Prednisone Guide
What this steroid does, common side effects, and why it's tapered carefully over time.
What Prednisone Does
Prednisone is a corticosteroid used alongside other anti-rejection medications, especially in the early months after a heart transplant. It helps calm the immune system's response to the new heart. Many transplant teams gradually reduce ("taper") the dose over time as the risk of early rejection decreases, sometimes stopping it altogether - though timelines vary a lot from person to person.
Common Side Effects
Increased appetite and weight gain
Mood changes, irritability, or trouble sleeping
Higher blood sugar
Fluid retention and higher blood pressure
Stomach irritation (often eased by taking it with food)
Slower wound healing and thinner skin with longer-term use
Bone density loss with long-term use
Because prednisone affects blood sugar, blood pressure, and weight, many recipients find it helpful to track these day to day and share the trend with their care team, rather than just a single reading.
Never Stop Abruptly
With longer-term use, your body reduces its own natural steroid production. Stopping prednisone suddenly - or missing a dose without a plan - can be genuinely dangerous. Dose changes, including any taper, should only be made by your transplant team. If you run out early, miss a dose, or think your dose needs adjusting, call your care team rather than changing it on your own.
Everyday Tips
Take it with food or milk if it upsets your stomach.
Keep a consistent daily schedule, and use a reminder if mornings are hectic.
Ask your team about calcium, vitamin D, or bone-density monitoring if you're on it long-term.
Mention to any other provider (dentist, urgent care, etc.) that you're taking a steroid, since it can affect healing and infection risk.
Have questions about how this applies to you? Contact your transplant team or care coordinator - they know your specific history and treatment plan.