Prednisolone

Indications
 Oral
Allergic and inflammatory disorders
Adult: 5-60 mg daily in 2-4 divided doses. Maintenance: 2.5-15 mg daily. Withdrawal should be gradual after long-term therapy.
Child: 1 mth-18 yr: Autoimmune inflammatory disorders: Initially, 1-2 mg/kg once daily; may reduce dose gradually after a few days if needed. Max: 60 mg daily. Autoimmune hepatitis: Initially, 2 mg/kg once daily, then reduce to minimum effective dose. Max: 40 mg daily.
Oral
Poorly controlled, moderate to severe asthma
Adult: Patients with at least 2 exacerbations/yr requiring oral corticosteroids: 40-60 mg daily in 1-2 divided doses; usually given as a short course treatment over 3-10 days until symptom resolution and patient achieves a peak expiratory flow (PEF) of at least 80% of his or her personal best. May be used with maintenance dosages of inhaled corticosteroid and a long-acting inhaled β2-agonist bronchodilator.
Child: Patients with >3 exacerbations/yr in children ≤4 yr or at least 2 exacerbations/yr in children 5-11 yr: 1-2 mg/kg daily for 3-5 days may be used with existing asthma treatment; dose may be given in 1-2 divided doses. Max: 60 mg daily.
Oral
Nephrotic syndrome
Child: 1 mth-18 yr: Initially, 60 mg/m2 (max: 80 mg) once daily for 4 wk until urine is protein-free followed by 40 mg/m2 every other day for 4 wk, then withdraw dose gradually. Prevention of relapse: 0.5-1 mg/kg once daily every other day for 3-6 mth.
Oral
Rheumatoid arthritis
Adult: Initially, 5-7.5 mg daily, adjusted as necessary.
Elderly: 5 mg daily.
Oral
Multiple sclerosis
Adult: 200 mg daily for 1 wk followed by 80 mg every other day for 1 mth.
Oral
Infantile spasms
Child: 1 mth-2 yr: Initially, 10 mg 4 times daily for 14 days; increase to 20 mg 3 times daily for 7 days if seizures are not controlled after 7 days; reduce dose slowly over 15 days until therapy is stopped. For patients taking 40 mg daily, reduce dose in steps of 10 mg every 5 days, then stop; in patients taking 60 mg daily, reduce dose to 40 mg daily for 5 days, then 20 mg daily for 5 days, then 10 mg daily for 5 days, then stop.
Oral
Idiopathic thrombocytopenic purpura
Child: 1-10 yr: 1-2 mg/kg daily (max: 14 days) or 4 mg/kg daily (max: 4 days).
Parenteral
Allergic and inflammatory disorders
Adult: Given as sodium phosphate ester: 5-60 mg prednisolone base daily IV inj/infusion or IM. Dose to be individualised based on the severity of the condition and patient's response.
Intra-articular
Joint inflammations
Adult: 5-25 mg (as acetate) or 2-30 mg (as phosphate) or 4-40 mg (as terbutate). The phosphate and tebutate may also be given intralesionally or injected into soft tissue.
Ophthalmic
Conjunctivitis
Adult: As 1% acetate suspension or 0.12% acetate suspension: Instill 1-2 drops into the affected eye(s) 2-4 times daily. Higher frequency may be used during the initial 24-48 hr, if needed. Re-evaluate if there is no improvement after 2 days of treatment.
Otic/Aural
Allergic and inflammatory conditions of the ear
Adult: As acetate or phosphate: 0.5 or 1% drops.
Topical/Cutaneous
Rheumatoid arthritis
Adult: As farnesylate: Apply onto the affected area when necessary.

