Prednisone and Alcohol: Is Alcohol Affecting Your Prescription?

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Mixing prednisone and alcohol is dangerous and can cause unwanted side effects, including liver damage, stomach issues, and problems with your immunity. Be sure to take prednisone as prescribed only and refrain from drinking alcohol.

In this article: 

• What is Prednisone?
• Alcohol Use Disorder (AUD)
• Alcohol and Prednisone: A Dangerous Mix
• Treating Alcoholism

What is Prednisone?

Prednisone is in the family of corticosteroids and is used to reduce the symptoms of inflammatory conditions, such as arthritis, asthma, and skin rashes.¹

The most common corticosteroids prescribed by doctors are:¹

• Prednisone
• Hydrocortisone
• Cortisone

Corticosteroid drugs also help suppress the immune system to prevent organ rejection in transplant recipients and to treat Addison’s disease—a rare condition where the adrenal glands aren’t working properly to produce natural corticosteroid that the body needs.

Corticosteroids are administered in different ways, depending on the condition being treated.

Methods these drugs can be taken include:¹

• Orally: Tablets, capsules, or syrups
• Inhaler and intranasal spray: Used for asthma and nasal allergies
• Eyedrops: Used to treat swelling after eye surgery
• Topically: Creams and ointments for skin rashes
• Injection: Used to treat tendonitis or inflammation in joints and muscles.

Despite the method of intake, all corticosteroids, including prednisone, should be taken as directed. These drugs carry their own set of side effects, and when mixed with alcohol, the side effects can become exaggerated and dangerous.

Not only can mixing prednisone and alcohol be a deadly combination, but research also shows that drinking alcohol excessively can cause you to potentially miss your dose of medication.² Abusing alcohol can lead to something called “blackouts,” which are brief periods of amnesia, where the user cannot recollect events that happened. In a blackout, you may forget to take your daily dose of prednisone.²

Alcohol Use Disorder (AUD)

Problem or binge drinking that worsens is known as alcohol use disorder (AUD).³ AUD or alcohol addiction is characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.

Alcohol and substance use disorders are among the most prevalent medical and health problems, with 1.9 million adults ages 18 years and older being diagnosed with AUD in 2019.³

Here are some warning signs to assess if you may have AUD:³

• Drinking more than you had planned.
• Trying to cut back or stop more than once unsuccessfully.
• Spending a lot of time drinking, being sick, or hungover.
• Obsessively thinking about drinking or wanting alcohol so badly you can’t focus.
• Having problems with work, school, or family because of your habit (or because you’re sick from drinking).
• Drinking even though it has caused problems for you or in your relationships.
• Replacing other activities that were important to you in order to drink.
• Finding yourself in situations while drinking or afterward that put you in danger.
• Drinking alcohol even though it made you depressed or anxious, hurt your health, or led to a blackout.
• Having to drink more than you used to for the same effect.
• Experiencing withdrawal symptoms when the buzz wears off, like trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or hallucinations.

Two or three of the above symptoms in the past year indicate a mild alcohol use disorder. It’s a moderate disorder if you’ve had four to five. Six or more of these symptoms indicate severe AUD.³

If you are prescribed corticosteroids like prednisone and are struggling with AUD, it is important to abstain from mixing large amounts of alcohol while taking the drug—or seek formal treatment if your alcohol problem is severe. If you have a condition that requires the use of prednisone, alcohol may interfere in the medication doing its job or may create other unwanted side effects.

Call 800-948-8417 Who Answers? to get help with a drinking problem. A caring treatment advisor can help you find a rehab center that’s right for you.

Alcohol and Prednisone: A Dangerous Mix

Because oral corticosteroids affect your entire body, they can likely cause significant side effects. Mixing prednisone with alcohol can enhance these negative side effects, depending on your biology, the amount of alcohol consumed, and the medication dosage. You can experience short-term or long-term effects from combining alcohol and prednisone.

Short-term Effects of Mixing Prednisone and Alcohol

When taking prednisone with alcohol, you can expect some or all of the following short-term side effects: ^1,2,3

• Blood pressure problems: Alcohol is a CNS depressant and can causes changes in blood pressure.
• Cognitive problems: Mood swings, memory, behavior, and other psychological effects, such as confusion, delirium, or blackouts. Prednisone and alcohol together can increase the chances these occur.
• Stomach issues: Alcohol irritates the stomach lining and produces acidity. Prednisone can also cause unwanted digestive issues.
• Weight gain: Alcohol causes a build-up of the fatty cells in tissues, and prednisone may increase appetite. Both prednisone and alcohol together can lead to excess or risky weight gain.
• Lowered immunity: Prednisone suppresses the immune system, which can leave someone more susceptible to infection or warding off illness. Alcohol also weakens immunity and can make you more vulnerable to infections.

