Prednisolone

Prednisolone is a prescription medication indicated in treatment of endocrine disorders, rheumatic disorders, collagen diseases, dermatologic disease, allergic states, ophthalmic diseases, respiratory diseases, hematologic disorders, neoplastic diseases, edematous states, gastrointestinal disease, and diseases affecting the nervous system.

• Prednisolone is available under the following different brand names: Pediapred, FloPred, Orapred, Orapred ODT, Millipred, Millipred DP, Prelone Syrup, and Veripred 20.

Adult and Pediatric Dosages:

Oral Solution

• 5 mg/5 ml
• 10 mg/5 ml
• 15 mg/5 ml
• 20 mg/5 ml
• 25 mg/5 ml

Tablet

• 5 mg

Tablet, dose pack

• 5 mg (6 days [21 tablets])
• 5 mg (12 days [48 tablets])

Tablet, orally disintegrating

• 10 mg
• 15 mg
• 30 mg

Dosing Considerations – Should be Given as Follows:

Adult Dosage Considerations:

Rheumatoid Arthritis

• 5.75 mg orally each day

Multiple Sclerosis

• 200 mg/day orally for 1 week, then 80 mg orally every other day for 1 month

Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) (off label)

• 30-40 mg orally daily for 10-14 days

Bell's Palsy (off label)

• 60 mg orally for 5 days; then taper down by 10 mg daily for 5 days for a total duration time of 10 days

Pediatric Dosage Considerations:

Inflammation

• 0.1-2 mg/kg/day orally in single daily dose or divided every 6-12 hours; not to exceed 80 mg/day

Acute Asthma

• 1-2 mg/kg/day in single daily dose or divided every 12 hours for 3-5 days

Nephrotic Syndrome

• First 4 weeks: 60 mg/m²/day or 2 mg/kg/day orally divided every 8 hours 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 orally every other day; not to exceed 80 mg/day Maintenance infrequent relapses: 0.5-1 mg/kg/dose orally every other day for 3-6 months. Treatment may have to be individualized

Common Side effects of Prednisolone include:

• acne
• adrenal suppression
• delayed wound healing
• diabetes mellitus
• gastrointestinal perforation
• glucose intolerance
• enlarged liver
• the low blood level of potassium and increased pH of the blood
• increased transaminases
• difficulty sleeping
• menstrual irregularity
• muscle disease
• inflammation of the nerves
• brittle bones (osteoporosis)
• sores in the stomach lining
• anal itching
• excess fluid in the skull (on withdrawal)
• psychosis
• convulsions (seizures)
• inflammation of the esophagus
• hives
• spinning sensation (vertigo)
• weight gain
• sodium retention
• fluid retention
• congestive heart failure
• potassium loss
• high blood pressure (hypertension)
• muscle weakness
• loss of muscle mass
• vertebral compression fractures
• pathologic fracture of long bones
• pancreatitis
• abdominal distention
• thin fragile skin
• small red spots on the skin
• skin discoloration
• facial flushing
• may suppress reactions to skin tests
• headache
• Cushingoid state
• growth suppression in children
• secondary adrenocortical and pituitary unresponsiveness
• decreased carbohydrate tolerance
• increased requirements for insulin
• posterior subcapsular cataracts
• increased pressure in the eye
• glaucoma
• bulging of the eye(s)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Prednisolone has no known severe interactions with other drugs.
• Serious interactions of prednisolone include:
  • mifepristone
• Prednisolone has serious interactions with at least 74 different drugs.
• Prednisolone has moderate interactions with at least 234 different drugs.
• Prednisolone has minor interactions with at least 127 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains prednisolone. Do not take Pediapred, FloPred, Orapred, Orapred ODT, Millipred, Millipred DP, Prelone Syrup, or Veripred 20 if you are allergic to prednisolone or any ingredients contained in this drug.
• Keep out of reach of children
• In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

• Documented hypersensitivity
• Systemic fungal infection, varicella, superficial herpes simplex keratitis
• Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (less than 2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in the maintenance of physiologic dosages (replacement therapy)

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Prednisolone?"

Long-Term Effects

• Long-term use associated with fluid retention and hypertension
• Development of Kaposi's sarcoma-associated with prolonged corticosteroid use
• See "What Are Side Effects Associated with Using Prednisolone?"

Cautions

• Use with caution in cirrhosis, diabetes, ocular herpes simplex, hypertension, diverticulitis, following myocardial infarction, thyroid disease, seizure disorders, hypothyroidism, myasthenia gravis, hepatic impairment, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, and pregnancy
• Thromboembolic disorders or myopathy may occur
• Delayed wound healing is possible
• Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
• Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)
• Some suggestions (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy
• Parenteral forms (prednisolone sodium phosphate) have been discontinued
• Suppression of the hypothalamic-pituitary-adrenal axis may occur particularly in patients receiving high doses for prolonged periods or in young children; discontinuation of therapy should be done through the slow taper
• Posterior subcapsular cataract formation associated with prolonged use of corticosteroids
• Prolonged use of corticosteroids may increase the risk of secondary infections
• Increase in intraocular pressure associated with prolonged use of corticosteroids
• Long-term use associated with fluid retention and hypertension
• Development of Kaposi's sarcoma-associated with prolonged corticosteroid use
• Acute myopathy associated with a high dose of corticosteroids
• Corticosteroid use may cause psychiatric disturbances

Pregnancy and Lactation

• Use prednisolone with caution if benefits outweigh risks
• Animal studies show risk and human studies are not available, or neither animal nor human studies were done
• Prednisolone is excreted in breast milk; use with caution if breastfeeding