How Long Does Prednisone Stay In Your System?

In our latest question and answer, the pharmacist discusses how long you can expect prednisone to stay in your system after your last dose.

Question

I was taking prednisone 20mg twice daily for 5 days. I was wondering how long before it is out of my system? I have a drug test coming up and was told that prednisone can cause a false negative.

Asked by Crystal On Sep 08, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 08, 2022
Last updated Apr 26, 2024

Key points

  • Prednisone has a short half-life, between 2 and 3 hours.
  • For most individuals, prednisone will be completely eliminated from your system around 12-18 hours after your last dose.

Answer

It can be difficult to give an exact time frame for how long prednisone stays in your system as several factors can influence this.

These factors include:

  • Age
  • Liver function
  • Other medications you may be taking
  • How long you have been taking the drug

However, for most individuals, prednisone will be completely metabolized and eliminated from your system in 12 to 18 hours due to its short half-life.

Prednisone Half-Life

Prednisone has been extensively studied and has a reported half-life between two and three hours.

For most individuals, it takes around 5 to 6 half-lives for a drug to be considered completely eliminated (i.e. out of your system).

Therefore, being conservative and assuming a half-life of three hours, you could expect prednisone to be out of your system around 18 hours after your last dose (6 half-lives X 3 hours).

Again, this may vary slightly from person to person, but you can reasonably expect that prednisone will be completely eliminated within a fairly well-defined range of 12 to 18 hours.

Other Variables That Influence How Long Prednisone Lasts

As mentioned at the beginning of this article, there are several factors that can influence how long prednisone stays in your system.

Perhaps the most significant variable is liver function since it is responsible for prednisone metabolism.

If you have decreased liver function, be it from disease or other factors (such as old age), you can expect prednisone to be more slowly eliminated.

Similarly, if you take drugs that decrease the activity of certain liver metabolizing enzymes, like CYP3A4, it could take longer for prednisone to be metabolized. Strong inhibitors of CYP3A4 include:

  • Amiodarone
  • Verapamil
  • Clarithromycin
  • Erythromycin
  • Fluoxetine
  • Ketoconazole

There are many other factors that could influence prednisone metabolism (e.g. age, kidney function, length of time taking the drug), which is why it is so difficult to give an exact determination on how long it will be present in your system. Overall though, we can expect 12 to 18 hours to be a fairly accurate estimate.

Prednisone Activity

It is important to note that even though has a fairly short half-life and is eliminated relatively quickly when compared to many other drugs, its biological action lasts much longer. In fact, most sources state that the effects of prednisone last between 18 to 36 hours per dose.

This long duration of action is due to the fact that the drug is highly protein bound in the plasma (specifically to albumin and transcortin) and because it is extensively distributed to various organs in the body (e.g. kidneys, liver).

It also is important to point out that prednisone itself is not active, but is metabolized in the liver to the active metabolite prednisolone. Prednisolone has a similar half-life to prednisone, around two to three hours.

Prednisone Drug Tests

Prednisone has not been reported to cause false positives for the most commonly screened drugs on urinalysis tests, which are:

  • Benzodiazepines
  • Opiates
  • Marijuana
  • Cocaine
  • PCP

Nevertheless, due to its similarity in structure to other steroids, it could feasibly cause false-positive readings for anabolic steroids or similar drugs.

It has been reported that prednisone (and other immunosuppressive drugs) can cause false negatives on certain diagnostic tests, like tuberculin (TB) skin and allergy tests since it can reduce immune response.

It is important to discuss your medication therapy with your doctor so they can advise you on how long before testing you need to stop prednisone (if necessary).

Final Words

Thanks for reaching out to us and please do so again in the future!

References

  • Pharmacokinetics 101, PubMed
  • Prednisone Monograph, AccessFDA
  • The Effect of Prednisone on Tuberculin Skin Test Reaction in Patients with Rheumatoid Arthritis, PubMed
  • Prednisone Monograph, DrugBank
  • Mechanism-based inhibition of cytochrome P450 3A4 by therapeutic drugs, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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