Prednisolone is a generic drug that’s prescribed for eye inflammation caused by various conditions. As with other drugs, prednisolone can cause side effects, such as burning or stinging feelings in the eye.
- ophthalmic suspension (mixture) containing the active drug prednisolone acetate
- ophthalmic solution containing the active drug prednisolone sodium phosphate
Prednisolone also comes in oral forms, such as a tablet, solution, and syrup. However, this article will focus on the ophthalmic forms of the drug.
Side effects are more likely with long-term use of prednisolone eye drops. For this reason, prednisolone eye drops are typically used short term.
Read on to learn about potential common, mild, and serious side effects of prednisolone eye drops. For a general overview of prednisolone, including details about its uses, talk with your doctor or pharmacist.
Prednisolone can cause certain side effects, some of which are more common than others. These side effects may be temporary. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
- stinging feeling or pain in the eyes
- burning feeling in the eyes
- increased eye pressure (see “Prednisolone: Side effect specifics” below)
Mild side effects can occur with prednisolone use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to the prescribing information for prednisolone eye drop solution or suspension.
Mild side effects that have been reported with prednisolone include:
- stinging feeling or pain in your eyes
- burning feeling in your eyes
- mild allergic reaction (see “Prednisolone: Side effect specifics” below)
These side effects are typically temporary, lasting just a few minutes. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking prednisolone and want to tell the FDA about it, visit MedWatch.
Prednisolone may cause serious side effects. These are rare but are more likely to occur in people with certain medical conditions, such as glaucoma. They’re also more likely to occur with long-term prednisolone use.
If you develop serious side effects while taking prednisolone, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- increased eye pressure, which can cause new or worsening glaucoma
- new or worsening eye infection
- cataract formation
- severe allergic reaction*
To learn more about these side effects, see the “Prednisolone: Side effect specifics” section below.
Prednisolone may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
Are side effects of prednisolone the same with 5-milliliter (mL) and 10-mL strengths?
Yes, side effects are expected to be the same with prednisolone 5-mL and 10-mL strengths. However, your risk of side effects may increase if you’re prescribed higher doses of the drug.
If you have questions about the side effects of different strengths of prednisolone, talk with your doctor or pharmacist.
Note: Prednisolone also comes as a 5-milligram (mg) and 10-mg tablet. However, this article focuses on the eye drop form of the drug. For more information about side effects of the tablet form of prednisolone, talk with your doctor or pharmacist.
Do prednisolone’s side effects vary between adults and children?
No, the side effects of prednisolone are typically the same between adults and children. However, children may experience severe side effects from the drug more often than adults. These side effects include cataracts and glaucoma.* (With cataracts, the eye lens becomes cloudy, which can lead to vision loss. With glaucoma, there’s increased pressure in the eye, which can damage the optic nerve.)
Children may also be more sensitive to the side effects of prednisolone. So, they may not tolerate the side effects as well as adults.
It’s important to note some forms of prednisolone eye drops approved by the Food and Drug Administration (FDA) are not approved for use in children. However, these forms of the drug may be prescribed for off-label use in children. With off-label use, doctors prescribe a drug in a way that’s not approved by the FDA. So, your child’s doctor may
If you’re concerned about whether prednisolone eye drops are safe for your child, talk with their doctor. They can also discuss alternative options with you.
* For more details about these side effects, see the “Prednisolone: Side effect specifics” section below.
Should I expect side effects when “coming off” prednisolone?
You might experience side effects when you stop taking prednisolone, especially if you’ve been using the medication long term.
In this case, your doctor will likely recommend that you slowly stop prednisolone treatment, instead of stopping suddenly. Stopping too soon may cause symptoms, such as fatigue and eye irritation. These are similar to symptoms you may see if you suddenly stop taking other forms of topical steroids. (Prednisolone eye drops are a type of steroid drug that you apply topically to your eye.)
