Things to avoid while taking prednisone

In this article:

• Foods to avoid
• Drinks to avoid
• Medications and supplements to avoid
• Activities to avoid

In this article

• Foods to avoid
• Drinks to avoid
• Medications and supplements to avoid
• Activities to avoid

Our bodies have a complicated relationship with inflammation. It’s a natural immune response to injury or infection, but it can also go rogue, contributing to everything from autoimmune diseases to respiratory, gastrointestinal, and mental disorders. Oral corticosteroids like prednisone are powerful anti-inflammatory drugs prescribed for rheumatoid arthritis and a wide variety of other inflammatory health conditions. Around ten million patients take them per year—but those ten million patients need to be careful what they eat, drink, and do while taking it since certain things might influence the drug’s effectiveness and side effects. 

Things to avoid while taking prednisone

Like any OTC or prescription medication, prednisone works best under certain conditions. “It is a powerhouse at relieving symptoms quickly, but you can pay the price later,” says board-certified rheumatologist Dr. Stella Bard, MD. “Taking it in short spurts for flares is okay, but taking it long term comes with a slew of side effects.”

Some foods might exacerbate prednisone’s side effects, as can beverages like coffee. Some drugs might interact with prednisone, inhibiting it or increasing the risk of more serious side effects. Before taking any corticosteroid, talk to a healthcare provider about your current diet and any drugs you’re already taking. They can provide medical advice to help your treatment go as smoothly as possible. 

But in general, here’s information on several things that may cause health concerns while taking prednisone.

What foods should you avoid while taking prednisone?

Foods rarely interact directly with prednisone, but because the drug can cause weight gain, raise blood sugar, and change how the body absorbs certain nutrients, it’s important to watch what you eat. So whenever possible, steer clear of the following foods:

• Sweets and simple carbohydrates: Things like cookies, cakes, and candy are already some of the most tempting foods on the shelves, and Dr. Bard says prednisone makes you crave them even more, so avoiding them is key. That’s because prednisone and sugary foods can both elevate blood glucose levels. 

• High-sodium, processed foods: According to Dr. Mary Greene, MD, a cardiologist with Manhattan Cardiology and contributor to Lab Finder, prednisone can cause high blood pressure. So she says patients should “avoid salty and processed foods while taking prednisone to avoid an unsafe increase in blood pressure.” Adding a little table salt to a homemade meal, however, is usually fine.
• Foods high in cholesterol and saturated fats: Prednisone might cause some weight gain and increased appetite. So a diet that’s high in cholesterol and fats can hurt your overall health. Avoid fried foods, butters and oils, full-fat dairy, and other foods cooked in fat. 

On the flip side, there are some foods you should try to include in your diet while taking prednisone. They include:

• Calcium and Vitamin D-rich foods: Prednisone inhibits the body’s calcium absorption and may, over a long time, cause osteoporosis. High-calcium foods like low-fat dairy, broccoli, tofu, cooked spinach or kale, and sardines can help keep your bones strong. Vitamin D helps the body absorb calcium, so foods like salmon, tuna, egg yolk, mushrooms, and vitamin D-fortified foods are a good idea too. 

• Lean, high-protein foods: A high-protein diet is important since prednisone causes increased protein breakdown. That may include lean meats, fish, poultry, eggs, beans, tofu, and/or nuts. 
• High-potassium foods: Potassium can help maintain body’s fluid balance, so bananas, oranges, apricots, prunes, cantaloupe, honeydew, and baked potatoes could be good additions to your diet. 

What drinks should you avoid while on prednisone?

Certain beverages can affect your prednisone treatment too. A few of the most common culprits include:

• Alcohol: Dr. Greene also recommends avoiding alcohol, since it can compound prednisone’s blood pressure effects. Drinking, especially binge drinking, can exacerbate some of prednisone’s other adverse effects too, like gastrointestinal issues, mood swings, elevated blood sugar, and weight gain. In addition, both may suppress your immune system, making you more susceptible to infections. 
• Coffee: That hot morning pick-me-up won’t directly affect prednisone, but the caffeine in coffee may worsen possible side effects, like insomnia and heartburn. It’s not a huge risk, but still something to consider. 
• High-sugar drinks: Soft drinks, sugary coffee drinks, certain fruit juices, and other sweetened drinks can raise your blood sugar levels. Since prednisone also might raise your blood sugar, it’s best to avoid them. 

It’s also important to stay hydrated while taking prednisone since water can help the body eliminate sodium, and prednisone affects how the body processes sodium. In general, the recommended daily water intake is at least half an ounce per pound of body weight. 

Medications or supplements to avoid while on prednisone

The most serious prednisone interactions don’t come from food or drinks but from other drugs. Always tell healthcare professionals about any prescription drugs, OTC medicines, or nutritional supplements you’re taking before starting a new prescription. Prednisone’s potential drug interactions include:

• NSAIDs: Non-steroidal anti-inflammatory drugs and corticosteroids both reduce inflammation, but they can also both cause gastrointestinal symptoms. Taking them together may make these mild side effects worse. Tylenol (acetaminophen) might be a safer option, but talk to your healthcare provider first. 
• Other immunosuppressants: Because prednisone suppresses certain immune functions, taking similar drugs can increase potential risks of infection and illness. Talk to your healthcare about this; sometimes your provider will give you prednisone for a shorter course while other immunosuppressant medications take effect. 

• Diabetes medications: The goal of diabetes drugs like metformin is to manage blood sugar. However, prednisone may cause high blood sugar, making the diabetes drugs less effective. 

• Blood thinners: Prednisone may change the way the liver processes anticoagulants like Warfarin and increase the risk of bleeding.
• Diuretics: Both diuretics (water pills) and prednisone can lower the body’s potassium, causing a deficiency. 
• Certain antibiotics: Macrolide antibiotics like clarithromycin may reduce prednisone clearance, leaving more of it in the body. Taking prednisone with quinolone antibiotics like levofloxacin and ciprofloxacin may increase the risk of tendon issues. 

• Live vaccines: Prednisone can increase your risk of infection, especially in high doses. And because live virus vaccines use weakened (but live) versions of a particular germ, they can cause the disease they’re intended to prevent. Examples of live vaccines include chickenpox, measles, mumps, and rubella. 

Activities and physical exercises to avoid while taking prednisone

If you’re worried about gaining weight while taking prednisone—or you’re just a fitness enthusiast—you’ll probably be looking to work out during your medical treatment. Good news: You don’t have to stop your exercise routine while taking prednisone. In fact, physical activity may even help mitigate some common side effects of prednisone. 

Regular exercise can help reduce inflammation and cut down the protein loss that occurs during prednisone use. Studies also suggest that it can help regular blood sugar and prevent bone loss. So continuing your usual daily activities shouldn’t be an issue. Just know that prednisone’s unwanted effects include fatigue, dizziness, and muscle weakness—so you might not feel full strength.