prednisolone (Flo-Pred, Pediapred, Orapred, Orapred ODT)

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    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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?

GENERIC AVAILABLE: 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

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.

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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.

Which 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.

Reference: FDA Prescribing Information

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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See more info: prednisolone on RxList
Reviewed on 9/21/2015
References
Reference: FDA Prescribing Information

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