Many people prescribed prednisone wonder whether they can keep drinking coffee. When it comes to caffeine and prednisone, the short answer is that moderate caffeine is generally considered acceptable for most people, because there is no well-known direct interaction between the two. However, caffeine can add to some of prednisone’s most common side effects, especially trouble sleeping, jitteriness, and stomach upset.
This article explains how caffeine and prednisone affect the body, where their effects overlap, how much caffeine is generally considered safe, and what to ask your doctor or pharmacist. It also briefly covers caffeine and anabolic steroids, which are a different type of drug.
Can you drink coffee while taking prednisone?
For most people, yes, in moderation. Caffeine does not appear to change how prednisone works or how the body processes it in a clinically important way. The main issue is that the two can cause similar side effects, so combining them can make those side effects more noticeable.
Because individual health conditions and medications vary, it is worth checking with your doctor or pharmacist, especially if you have heart problems, high blood pressure, anxiety, stomach ulcers, or trouble sleeping.
Does caffeine interact with prednisone?
There is no well-known direct drug interaction between caffeine and prednisone. Instead, they have overlapping effects:
Sleep: Prednisone commonly causes insomnia, and caffeine is a stimulant that can delay sleep and reduce sleep quality. Together, they can make sleeping difficult.
Restlessness and mood: Prednisone can cause nervousness, irritability, and mood changes. Caffeine can add jitteriness and anxiety, particularly at higher intakes.
Stomach irritation: Prednisone can irritate the stomach, and caffeinated drinks such as coffee can worsen heartburn or indigestion in some people.
Blood pressure: Prednisone can raise blood pressure, particularly with longer use, and caffeine can cause a temporary rise in blood pressure.
How much caffeine is safe while taking prednisone?
For healthy adults, the US Food and Drug Administration (FDA) states that up to about 400 milligrams of caffeine a day, roughly four to five cups of brewed coffee, is not generally associated with harmful effects (FDA, 2018). People taking prednisone may feel better with less, particularly if they notice sleep problems or jitteriness.
Caffeine content varies widely between drinks. Energy drinks and pre-workout supplements can contain large amounts, sometimes combined with other stimulants, so they are worth checking carefully. Our article on energy drinks after workouts looks at these products in more detail.
Tips for combining caffeine and prednisone
These general tips may help reduce overlapping side effects:
Have caffeine earlier in the day. Avoiding caffeine in the afternoon and evening can help with prednisone-related sleep problems.
Follow your prescription instructions for timing. Prednisone is often prescribed in the morning, partly to reduce sleep disruption. Take it exactly as your doctor directs.
Take prednisone with food if instructed, and notice whether coffee on an empty stomach worsens stomach discomfort.
Watch for symptoms such as a racing heart, anxiety, or poor sleep, and cut back on caffeine if they appear.
Do not stop or change your prednisone dose to reduce side effects without speaking to your doctor. Stopping suddenly after longer use can be dangerous, because the body’s own production of cortisol may be suppressed.
What about long-term prednisone and bone health?
Long-term corticosteroid use can reduce bone density and increase the risk of fractures. High caffeine intake has been associated with small increases in calcium loss. For most people, moderate caffeine is unlikely to matter much, but people on long-term prednisone may want to discuss their caffeine intake, calcium, and vitamin D with their doctor as part of protecting their bones.
Is prednisone the same as anabolic steroids?
No. Prednisone is a corticosteroid, a medication used to reduce inflammation and suppress the immune system in conditions such as asthma, arthritis, and inflammatory bowel disease. Anabolic-androgenic steroids are related to testosterone and are a different class of drug. Our guide to the key facts about steroids explains the difference.
Caffeine and anabolic steroids
For people who use anabolic steroids, caffeine raises similar concerns. Anabolic steroid use is associated with increased blood pressure, as explained in our article on steroids and blood pressure, and caffeine can add a temporary increase. Both can also disrupt sleep and affect mood.
High-stimulant pre-workout products and energy drinks are the main concern, because they can deliver large amounts of caffeine quickly. Anyone using anabolic steroids who experiences palpitations, chest pain, or persistently raised blood pressure should seek medical advice.
When to talk to your doctor or pharmacist
Ask your doctor or pharmacist about caffeine if you:
Have heart disease, an irregular heartbeat, or high blood pressure.
Have stomach ulcers or significant reflux.
Experience anxiety, panic attacks, or severe sleep problems while taking prednisone.
Take other medications that may interact with caffeine.
Seek urgent medical attention for chest pain, a very fast or irregular heartbeat, or severe headache.
The bottom line
When it comes to caffeine and prednisone, moderate caffeine is generally considered acceptable for most people, and there is no well-known direct interaction between them. However, caffeine can add to prednisone’s side effects, especially sleep problems, restlessness, stomach irritation, and temporary rises in blood pressure.
Having caffeine earlier in the day, keeping intake moderate, and following your prescription instructions can help. If you have heart problems, high blood pressure, or other health conditions, check with your doctor or pharmacist about what is right for you.
References
Food and Drug Administration. Spilling the beans: how much caffeine is too much? Consumer update. 2018.