Multiple organ systems, such as the stomach and immune system, interact with liver cells, so alcohol metabolism varies according to the resiliency or lack of resiliency in each person’s physiology.

Enzymes in the liver work to oxidize (break down) the alcohol and eliminate it from the body.⁴ Cirrhosis of the liver can occur when you consume too much alcohol and the liver can no longer process it effectively. The more alcohol in your system, the harder the body works to get rid of it to prevent alcohol poisoning.

If you are also on prednisone, the liver is essentially working overtime to dispel toxins from your body. Combining alcohol and prednisone causes your system to exhaust itself causing danger to your health and, over time, your organs may not be able to work as efficiently.

Long-Term Effects of Mixing Prednisone and Alcohol

In addition to the short-term effects of taking prednisone and alcohol simultaneously, you may notice some long-term effects of mixing the two: ^1,2,3

• Thinning bones: Alcohol and prednisone increase the chances of osteoporosis (brittle bones) which can lead to fractures or weakening of the skeletal system.
• Diabetic complications: Alcohol drops blood sugar whereas prednisone does the opposite. Nevertheless, if you have diabetes and are taking prednisone, you must be careful as alcohol and prednisone affect blood sugar differently.

Decreased liver function affects your ability to uptake/process protein, so if you also have diabetes, you can’t heal as quickly or as efficiently.⁴ In some extreme cases, you may end up on dialysis. Specific factors may aid in or prevent alcohol metabolism.⁴

Managing the Side Effects of Prednisone

Taking prednisone by itself can come with its own side effects, regardless of whether you’re drinking alcohol at the same time. You can manage prednisone side effects by:⁵

• Taking the dose in the morning with food. This prevents indigestion, heartburn, and acidity.
• Eating healthy, nutritious food and exercising. This helps to maintain a healthy weight and physiology.
• Keeping your immunity high. This helps ward away illnesses and infections.

Talk to your doctor if you have concerns about taking prednisone. Generally, minimal alcohol intake is ok on certain steroids, but this is something that is best discussed with your doctor.⁵ If you have any signs of AUD and are worried about taking medications, it’s best to consult with professionals who can guide you and help you find treatment for your AUD if necessary.

AUD treatment is tailored to address problems specific to the individual. Options for treatment include inpatient treatment, outpatient treatment, detoxification, and other residential and non-residential rehabs. Additionally, current times have called for an increased need for online and remotely accessible recovery services.

Treating Alcoholism

If you’re struggling to stop drinking alcohol while taking prednisone, there is help available. Call 800-948-8417 Who Answers? to speak to a rehab treatment specialist and discuss your options.

For help with alcohol addiction, you may consider:^3,6

• Medications: Certain medications such as naltrexone have been used in treating AUD.
• Behavioral therapy: Such as cognitive-behavioral therapy, counseling, and motivational interviewing
• Recovery apps: Tempest, SoberTool, Nomo, and Simple Habit are popular recovery apps.
• Mutual support groups: Including Alcoholics Anonymous, Celebrate Recovery, SMART Recovery, and other secular, religious, and spiritual organizations..

Tools and resources are available to help provide additional support. If you are worried about your drinking habits and are taking prednisone please use caution and refer to your doctor for recommendations.

Lastly, if you or your loved one is experiencing symptoms of AUD, your best option is to seek professional treatment, which comes in several different options, such as short-term or long-term inpatient or outpatient rehab, depending on the severity of the condition.

Call our caring support specialists today at 800-948-8417 Who Answers? for more information. Help is available.

References

1. Mayo Clinic. (2021). Prednisone and other corticosteroids.
2. White, A. (n.d.). What happened? Alcohol, memory blackouts, and the brain. Retrieved March 08, 2021.
3. National Institute on Alcohol Abuse and Alcoholism. (2020). Understanding alcohol use disorder.
4. Nagy, L. (2004). Molecular aspects of alcohol metabolism: Transcription factors involved in early ethanol-induced liver injury. Annual Review of Nutrition, 24, 55-78.
5. United Kingdom National Health Service. (2020). Steroid tablets.
6. Healthline. (n.d.). The best alcohol addiction recovery apps of 2020.