4 known interactions • 2 major • 2 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
NSAIDs (ibuprofen, naproxen)
Additive GI toxicity — significantly increased risk of peptic ulcer disease, GI bleeding, and perforation.
Management: Avoid combination when possible. If both needed, add PPI gastroprotection.
Vaccines (live vaccines)
Immunosuppressive doses of prednisone (>20mg/day for >14 days) are a contraindication for live vaccines (MMR, varicella, yellow fever, intranasal influenza).
Management: Administer live vaccines before starting corticosteroids. Wait ≥1 month after stopping high-dose corticosteroids.
Antidiabetic medications (insulin, metformin)
Corticosteroids cause dose-dependent hyperglycemia by increasing hepatic gluconeogenesis and reducing peripheral glucose uptake. Can precipitate diabetes in at-risk individuals.
Management: Monitor blood glucose closely. Dose adjustments of antidiabetic medicines are usually required.
Warfarin
Prednisone can either increase or decrease warfarin effect (variable interaction). Also increases GI bleeding risk.
Management: Monitor INR closely when corticosteroids are started or stopped.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Prednisone. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.