Prednisone and Alcohol: What You Should Know

It is generally advisable to limit or avoid alcohol while taking prednisone because alcohol can irritate the stomach and intestines and may increase the risk of ulcers or gastrointestinal bleeding, especially at higher steroid doses or if you have a history of ulcers. ^[1] Alcohol and corticosteroids can also compound side effects like elevated blood sugar, infection risk, and bone health concerns, so being cautious can help you stay safer during treatment. ^{[2] [3]}

---

Why Mixing Prednisone and Alcohol Can Be Risky

• Higher risk of stomach irritation and ulcers: Systemic corticosteroids make the stomach and intestines more susceptible to the irritating effects of alcohol, which can raise the risk of ulcers and bleeding. ^[1] The likelihood of peptic ulcers and gastrointestinal hemorrhage increases with steroid use, and the risk tends to rise with higher doses. ^[2]

• Immune system effects: Prednisone suppresses the immune system, and heavier alcohol use can also impair immune function; together, they may raise the chance of infections. ^[3] The increased infection risk with systemic corticosteroids is dose-related and influenced by underlying health conditions. ^[3]

• Blood sugar and metabolic effects: Prednisone can increase blood glucose; alcohol can also destabilize glucose levels, which is more concerning for people with diabetes or prediabetes. ^[4] Changes in steroid exposure and response vary among individuals, and metabolic side effects like diabetogenesis have been linked to steroid therapy. ^[4]

• Bone and overall health: Chronic or high-dose prednisone is associated with bone loss (osteoporosis), and excessive alcohol can further harm bone health, compounding long-term risks. ^[4]

---

Practical Guidance If You Choose to Drink

• Prefer abstinence or strict moderation: If you don’t have a history of ulcers and you’re on a short, low-dose course, some clinicians may consider small amounts of alcohol, but minimizing intake reduces gastrointestinal and infection risks. ^{[2] [3]}

• Take prednisone with food or milk: Food can help reduce stomach upset from steroids, which is especially helpful if any alcohol is consumed. ^[1]

• Avoid NSAIDs and aspirin with alcohol and steroids: Combining alcohol, aspirin, or certain arthritis medications with corticosteroids can further irritate the stomach and increase ulcer risk. ^[1]

• Know your personal risk factors: A history of ulcers, gastrointestinal bleeding, heavy alcohol use, diabetes, liver disease, or high-dose/long-term steroid use all warrant avoiding alcohol completely. ^{[2] [3] [4]}

---

Short Courses vs. Long-Term Use

• Short, low-dose courses: The overall risks may be lower, but alcohol can still irritate the stomach; limiting or avoiding alcohol is still the safer choice. ^[1] Steroid-associated infectious complications are less pronounced at daily doses under 10 mg or total cumulative doses under 700 mg, yet caution remains prudent. ^[3]

• High-dose or prolonged therapy: With higher doses or longer duration, risks of ulcers, bleeding, infections, and metabolic problems rise; alcohol avoidance becomes more important. ^{[2] [3] [4]}

---

Red Flags That Need Urgent Attention

• Stomach or GI symptoms: Seek care promptly for severe stomach pain, black or tarry stools, vomiting blood, or persistent nausea, which can signal bleeding or ulcers. ^[2]

• Signs of infection: Fever, chills, or new/worsening symptoms while on prednisone should be evaluated quickly due to increased infection risk. ^[3]

• Glucose issues: For those with diabetes or prediabetes, monitor blood sugar more closely, especially if drinking alcohol, and discuss any significant changes with a clinician. ^[4]

---

Tips to Reduce Risk

• Keep alcohol minimal or avoid it: This is the simplest way to reduce stomach and bleeding risks while on prednisone. ^{[1] [2]}

• Eat before drinking and dose timing: Take prednisone with food and avoid drinking on an empty stomach to reduce irritation. ^[1]

• Hydrate and choose lower‑alcohol options: If you drink, opt for lower‑alcohol beverages, drink slowly, and stay well hydrated.

• Coordinate with your care team: If you’re unsure, ask your clinician or pharmacist based on your dose, duration, and medical history; they can personalize guidance. ^[1]

---

Quick Comparison: Prednisone + Alcohol Considerations

Factor	Why It Matters	Practical Advice
Stomach/Ulcer Risk	Steroids and alcohol both irritate the GI tract; risk increases with dose and history of ulcers. [1] [2]	Prefer abstinence; if drinking, keep it minimal and take prednisone with food. [1]
Infection Risk	Systemic steroids raise infection risk, especially at higher doses or with certain conditions. [3]	Avoid alcohol that could impair immunity; monitor for fever or worsening symptoms. [3]
Blood Sugar	Prednisone can raise glucose; alcohol can destabilize control. [4]	Monitor closely if you have diabetes; limit or avoid alcohol. [4]
Drug Combinations	Alcohol plus aspirin/NSAIDs with steroids further increases GI risk. [1]	Avoid combining alcohol with NSAIDs/aspirin while on steroids. [1]
Dose/Duration	Risks increase with higher and longer steroid use. [2] [3]	The longer/higher the dose, the more strongly alcohol should be avoided. [2] [3]

---

Bottom Line

While some people on short, low-dose prednisone might tolerate a very small amount of alcohol, limiting or avoiding alcohol is the safer approach because stomach irritation, ulcers, bleeding, infection risk, and glucose changes are more likely when alcohol is combined with corticosteroids. ^{[1] [2] [3]} Taking prednisone with food, avoiding NSAIDs/aspirin with alcohol, and being mindful of personal risk factors can further reduce potential harm. ^{[1] [2]}