However, if your doctor prescribes prednisolone for short-term use, you’ll likely be able to stop treatment right away.
Talk with your doctor if you’re interested in stopping prednisolone treatment. They’ll advise the best way for you to do so.
Is weight gain a side effect of prednisolone eye drops?
No, weight gain is not a known side effect of prednisolone eye drops. This form of prednisolone is used topically on your eye rather than systemically (throughout your whole body). So, lower amounts of the drug tend to enter your system. Due to this, side effects that impact the whole body, such as weight gain, are very rare.
If you’re concerned about weight gain with prednisolone treatment, talk with your doctor. They can provide advice on maintaining a weight that’s healthy for you.
Learn more about some of the side effects that prednisolone may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for prednisolone eye drop solution or suspension.
Prednisolone eye drops can increase the pressure inside the eye, which could lead to glaucoma. The drug could also worsen glaucoma if you already have this condition. Glaucoma was rarely reported in clinical trials of prednisolone solution and suspension.
The pressure inside your eye is called intraocular pressure. When it becomes too high, glaucoma can develop. Usually, you won’t have any symptoms of increased eye pressure, but over time it can lead to blurred vision or vision loss.
Your risk of this side effect may increase if you have certain conditions or a family history of them. These include:
- primary open-angle glaucoma (an eye disease that causes vision loss over time)
- high myopia (nearsightedness that develops at a young age and worsens over time)
- conditions of the connective tissue, such as rheumatoid arthritis
Older adults and children under the age of 6 years have a higher risk of developing increased pressure in the eye. Long-term prednisolone use can also lead to increased eye pressure. It’s usually seen after 3 to 6 weeks of using the medication. However, it can occur earlier.
What you can do
You can help prevent glaucoma by providing your doctor with your full medical history. This includes all conditions you’ve had or currently have. They can determine whether prednisolone eye drops are right for you.
If your doctor prescribes prednisolone eye drops for 10 days or longer, they’ll likely want to monitor your eye pressure. This is because increased eye pressure doesn’t usually cause symptoms. So, they’ll recommend regular visits to an ophthalmologist (eye doctor) to monitor your eye pressure.
Be sure to follow your doctor’s recommendations and have all eye exams that they recommend. This will allow them to detect increases in eye pressure before it causes serious damage.
New or worsening eye infection
Prednisolone eye drops can cause a new or worsening eye infection, especially if they’re used long term. This is because prednisolone lowers your immune system’s ability to fight an eye infection. It’s not known how many people in clinical trials of prednisolone solution or suspension had this side effect.
Eye infections that can occur with prednisolone eye drops include fungal infections, viral infections such as herpes simplex, and others.
Symptoms can include:
- eye redness
- eye pain
- itching in your eye
What you can do
You can help prevent new or worsening eye infections by practicing good eye hygiene. Be sure to always clean your hands before touching your eyes or face. You should also avoid touching the tip of the prednisolone bottle against surfaces, such as a countertop or with your fingers.
Also, make sure to keep all appointments that your doctor recommends. This is so they can monitor for any signs of infection.
If you develop symptoms of an infection, contact your doctor. They may prescribe an antimicrobial medication.
Cataracts are a serious side effect of prednisolone eye drops. With cataracts, the eye lens becomes cloudy, which can lead to vision loss. It’s not known how common this side effect was in clinical trials of prednisolone solution or suspension.
Cataracts are more likely to form with long-term use of prednisolone eye drops. The drug causes a certain type of cataract called posterior subcapsular cataract. With this type of cataract, you see a glare and have other vision problems.
What you can do
Talk with your doctor to learn about your risk of developing cataracts. If your doctor prescribes prednisolone eye drops long term, they’ll recommend routine appointments. This is to monitor your eyes for signs of cataract formation.
