Can You Drink Alcohol While Taking Prednisone for IBD?

People taking prednisone for ulcerative colitis or Crohn’s disease can consume alcohol but should do so in moderation.

People with inflammatory bowel disease (IBD) or other chronic conditions who take prednisone can drink alcohol — in moderation.

Due to the potential for complications and side effects, people taking prednisone should aim to limit their alcohol intake to no more than one to two alcoholic beverages per day.

Learn more about how prednisone interacts with alcohol, possible side effects, and what else to avoid when taking prednisone.

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How does prednisone work?

Prednisone is one type of corticosteroid, sometimes simply called a steroid. Prednisone has been used as a treatment for IBD since the 1950s.

It’s a fast-acting, anti-inflammatory drug used during periods of acute IBD flares.

For IBD, prednisone works by suppressing the immune system and reducing the amount of inflammation in the digestive tract. Prednisone can also reduce inflammation in other parts of the body, like the eyes, skin, and joints.

Prednisone isn’t effective for about 20–30% of people with an IBD flare-up, according to the Crohn’s & Colitis Foundation. However, the majority of people do see fast improvement within days of beginning the drug.

How does alcohol interact with prednisone?

The prescribing information for prednisone does not suggest a direct interaction between alcohol and prednisone.

However, prednisone and alcohol share many possible side effects. Combining the two may enhance those side effects.

For example, both alcohol and prednisone can cause an upset stomach if taken without food. When taken together on an empty stomach, this pain can worsen.

People taking prednisone can limit or avoid alcohol to reduce the likelihood of the following side effects:

Weakened immune system

Prednisone works by suppressing the immune system. This means people taking the medication have a greater risk of developing infections and getting sick.

In particular, people who take prednisone may be vulnerable to oral or genital yeast infections and urinary tract infections.

Alcohol may also weaken the immune system, which could be problematic for those already taking immunosuppressing medications like prednisone.

Long-term heavy alcohol use can increase the risk of pneumonia or tuberculosis. Prednisone can also reactivate latent TB.

It’s not just long-term heavy drinking that can cause side effects: High alcohol use on a single occasion also limits the body’s ability to fight infection, and this effect can last up to 24 hours after drinking.

High blood pressure

Drinking a lot of alcohol, whether on a single occasion or over a long period, can cause problems for the heart, including high blood pressure.

Prednisone can also lead to high blood pressure in some people.

High blood sugar

Prednisone may raise the risk of high blood sugar, also known as hyperglycemia.

Alcohol can have a similar effect on blood sugar: Having more than three standard drinks in a day can cause higher blood glucose and A1C levels.

Mood changes

Prednisone and other steroids may cause mood changes, such as euphoria and severe depression.

Drinking a lot over the long term may also lead to mental health concerns, such as depression and anxiety.

Alcohol can also affect the communication pathways in the brain, making it harder to think.

Sleep problems

Insomnia is a known side effect of prednisone. Alcohol can also cause problems with sleep. Alcohol and sleep issues have multiple types of interactions.

Because alcohol is a sedative, alcohol may help some people with insomnia.

However, research suggests that alcohol can also disrupt sleep, particularly in the rapid eye movement (REM) stage of the sleep cycle.

Using alcohol as a sleep tool may cause issues in the long term. Sleep quality may decline and the need to consume more alcohol to fall asleep may increase, leading to alcohol dependence.

What are the most serious risks of combining alcohol with prednisone?

One of the most notable risks of prednisone is the drug’s effect on bone density.

Corticosteroids like prednisone can cause osteoporosis in up to 40% of people who take it long term.

For this reason, people taking prednisone should limit their alcohol intake, since heavy alcohol use can reduce bone mass and increase the risk of broken bones.

The American College of Rheumatology has guidelines for preventing osteoporosis due to prednisone use: Adults who take 2.5 milligrams (mg) or more of prednisone every day for more than 3 months should limit their alcohol intake to one to two alcoholic beverages per day.

Are some people more at risk than others for serious side effects?

Side effects from prednisone can affect anyone.

However, people taking a high dose of the drug (40 mg or more per day) may have an increased risk of side effects. People who take prednisone over a long period may also have a greater risk of side effects.

Frequently asked questions

How long does prednisone stay in your system?

The elimination half-life of a drug refers to the time it takes for the concentration of a drug to fall to half of the starting dose when it entered the body.

For prednisone, the elimination half-life is 3–4 hours in adults. Research suggests prednisone may still be detectable in urine for 24 hours after taking it.

Can you drink coffee while taking prednisone?

There are no restrictions on consuming caffeine, including coffee, in the prescribing information for prednisone.

However, the caffeine in coffee may contribute to sleep problems, compounding prednisone’s potential for sleep problems as well. (For this reason, doctors recommend taking prednisone in the morning.)

If you’re concerned about your sleep, ask your doctor for advice.

What else should you avoid while taking prednisone?

Prednisone interacts with many medications. Be sure to talk with your doctor about all the prescription and over-the-counter medications and supplements you’re taking before starting prednisone.

Prednisone may also cause salt and water retention. Limiting sodium intake may be recommended for some people.

People taking prednisone who smoke are also advised to quit smoking to help prevent the development of osteoporosis.

The takeaway

People taking prednisone for IBD can consume alcohol in small amounts. The recommended limit is no more than two alcoholic beverages per day.

Alcohol and prednisone have many side effects in common, so taking them together may cause issues.

If you’re concerned about any medication interactions and side effects, talk with your doctor.