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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West Syndrome (Symptoms, Causes, Treatment, Prognosis, Life Expectancy)
West Syndrome is rare condition that affects infants and children, and has three distinct signs and symptoms (characteristics), 1) abnormal brain waves on EEG, 2) infantile spasms (jackknife seizures), and 3) mental retardation. West syndrome characteristics appear between age 3 and 12 months. West syndrome is caused or associated with severe brain damage at birth, tuberosis sclerosis, and prenatal, perinatal, and postnatal disorders. Cryptogenic West syndrome has no identifiable cause). There is no treatment or cure for West syndrome. Symptoms and signs of West syndrome may be managed with medication. The prognosis and life expectancy for an individual with West syndrome varies depending upon the cause and severity of signs and symptoms. For every 100 infants and children, about five will not live past age five.
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Asthma Medications
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered-dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC asthma drugs like Primatene Mist and Bronkaid.
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Ramsay Hunt Syndrome
Ramsay Hunt syndrome is an infection of a facial nerve that causes a red painful rash with blisters and facial paralysis. Other symptoms of Ramsay Hunt syndrome may include ear pain, hearing loss, dizziness (or vertigo), dry eye, and changes in taste sensation. The herpes zoster virus causes the infection.
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Addison's Disease
Addison disease is a hormonal (endocrine) disorder involving destruction of the adrenal glands (small glands adjacent to the kidneys). Diseased glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary for normal daily body functions. Symptoms include weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin. Treatment of Addison disease involves replacing, or substituting, the hormones that the adrenal glands are not making.
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Henoch-Schonlein Purpura
Henoch-Schonlein purpura (HSP or anaphylactoid purpura), a type of blood vessel inflammation, results in rash, arthritis, and occasional abdominal cramping. HSP often resolves on its own. Joint pain may be treated with anti-inflammatory and cortisone medications.
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Churg-Strauss Syndrome
Churg-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 Disease
Takayasu disease (also referred to as Takayasu arteritis) is a chronic inflammation of the aorta and its branch arteries. Takayasu disease is most common of Women of Asian descent and usually begins between 10 and 30 years of age. Symptoms include painful extremities, dizziness, headaches, chest and abdominal pain, and a low-grade fever. Treatment for Takayasu disease includes cortisone medication to suppress the inflammation.
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Erythema Nodosum
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in three to six weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
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Insect Sting Allergies
The majority of stinging insects in the United States are from bees, yellow jackets, hornets, wasps, and fire ants. Severity of reactions to stings varies greatly. Avoidance and prompt treatment are essential. In selected cases, allergy injection therapy is highly effective.
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Polyarteritis Nodosa
Polyarteritis nodosa is a rare autoimmune disease characterized by spontaneous inflammation of the arteries of the body. The most common areas of involvement include the muscles, joints, intestines (bowels), nerves, kidneys, and skin. Poor function or pain in any of these organs can be a symptom. Polyarteritis nodosa is most common in middle age persons. Polyarteritis is a serious illness that can be fatal. Treatment is focused on decreasing the inflammation of the arteries by suppressing the immune system.
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Primary Biliary Cirrhosis Treatment (PBC)
Primary biliary sclerosis (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) 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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Juvenile Rheumatoid Arthritis (JRA)
Juvenile rheumatoid arthritis (JRA) annually affects one child in every thousand. There are six types of JRA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
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Granulomatosis With Polyangiitis
Granulomatosis with polyangiitis is a condition that usually affects young or middle-aged adults, 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. Granulomatosis with polyangiitis may be fatal within months without treatment. Treatment aims to stop inflammation with high doses of prednisone and cyclophosphamide.
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Thyroiditis
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
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Eosinophilic Fasciitis (Shulman's Syndrome)
Eosinophilic fasciitis is a skin disease that causes thickening and inflammation of the skin and fascia. Symptoms include redness, warmth, and hardening of the skin, as well as occasional tissue and joint pain. Treatment for eosinophilic fasciitis aims to eliminate inflammation through the use of aspirin, NSAIDs, and cortisone. Aggressive forms of eosinophilic fasciitis may require the use of immune-suppression medications.
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Bullous Pemphigoid
Bullous pemphigoid is a skin disease that causes blistering eruptions on the skin's surface and sometimes affects the inner lining of the mouth. Symptoms include severe itching and burning sensations. Treatment involves topical cortisone and sometimes high doses of cortisone. Severe cases may require immune-suppression drugs such as azathioprine.
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Essential Mixed Cryoglobulinemia
Essential mixed cryoglobulinemia is a condition caused by abnormal blood proteins called cryoglobulins. Symptoms include joint pain, swelling, skin vasculitis, enlarged spleen, and nerve and kidney disease. Treatment involves medications that reduce inflammation and suppress the immune system.
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Latex Allergy
Latex 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.
Treatment & Diagnosis
- Gout FAQs
- Rheumatoid Arthritis FAQs
- Psoriasis FAQs
- Systemic Lupus Erythematosus FAQs
- Multiple Sclerosis MS FAQs
- Eczema FAQs
- COPD (Chronic Obstructive Pulmonary Disease) FAQs
- Ulcerative Colitis FAQs
- Crohn's Disease FAQs
- Rheumatoid Arthritis (RA): 17 Warning Signs of Serious Complications
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Corticosteroid Side Effects
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- What Is the Treatment For Polymyositis in the Lungs (Pulmonary)?
- Immune Thrombocytopenic Purpura (ITP) Symptoms and Causes
- Lupus Nephritis Treatment
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Corticosteroids (Systemic, Oral, Injections, Types)
- prednisone (Prednisone Intensol, Rayos) Corticosteroid
- Predinsone Side Effects (Adverse Effects)
- dexamethasone (Decadron, DexPak)
- Drug Interactions
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- hydrocortisone oral (Cortef)
- Side Effects of Orapred (prednisolone)
Prevention & Wellness

QUESTION
Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off. See AnswerHealth Solutions From Our Sponsors

Report Problems to the Food and Drug Administration
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REFERENCE:
FDA Prescribing Information