One of the great benefits of an interactive website such as this one is that people get to point out things we may have omitted. They often illustrate their points with their own experience. This reader experienced a very troubling prednisone side effect that is worth keeping in mind.
Q. Your discussion of prednisone side effects is lacking an important one. I have seen no mention of AVN (avascular necrosis), a serious consequence of this drug.
I was on prednisone for supposedly “short-term low-dose” therapy, which turned out to be neither. I developed AVN two years after I stopped taking it. As a result, I lost my hip at age 58.
The package insert states that prednisone can cause this horrible condition. I was in excruciating pain in a wheelchair for two years before I finally gave in and had a hip replacement.
Doctors prescribe this medication too casually for non-life-threatening problems.
Avascular Necrosis
A. Avascular necrosis (also called osteonecrosis) results from loss of the blood supply to bones, resulting in tissue death. The hip is especially susceptible to this complication. If this extremely serious adverse effect occurs, the hip may well need to be replaced.
Conventional wisdom is that this complication only occurs after high doses of corticosteroids for long periods of time. That may, as you note, make doctors more comfortable prescribing these drugs. There are, however, cases in the medical literature of a prednisone side effect similar to yours (Clinical Orthopaedics and Related Research, June, 1992; BMJ, June 30, 2001).
We have written about other side effects from prednisone and similar corticosteroids here. We appreciate the reminder that patients should be warned about “rare but serious” adverse effects prior to starting on any new medication. This prednisone side effect may not happen often, but when it does, it is devastating.
