Can Someone With Lupus Ever Stop Taking Prednisone?

Corticosteroids, also called steroids, are often used to treat lupus. Prednisone is the most commonly prescribed steroid for lupus. While it is effective at reducing inflammation and its symptoms, it can also have many side effects. Even during times of low disease activity, about 50 to 85 percent of those with lupus are given long-term steroids.^1,2

Although stopping steroids suddenly has been linked with a higher risk of lupus flares, a new study found that those with a prolonged lupus remission may be able to slowly discontinue steroids successfully.²

Research on stopping prednisone

The new study was performed at the University of Toronto Lupus Clinic. It included people whose lupus was in prolonged clinical remission continually for 2 years for the first time during their disease.²

At the start of the study, participants were taking 5 mg per day of prednisone. Over 2 years, these people either stayed at 5 mg per day or were told to slowly taper the dose until they were no longer taking it.²

Participants followed a schedule that allowed them to stop prednisone within 9 to 18 months. The schedule depended on:²

• How often their appointments were
• Withdrawal symptoms
• Personal preference

By the end of the first year, those who decreased their dose had fewer flares than those who stayed on the same dose. By the end of the second year, those who stopped taking prednisone still had fewer flares than the maintenance group.^2,3

What are the side effects of stopping prednisone suddenly?

If you are taking prednisone for an extended period of time, it is important not to stop taking the drug abruptly. Slowly reducing the amount you take is strongly suggested in order to avoid or decrease side effects.

Side effects that can occur when stopping prednisone suddenly or tapering too quickly can include:⁴

• Severe fatigue
• Weakness
• Body aches or joint pain
• Nausea
• Loss of appetite
• Feeling lightheaded

These side effects occur because prednisone is like the hormone cortisol. Cortisol is made naturally by the adrenal glands. When you are on prednisone for an extended amount of time, your adrenal glands make less cortisol.⁴

Stopping prednisone suddenly creates a lack of cortisol-like substances, and your adrenal glands need time to make more again.

What are the risks of long-term steroid use?

Although steroids like prednisone are effective at controlling lupus flares and symptoms, long-term use may be cause for concern. Side effects of prolonged use can include:⁵

• Decreased immunity and increased risk of infection
• Decreased protective response to physical stress
• Increased risk of stomach ulcers or bleeding
• Weak, thin, or brittle bones (osteoporosis)
• Weight gain
• Mood changes
• Higher blood sugar levels

Things to consider

If you have been in prolonged remission from lupus and are interested in reducing or stopping prednisone, talk with your doctor. Given the risks of long-term steroid use, you may be concerned about being on them for long periods of time. Before reducing prednisone or stopping it entirely, talk with your doctor. Your doctor can tell you if tapering prednisone is right for you.