This article describes possible interactions with prednisone oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Prednisone comes as tablets and a solution that you swallow. Interactions of prednisone may vary depending on the form of prednisone your doctor prescribes.
Other drugs and prednisone
The drugs in the list below may interact with prednisone oral tablet. This article does not include all drugs that may interact with prednisone.
Drug classes or drugs that may interact with prednisone oral tablet include:
- birth control pills and other drugs that contain estrogen
- certain antibiotic drugs
- drug examples: clarithromycin, erythromycin (Eryc, others)
- what might happen: can increase the effect and risk of side effects of prednisone
- certain antiepileptic drugs
- drug examples: phenytoin (Dilantin), carbamazepine (Tegretol, others)
- what might happen: can make prednisone less effective
- certain antifungal drugs
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the effect and risk of side effects of prednisone
- diuretics
- drug examples: furosemide (Lasix), chlorthalidone (Thalitone)
- what might happen: can increase the risk for side effects of prednisone and the diuretic
- amphotericin B (Abelcet, Ambisome)
- what might happen: can increase the risk for side effects of prednisone and amphotericin B
- cyclosporine (Gengraf, Neoral, Sandimmune)
- what might happen: can increase the effect and risk of side effects of prednisone and cyclosporine
- desmopressin (DDAVP)
- what might happen: can increase the risk of side effects of desmopressin
- digoxin (Lanoxin)
- what might happen: can increase the risk of side effects of prednisone and digoxin
- vigabatrin (Sabril)
- what might happen: can increase the risk of side effects of prednisone and vigabatrin
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When to avoid prednisone
Certain health conditions or other factors could increase some risks with prednisone oral tablet. Because of this, doctors may not prescribe prednisone in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for prednisone oral tablet:
- Systemic (whole body) fungal infection: If you have a fungal infection affecting your whole body, taking prednisone oral tablet may worsen the infection.
- Past allergic reaction to prednisone: If you’ve ever had an allergic reaction to prednisone oral tablet, taking it again may cause another allergic reaction.
Before you start taking prednisone, tell your doctor if anything listed above relates to you. They can recommend whether you should take prednisone.
Alcohol and prednisone
Prednisone oral tablet is not known to interact with alcohol.
If you have side effects from taking prednisone, though, drinking alcohol could worsen them. Examples of these side effects include:
- diarrhea
- nausea and vomiting
- trouble sleeping
If you drink alcohol and have concerns about prednisone interactions with alcohol, talk with your doctor.
Other interactions and prednisone
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether prednisone oral tablet has these interactions.
The information below does not include all other possible interactions with prednisone.
Prednisone and supplements
Before taking prednisone oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Prednisone interactions with herbs
Prednisone oral tablet may interact with echinacea. Some people use this herb to help support their immune system.
Taking prednisone while using echinacea may make prednisone less effective.
Because of this, ask your doctor or pharmacist before using echinacea while taking prednisone oral tablet.
Prednisone interactions with vitamins
Prednisone oral tablet is not known to interact with any vitamins. But this does not mean interactions with vitamins cannot happen or will not be identified later.
Because of this, ask your doctor or pharmacist before taking any vitamins while taking prednisone oral tablet.
Prednisone and food
Prednisone may interact with grapefruit and grapefruit juice. Consuming grapefruit or grapefruit juice while you are taking prednisone could increase the effect of the drug and your risk of prednisone side effects.
Because of this, talk with your doctor or pharmacist about what foods to avoid while taking prednisone oral tablet.
Prednisone and vaccines
Prednisone oral tablet may interact with live vaccines. Examples of live vaccines include the measles, mumps, and rubella (MMR), the chickenpox, and the cholera vaccines.
Live vaccines contain a weakened or killed version of the germ they protect against. They do not typically cause infection in people with a healthy immune system. But if you have a weakened immune system (immunosuppressed), which can happen if you take prednisone long term, you could acquire an infection from receiving a live vaccine.
If you are taking prednisone long term, it could also interact with inactivated (non-live) vaccines. Examples include the annual flu vaccine (except the nasal spray form, which is a live vaccine) and the COVID-19 vaccine. Inactivated vaccines may not work as well if you are taking prednisone long term.
Talk with your doctor or pharmacist before receiving any vaccines while taking prednisone oral tablet.
Prednisone and lab tests
Prednisone oral tablet may interact with a skin test used to check for tuberculosis, called a purified protein derivative (PPD) test.
Taking prednisone and having this test may lead to inaccurate test results.
Talk with your doctor or pharmacist before having any tests while taking prednisone oral tablet.
Prednisone and cannabis or CBD
Prednisone oral tablet is not known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this does not mean interactions cannot happen or will not be identified later.
As with any drug or supplement, tell your doctor before taking cannabis with prednisone.
Note: Cannabis is illegal at the federal level in the United States but is legal in many states to varying degrees.
Health factors and prednisone
Certain medical conditions or other health factors may increase the risk of interactions with prednisone oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking prednisone, tell your doctor about your health history. They will determine whether prednisone is right for you.
These health conditions or other factors might interact with prednisone oral tablet:
Preventing prednisone interactions
You may be able to help avoid certain interactions with prednisone oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if your doctor prescribes a new drug while you are taking prednisone oral tablet.
Taking prednisone exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about prednisone and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does prednisone have similar interactions as other corticosteroids, such as methylprednisolone or dexamethasone?
- Should I tell you if I start taking another medication or supplement during my prednisone treatment?
- If I have certain health conditions, will I be monitored more closely while I’m taking prednisone?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
