How Prednisone Affects Your Heart

If you have a condition like asthma, arthritis or inflammatory bowel disease (IBD), your doctor may prescribe corticosteroids, such as prednisone. Corticosteroids are a class of medications that includes a wide range of generic and brand-name drugs. They’re used to reduce inflammation and regulate an overactive immune system.

But in some cases, corticosteroids can also affect your heart rate and rhythm.

Interventional cardiologist David Zidar, MD, PhD, explains how to stop heart palpitations from prednisone.

How does prednisone affect your heart?

Prednisone and other corticosteroids can cause a range of heart issues, from heart palpitations to high blood pressure. Dr. Zidar outlines how these medications can impact your heart.

Slows down or speeds up your heart rate

Prednisone may cause an imbalance of key electrolytes, like potassium, calcium, sodium and magnesium. When electrolyte levels rise or fall, your heart rate may slow down (bradycardia) or speed up (tachycardia).

Induces heart palpitations

“Heart palpitations are a relatively broad symptom. For example, sometimes it can come from arrhythmias, where the heart beats faster,” explains Dr. Zidar. “Palpitations can also feel like an extra heartbeat or like your heart is beating harder.”

Symptoms of both bradycardia and tachycardia can include heart palpitations. This can feel like your heart is:

• Racing
• Pounding
• Flip-flopping
• Missing a beat
• Having an extra beat
• Fluttering

Increases your blood pressure

An electrolyte imbalance from prednisone can also affect how you retain water and sodium, leading to a higher amount of fluids circulating in your body.

“These things can raise your blood pressure and can increase the feeling of pressure inside your heart,” explains Dr. Zidar.

Prednisone is more likely to cause high blood pressure if you’re taking the medication for a longer period of time or on a higher dose.

Effects on heart conditions

Certain heart conditions can increase the risk of side effects like heart palpitations from prednisone. So, it’s important to let your healthcare provider know if you have any existing heart conditions, such as heart disease and high blood pressure.

“In general, most healthcare providers are comfortable when a patient with a heart condition is prescribed prednisone, but it’s important to know the medication can have a wide range of impacts,” Dr. Zidar clarifies.

Prednisone may amplify some symptoms, like shortness of breath or chest pain, that you may already experience on a day-to-day basis

How to prevent heart palpitations while taking prednisone

Heart palpitations can feel scary. But there are steps you can take to help reduce or stop them while taking prednisone.

• Don’t stop prednisone cold turkey. Dr. Zidar advises against stopping the medication without consulting your doctor first. “Prednisone can be prescribed for conditions that are life-threatening, and so there may be a risk to stopping prednisone,” he explains. If your doctor decides you can stop taking the medication, they’ll usually give you instructions on how to safely wean yourself off of it.
• Talk to your doctor about reducing your dosage amount. “In some cases, reducing your dosage can maintain the effect of the medicine without having as many side effects,” he notes.
• Consider the length of time. Prednisone isn’t meant to be a long-term medication. In some cases, you may only need to take a few doses. Other times, your prescription may run for several months. Talk to your doctor about expectations.
• Think twice about using a supplement. You may be tempted to try over-the-counter supplements like magnesium or potassium to address electrolyte imbalances. But supplements aren’t regulated by the U.S. Food and Drug Administration (FDA), so that means any supplement could contain inconsistent ingredients and may also interfere with any other medications you’re taking.
• Reduce your sodium. Following a low-sodium diet, like the DASH diet, can be a good way to help reduce water retention and maintain an ideal electrolyte balance to prevent palpitations.
• Stay hydrated. It sounds like a no-brainer — if you’re thirsty, make sure you’re drinking water. But don’t go overboard, says Dr. Zidar. Drinking too much water can contribute to an electrolyte imbalance, doing more harm than good.
• Practice deep breathing. If you’re experiencing heart palpitations, using techniques like box breathing can help lower your heart rate, reduce blood pressure and decrease stress.

In most cases, you should be able to manage any heart-related side effects, like heart palpitations, at home or under the guidance of your doctor.

But Dr. Zidar adds that it’s a good idea to seek emergency care if you:

• Feel lightheaded
• Experience chest pain
• Have trouble breathing
• Have swelling in your legs (edema)

Be aware of your symptoms

It’s important to know how taking a medication like prednisone can affect your heart.

“There’s a constellation of symptoms that prednisone can cause, so it’s important to be aware of how you’re feeling,” advises Dr. Zidar. “Make sure you’re in touch with your doctor if you feel as though these symptoms are beginning to overwhelm you.”

You and your doctor can have a discussion about whether prednisone is right for you.

“Even though the side effects of prednisone can be very bothersome to many people, there is often a necessary reason to be on it,” he concedes. “Your doctor can work with you to manage side effects.”