Generic Name

Prednisolone

Precaution

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. Lactation: Excreted in breast milk; use caution

Indication

Rheumatoid arthritis, Multiple sclerosis, Allergic and inflammatory disorders, Nephrotic syndrome, Idiopathic thrombocytopenic purpura, Joint inflammations, Moderate to severe asthma, Infantile spasms

Contra Indication

Live vaccines; herpes simplex keratitis, systemic infections.

Dose

N/A

Side Effect

Acne,Adrenal suppression,Delayed wound healing,Diabetes mellitus,GI perforation,Glucose intolerance,Hepatomegaly,Hypokalemic alkalosis,Increased transaminases,Insomnia,Menstrual irregularity,Myopathy,Neuritis,Osteoporosis,Peptic ulcer,Perianal pruritus,Pituitary adrenal axis suppression,Pseudotumor cerebri (on withdrawal),Psychosis,Seizure,Ulcerative esophagitis,Urticaria,Vertigo,Weight gain 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.

Pregnancy Category

Mode of Action

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.

Interaction

Efficacy may be reduced by phenytoin, phenobarb, rifampicin. Corticoids may reduce the effects of diuretics, hypoglycaemics, anticholinesterases, salicylates.

Pregnancy Category Note

Pregnancy Prednisolone shown to be teratogenic in mice when given in doses 1-10 times human dose; dexamethasone, hydrocortisone, and prednisolone were ocularly applied to both eyes of pregnant mice five times per day on days 10 through 13 of gestation; a significant increase in the incidence of cleft palate observed in fetuses of treated mice; there are no adequate well-controlled studies in pregnant women; prednisolone should be used during pregnancy only if potential benefit justifies potential risk to fetus Lactation Not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk; systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects Because of potential for serious adverse reactions in nursing infants from prednisolone, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother

Adult Dose

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. Poorly controlled, moderate to severe asthma, COPD 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 10-14 days until symptom resolution and patient achieves a peak expiratory flow (PEF) of at least 80% of his or her personal best. Rheumatoid arthritis Adult: Initially, 5-7.5 mg daily, adjusted as necessary. Elderly: 5 mg daily. Multiple sclerosis Adult: 200 mg daily for 1 wk followed by 80 mg every other day for 1 mth. Bells Palsy 60 mg PO qDay for 5 days; then taper down by 10 mg daily for 5 days for total duration time of 10 days

Child Dose

Inflammation 0.1-2 mg/kg/day PO in single daily dose or divided q6-12hr; not to exceed 80 mg/day Acute Asthma 1-2 mg/kg/day in single daily dose or divided q12hr for 3-5 days Nephrotic Syndrome First 4 weeks: 60 mg/m²/day or 2 mg/kg/day PO divided q8hr until urine is protein free for 3 consecutive days; not to exceed 28 days; dose not to exceed 80 mg/day Subsequent 4 weeks: 40 mg/m² or 1-1.5 mg/kg PO every other day; not to exceed 80 mg/day Maintenance in frequent relapses: 0.5-1 mg/kg/dose PO every other day for 3-6 months Idiopathic thrombocytopenic purpura Child: 1-10 yr: 1-2 mg/kg daily (max: 14 days) or 4 mg/kg daily (max: 4 days).

Renal Dose

N/A

Administration

Should be taken with food.