What is prednisolone, and how does it work (mechanism of action)?
Prednisolone is a synthetic adrenal corticosteroid (cortisone). Corticosteroids are natural substances produced by the adrenal glands located adjacent to the kidneys. Corticosteroids have potent anti-inflammatory properties, and are used in a wide variety of inflammatory conditions such as arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes. There are numerous preparations of corticosteroids including tablets, capsules, liquids, topical creams and gels, inhalers, eye drops, as well as injectable and intravenous solutions. The FDA approved prednisolone in June 1955.
What brand names are available for prednisolone?
Flo-Pred, Pediapred, Orapred, Orapred ODT
Is prednisolone available as a generic drug?
Yes
Do I need a prescription for prednisolone?
Yes
What are the side effects of prednisolone?
Prednisolone side effects depend on the dose, the duration and the frequency of administration. Short courses of prednisolone - days to a week or two - are usually well tolerated with few and mild side effects. Long-term, high doses of prednisolone will usually produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of prednisolone should be used for the shortest length of time to minimize side effects. Alternate day dosing can also help reduce side effects.
Side effects of prednisolone and other corticosteroids range from mild annoyances to serious irreversible damage. Side effects include
- fluid retention,
- weight gain,
- high blood pressure,
- potassium loss,
- headache,
- muscle weakness,
- puffiness of and hair growth on the face,
- thinning and easy bruising of the skin,
- glaucoma,
- cataracts,
- peptic ulceration,
- worsening of diabetes,
- irregular menses,
- growth retardation in children,
- convulsions, and
- psychic disturbances. (Psychic disturbances can include depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior.)
Prolonged use of prednisolone can depress the ability of body's adrenal glands to produce corticosteroids. Abruptly stopping prednisolone can cause symptoms of corticosteroid insufficiency, with accompanying nausea/a>, vomiting, and even shock. Therefore, withdrawal of prednisolone is usually accomplished by gradual tapering. Gradually tapering prednisolone not only minimizes the symptoms of corticosteroid insufficiency, but it also reduces the risk of an abrupt flare of the disease under treatment.
Prednisolone and other corticosteroids can mask signs of infection and impair the body's natural immune response to infection. Patients on corticosteroids are more susceptible to infections and can develop more serious infections than healthy individuals. For instance, chickenpox and measles viruses can produce serious and even fatal illnesses in patients on high doses of prednisolone. Live virus vaccines, such as smallpox vaccine, should be avoided in patients taking high doses of prednisolone, since even vaccine viruses may cause disease in patients taking prednisolone. Some infectious organisms, such as tuberculosis (TB) and malaria, can remain dormant in a patient for years. Prednisolone and other corticosteroids can reactivate dormant infections in these patients and cause serious illnesses. Patients with dormant TB may require anti-TB medications while undergoing prolonged corticosteroid treatment.
By interfering with the patient's immune response, prednisolone can impede the effectiveness of vaccinations. Prednisolone can also interfere with the tuberculin skin test and cause false negative results in patients with tuberculosis infection.
Prednisolone impairs calcium absorption and new bone formation. Patients on prolonged treatment with prednisolone and other corticosteroids can develop thinning of bone (osteoporosis) and an increased risk of bone fractures. Supplemental calcium and vitamin D are encouraged to slow this process of bone thinning. In some patients, medications used to treat osteoporosis may be prescribed. In rare individuals, destruction of large joints (osteonecrosis) can occur while undergoing treatment with prednisolone or other corticosteroids. These patients experience severe pain in the involved joints, and can require replacement of joints. The reason behind such destruction is not clear.
What is the dosage for prednisolone?
Dosage requirements of corticosteroids vary among individuals and the diseases being treated. The usual starting dose range is 5 mg to 60 mg daily depending on the disease being treated. Doses are adjusted based on patient response. In general, the lowest possible effective dose is used. Corticosteroids given in multiple doses throughout the day are more effective, but also more toxic than alternate-day therapy where twice the daily dose is administered every other morning. Prednisolone should be taken with food to reduce irritation of the stomach and intestines.
SLIDESHOW
Types of Psoriasis: Medical Pictures and Treatments See SlideshowWhich drugs or supplements interact with prednisolone?
Rifampin decreases blood levels of prednisolone by increasing its breakdown in the liver. The dose of prednisolone may need to be increased in order to avoid therapeutic failure.
Corticosteroids have variable effects of warfarin (Coumadin) therapy. Coagulation levels should be monitored more closely when anticoagulants are combined with corticosteroids.
Estrogens may increase the levels of prednisolone by decreasing its breakdown. When estrogens are used with prednisolone, side effects of prednisolone should be monitored.