Symptoms can be mild or serious and can include:
- skin rash
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking prednisolone. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Be sure to talk with your doctor about your health history before you take prednisolone. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:
Certain eye infections: Prednisolone eye drops can worsen certain eye infections.* These infections include herpes simplex keratitis, fungal diseases, tuberculosis of the eye, and viral diseases of the cornea and conjunctiva. If you have any of these eye infections, your doctor will likely not prescribe this medication.
Allergic reaction: If you’ve had an allergic reaction* to prednisolone or any of its ingredients, your doctor will likely not prescribe prednisolone. Taking prednisolone could cause you to have another allergic reaction. Ask your doctor about other medications that may be better options for you.
Thinning sclera or cornea: Prednisolone may not be right for you if you have a condition that causes thinning of your sclera or cornea. Prednisolone can cause perforations (holes) in the sclera or cornea if they’re already thinning. If you already have a condition that causes this, your doctor will likely not prescribe prednisolone eye drops.
Foreign body removal procedure: If you recently had a simple procedure to remove a foreign body, such as plastic or metal, from your cornea, tell your doctor. They will likely not prescribe the prednisolone eye drop solution. However, they may prescribe the prednisolone eye drop suspension if it’s safe for you to use.
Recent cataract surgery: If you’ve recently had cataract surgery, your doctor will consider whether prednisolone is the right drug for you based on your medical history. Prednisolone can delay the time it takes for your eyes to heal after cataract surgery. So, if you have risk factors that may affect healing, your doctor will likely not prescribe this drug.
Glaucoma: Prednisolone eye drops can cause or worsen glaucoma.* If you have glaucoma, your doctor likely won’t prescribe this drug.
Cataracts: Prednisolone eye drops can cause or worsen cataracts.* If you have cataracts, your doctor likely won’t prescribe this medication for you.
* To learn more about this side effect, refer to the “Prednisolone: Side effect specifics” section above.
Alcohol with prednisolone
There are no known interactions between prednisolone eye drops and alcohol.
However, excessive alcohol drinking may decrease your body’s ability to fight infections. Prednisolone eye drops can cause eye infection as a side effect. So, drinking lots of alcohol while using prednisolone may increase the risk of this side effect further.
If you drink alcohol, talk with your doctor to learn whether it is safe to drink while using prednisolone eye drops.
Pregnancy and breastfeeding while using prednisolone
Below is information about using prednisolone eye drops during pregnancy and while breastfeeding.
Pregnancy and prednisolone
It’s not known whether prednisolone eye drops are safe to use during pregnancy.
In animal studies, prednisolone acetate (the active ingredient in prednisolone suspension) was found to harm the fetus. This included cleft palate (structural changes to the lip and the mouth that can cause trouble with eating or speaking).
There haven’t been any animal or human studies done to assess whether it’s safe to use prednisolone sodium phosphate during pregnancy. (Prednisolone sodium phosphate is the active ingredient in prednisolone solution.)
If you are pregnant and considering treatment with either form of prednisolone eye drops, talk with your doctor about whether they’re safe for you. They’ll consider the risks and benefits of the drug and determine whether it’s right for you.
Breastfeeding and prednisolone
It’s not known whether prednisolone eye drops are safe to use while breastfeeding. It’s also not known whether prednisolone eye drops pass into breast milk.
However, oral forms of prednisolone are known to pass into breast milk. This can suppress the growth of a child who is breastfed and cause other developmental problems.
If you’re breastfeeding, talk with your doctor to learn whether prednisolone eye drops are safe for you and your child.
The most common side effects of prednisolone eye drops, such as burning and stinging in your eyes, are mild. And they may go away within minutes.
However, prednisolone eye drops can cause more serious side effects, such as glaucoma and eye infection. Before using prednisolone eye drops, your doctor will review your medical history to determine whether the drug is right for you.
If you’d like to learn more about prednisolone, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug. Referring to the following articles can provide you with additional information:
- Cost: If you’d like to learn about prednisolone and its cost, see this article.
- A look at your condition: For details about eye health, see our eye health hub.
Disclaimer: Medical News Today 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.