Alcohol can worsen the side effects of prednisone, such as weight gain. It may not be safe for people with certain medical conditions to drink alcohol while taking prednisone.

Prednisone is a synthetic form of an adrenocortical steroid that healthcare professionals prescribe to treat several different conditions. It can help balance hormones in people whose adrenal glands do not produce enough corticosteroids.

Prednisone belongs to the corticosteroid class of medications. These are powerful anti-inflammatories and can help treat diseases that cause inflammation, such as lupus, multiple sclerosis, and arthritis. Prednisone reduces inflammation by altering the function of the immune system.

In this article, we explore the side effects of prednisone and alcohol and if they might be safe to use together.

Woman holding a prednisone pill and a glass of alcoholShare on Pinterest
A person should speak to a doctor before drinking alcohol when taking prednisone.

The package label for prednisone does not indicate a direct interaction between alcohol and prednisone, and clinical studies on the safety of drinking alcohol while taking prednisone are lacking.

However, prednisone is known to affect metabolism — how the body breaks down food into energy. The body converts prednisone to prednisolone, which the liver then metabolizes before a person excretes in the urine. Because the liver also metabolizes alcohol, it is possible prednisone may change the effects of alcohol on the body. Alternatively, alcohol may alter the way the body metabolizes prednisone.

The question of whether you can drink on steroids, or particularly prednisone, could depend on several factors, including:

  • how large the dosage of prednisone is
  • whether it is a short- or long-term course of treatment
  • how much alcohol the person drinks
  • medical conditions the person has

In general, a person’s doctor can best determine whether mixing prednisone with alcohol will be safe.

Potential risks of using alcohol and prednisone together include:

Gastrointestinal problems

Prednisone can increase the risk of gastrointestinal disturbance, such as an upset stomach. Long-term use of alcohol causes inflammation of the stomach lining, which can lead to stomach ulcers, heartburn, and malnutrition.

People with existing stomach issues, such as heartburn, should avoid using prednisone and alcohol together.

Weakened immune system

Prednisone weakens the immune system, which can make people more vulnerable to infections. This means someone taking prednisone may have more trouble than they usually would fighting off diseases. Exposure to measles or chickenpox can cause more severe infections in people taking steroids.

Alcohol also weakens the immune system, and chronic alcohol use can make it easier for people to become ill with pneumonia or tuberculosis. Anyone who takes prednisone and drinks alcohol regularly has a higher risk of developing an infection.

Weight gain

While multiple factors are involved, research suggests that alcohol intake can lead to weight gain in some people. Weight gain is also a possible side effect of prednisone.

Brittle bones

Long-term prednisone use can make the bones weaker and more brittle, leading to osteoporosis. Alcohol use is also a risk factor for osteoporosis due to the loss of nutrients necessary for bone growth.

Blood sugar changes

Alcohol can cause blood sugar levels to drop, which can be problematic for a person with diabetes. People with diabetes also need to be aware that alcohol can cause inflammation of the pancreas and lead to complications.

Prednisone can increase blood sugar levels. Anyone with diabetes who is taking prednisone may require more insulin or medication to lower their blood sugar.

There are several precautions to follow while taking prednisone:

  • Take prednisone with food to prevent stomach upset.
  • Consult a doctor before taking prednisone while pregnant or breastfeeding.
  • Speak with a doctor before receiving vaccinations while on prednisone.
  • Do not stop a dosage of prednisone unless a doctor advises it.
  • Ask a doctor about potassium or calcium supplements.
  • Eat healthful, well-balanced meals to maintain weight and control blood sugar.
  • Avoid stimulants, such as caffeine, because these can worsen insomnia, a side effect of prednisone.

Whether it is safe to drink alcohol while on prednisone depends on the dosage of the medication, the length of the course of treatment, how frequently a person uses alcohol, and other conditions the person may have. These conditions may include gastrointestinal inflammatory disorders, osteoporosis, osteopenia, and diabetes.

A person taking prednisone may want to avoid alcohol until they finish the treatment.

Alcohol can worsen some side effects of prednisone, such as immune system suppression, bone weakening, and weight gain. It is best to speak with a doctor to avoid serious complications.