Special Populations: Increase dose in patients with hyperthyroidism. Use lowest effective dose in elderly patients.
Contraindications
 Live vaccines; herpes simplex keratitis, systemic infections.
Warnings / Precautions
 Patients with hypothyroidism, cirrhosis, ulcerative colitis, CHF, convulsive disorders, thrombophlebitis, peptic ulcer, elderly. DM, hypertension, psychological disturbances, osteoporosis; pregnancy, lactation. Adrenal suppression and infection. May cause irreversible growth retardation, glaucoma, corneal perforation. Topical: Broken or infected skin. Not to be applied over large areas under occlusive dressings.
Adverse Reactions
 Cushing's syndrome and growth retardation in childn; osteoporosis, fractures. Peptic ulceration; glaucoma, cataracts; hyperglycaemia, pancreatitis; increased appetite, obesity. Topical: Thinning and atrophy, systemic absorption with prolonged use over large surface, broken skin or under occlusive dressing. Rash, allergic reactions, pruritus. Intradermal/Intralesional: Local hypopigmentation of hyperpigmented lesions. Ophthalmic: Raised IOP and reduced visual function.
Potentially Fatal: Acute adrenal insufficiency precipitated by infection, trauma or surgery in patients on long-term therapy or following cessation of such therapy. CV collapse following rapid IV injection.
Overdose Reactions
 Treatment of acute overdose includes immediate gastric lavage or emesis followed by supportive and symptomatic therapy. For chronic overdose, the dosage of prednisolone may be reduced temporarily, or introduce alternate day treatment.
Drug Interactions
 Increased requirement of insulin and oral hypoglycaemics. Actions blunted by barbiturates, phenytoin, rifampicin. Increased bioavailability with estrogens and oral contraceptives. Increases plasma salicylate levels. Increased risk of convulsions when used with ciclosporin, increased clearance by carbimazole or carbamazepine. Increased risk of GI bleeding and ulceration when used with NSAIDs. May decrease methotrexate clearance.
See Below for More prednisolone Drug Interactions
Lab Interactions
 May interfere with response to skin test.
Food Interactions
 Limit caffeine.
Mechanism of Actions
 Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.
Absorption: Readily absorbed from the GI tract with peak plasma concentrations after 1-2 hr (oral); initial absorption is affected by food.
Distribution: Inactivated as it crosses the placenta; enters the breast milk. Protein-binding: Extensive.
Excretion: Via urine (as free and conjugated metabolites); 1-2 hr (elimination half-life).
Administration
 Should be taken with food.
Storage Conditions
 Intra-articular: Store at 20-25°C. Ophthalmic: Store at 20-25°C. Oral: Store at 20-25°C. Otic/Aural: Store at 20-25°C. Parenteral: Store at 20-25°C. Topical/Cutaneous: Store at 20-25°C.
ATC Classification
 C05AA04 - prednisolone ; Belongs to the class of products containing corticosteroids for topical use. Used in the treatment of hemorrhoids and anal fissures.
D07AA03 - prednisolone ; Belongs to the class of weak (group I) corticosteroids. Used in the treatment of dermatological diseases.
D07XA02 - prednisolone ; Belongs to the class of weak (group I) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
H02AB06 - prednisolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
A07EA01 - prednisolone ; Belongs to the class of corticosteroids acting locally. Used in the treatment of intestinal inflammation.
R01AD02 - prednisolone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
S01BA04 - prednisolone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye.
S01CB02 - prednisolone ; Belongs to the class of corticosteroids/antiinfectives/mydriatics combinations. Used in the treatment of eye diseases.
S02BA03 - prednisolone ; Belongs to the class of corticosteroids used in the treatment of inflammation of the ear.
S03BA02 - prednisolone ; Belongs to the class of corticosteroids used in ophthalmologic and otologic preparations.
Storage
 Intra-articular: Store at 20-25°C. Ophthalmic: Store at 20-25°C. Oral: Store at 20-25°C. Otic/Aural: Store at 20-25°C. Parenteral: Store at 20-25°C. Topical/Cutaneous: Store at 20-25°C.
Available As
  • Prednisolone 0.01%
  • Methylprednisolone 0.1%
  • Prednisolone 0.1%
  • Methyl Prednisolone 0.1% w/w
  • Prednisolone 0.2%
  • Prednisolone 0.25%
  • Prednisolone 0.3%
  • Prednisolone 0.5%
  • Prednisolone 0.5% w/v
  • Prednisolone 1%
  • Prednisolone 1% w/v
  • Prednisolone 1.0%
  • Prednisolone 1.0% w/v
  • Prednisolone 10 mg
  • Methylprednisolone 10 mg
  • Methylprednisolone 100 mg
  • Prednisolone 1000 mg
  • Methyl Prednisolone 1000 mg
  • Methylprednisolone 1000 mg
  • Prednisolone 125 mg
  • Methyl Prednisolone 125 mg
  • Methylprednisolone 125 mg
  • Prednisolone 15 mg
  • Methylprednisolone 16 mg
  • Methyl Prednisolone 16 mg
  • Prednisolone 16 mg
  • Methylprednisolone 2 mg
  • Methylprednisolone 2.5 mg
  • Prednisolone 2.5 mg
  • Prednisolone 20 mg
  • Methyl Prednisolone 200 mg
  • Methylprednisolone 24 mg
  • Methylprednisolone 250 mg
  • Prednisolone 3 mg
  • Prednisolone 30 mg
  • Prednisolone 4 mg
  • Methyl Prednisolone 4 mg
  • Methylprednisolone 4 mg
  • Prednisolone 40 mg
  • Methyl Prednisolone 40 mg
  • Methylprednisolone 40 mg
  • Prednisolone 5 mg
  • Methyl Prednisolone 500 mg
  • Prednisolone 500 mg
  • Methylprednisolone 500 mg
  • Methylprednisolone 6 mg
  • Methylprednisolone 8 mg
  • Prednisolone 8 mg
  • Methyl Prednisolone 8 mg
  • Methyl Prednisolone 80 mg
  • Methylprednisolone 80 mg
  • Prednisolone 80 mg

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    One Response to Prednisolone

    1. January 25, 2014 at 10:31 pm #

      It’s uses relieves broken skin, but on temporary terms. Any other indication for permanent cure on ladies above age 50 years !

      Reply

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