu.

Given the high risks of taking prednisone for the influenza virus, several alternatives to help decrease the effects of flu symptoms may be more effective and safe for your health. 

“Some of the viral infections in patients, like flu, for instance, can be helped by acetaminophen (Tylenol, Excedrin) or ibuprofen (Advil, Motrin) to lower fever and relieve pain as well,” Dr. Soliman explains. “Often, courses of antivirals, such as oseltamivir (Tamiflu), are suggested within the first 48 hours of symptoms appearing to lessen the impact of the flu. Finally, consideration of inhaled corticosteroid preparation is reasonable for asthmatic patients and those with other respiratory disorders since it has local action and few side effects.”

Other examples of antiviral drugs and inhaled corticosteroids include:

  • Zanamivir
  • Peramivir
  • Baloxavir
  • Fluticasone
  • Budesonide
  • Mometasone

Please speak with your healthcare provider to discuss alternatives to prednisone for treating the flu.

The bottom line

Medical experts do not recommend the use of corticosteroids like prednisone to treat the influenza virus. This is because prednisone’s mechanism of action can weaken your immune system, making it harder for your body to fight against the virus. Prednisone is only prescribed for the virus if the person has a critical illness like severe influenza that has caused significant lung tissue damage. Several other medications, such as antiviral drugs and inhaled corticosteroids, are safer and more effective for treating influenza than prednisone. 

If you want to learn more about prednisone for the influenza virus, please seek professional medical advice from your healthcare provider.