Steroids increase blood sugar (glucose) levels and, therefore, reduce the effect of drugs used for treating diabetes.
Activity of cyclosporine and corticosteroids increase when both drugs are combined. Seizures have been reported.
Combining aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids increases the risk of gastrointestinal side effects.
Combining corticosteroids with potassium-depleting agents (for example, diuretics) increases the risk of low blood potassium (hypokalemia). Vaccines are less effective in patients on prolonged corticosteroid treatment because corticosteroids suppress the immune system. Corticosteroids may also allow organisms contained in live attenuated vaccines to replicate.
What else should I know about prednisolone?
What preparations of prednisolone are available?
- Tablets: 5 mg.
- Tablets (Disintegrating): 10, 15, 30 mg
- Syrup or Suspension: 5, 10, 15, 20 or 25 mg/5 ml (teaspoon).
How should I keep prednisolone stored?
Store at room temperature, 15 C to 30 C (59 F to 86 F). Do not refrigerate.
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Summary
Prednisolone (Flo-Pred, Pediapred, Orapred, Orapred ODT) is a corticosteroid prescribed to achieve prompt suppression of inflammation due to inflammatory and allergic conditions (for example, rheumatoid arthritis, lupus, gout, ulcerative colitis, Crohn's disease, hay fever, types of dermatitis, and many others. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Juvenile Rheumatoid Arthritis (JRA)Juvenile rheumatoid arthritis (JRA) affects one child in every thousand annually. There are six types of juvenile rheumatoid arthritis. Treatment of rheumatoid arthritis depends upon the type the child has and should focus on treating the symptoms.
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Latex AllergyLatex allergy is a condition where the body reacts to latex, a natural product derived from the rubber tree. The reaction can either be delayed and cause a skin rash or immediate, which can lead to anaphylaxis. Avoiding latex is the most effective way to prevent an allergic reaction.
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Primary Biliary Cirrhosis (PBC) TreatmentPrimary biliary cirrhosis (PBC) is thought to be an autoimmune disorder that involves the deterioration of the liver's small bile ducts. These ducts are crucial to transport bile to the small intestine, digesting fats, and removing wastes. Symptoms of PBC are edema, itching, elevated cholesterol, malabsorption of fat, liver cancer, gallstones, urinary tract infections (UTIs), and hypothyroidism. Treatments include ursodeoxycholic acid (UDCA); colchicine (Colcrys); and immunosuppressive medications, such as corticosteroids; obeticholic acid (Ocaliva); and medications that treat PBC symptoms. For PBC that is associated with cirrhosis of the liver, liver transplantation may be indicated in extreme cases.
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Eosinophilic Fasciitis (Shulman's Syndrome)Eosinophilic fasciitis (EF) is a rare disease that leads to inflammation and thickening of the skin and fascia underneath. In patients with eosinophilic fasciitis, the involved fascia is inflamed with the eosinophil type of white blood cells. This leads to symptoms of progressive thickening and often redness, warmth, and hardness of the skin surface.
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Granulomatosis With PolyangiitisGranulomatosis with polyangiitis (GPA), Wegener granulomatosis, is an inflammation of the arteries supplying blood to the sinuses, lungs, and kidneys. Symptoms of granulomatosis with polyangiitis include bloody sputum, fatigue, weight loss, joint pain, sinusitis, shortness of breath, and fever.
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Churg-Strauss SyndromeChurg-Strauss Syndrome is a form of vasculitis. Vasculitis is an inflammation of the blood vessels. Symptoms of Churg-Strauss syndrome include fatigue, weight loss, inflammation of the nasal passages, numbness, and weakness. Treatment is directed toward both quieting the vasculitis and suppressing the immune system.
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Takayasu DiseaseTakayasu disease, Takayasu's arteritis, is a chronic inflammation of the aorta and its branch arteries. Takayasu disease is most common in women of Asian descent and usually begins between 10 to 30 years of age. Symptoms include painful extremities, dizziness, headaches, chest and abdominal pain, and a low-grade fever.
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Essential Mixed CryoglobulinemiaEssential mixed cryoglobulinemia is a condition caused by abnormal blood proteins called cryoglobulins. Cryoglobulins may or may not cause disease. Cryoglobulins can accompany another condition (such as dermatomyositis, multiple myeloma, viral infections, or lymphoma) or be an isolated condition themselves, called cryoglobulinemia.
Treatment & Diagnosis
- ITP Symptoms and Causes
- Rheumatoid Arthritis (RA): 17 Warning Signs of Serious Complications
- Lupus Nephritis Treatment
- Indications for Drugs: Approved vs. Non-approved
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Corticosteroid Side Effects
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
REFERENCE:
FDA Prescribing Information
