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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?
Do I need a prescription for prednisolone?
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,
- muscle weakness,
- puffiness of and hair growth on the face,
- thinning and easy bruising of the skin,
- 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.
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.
Estrogens may increase the levels of prednisolone by decreasing its breakdown. When estrogens are used with prednisolone, side effects of prednisolone should be monitored.
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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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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Eosinophilic Fasciitis (Shulman's Syndrome)
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Hay Fever (Allergic Rhinitis)
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Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
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Rheumatoid Arthritis (RA)
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Reflex Sympathetic Dystrophy Syndrome
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Insect Sting Allergies
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Lupus (Systemic Lupus Erythematosus or SLE)
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Hives (Urticaria & Angioedema)
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Granulomatosis With Polyangiitis
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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.
Bell's Palsy (Facial Nerve Problems) Paralysis Causes and Treatments
Bell's palsy is one type of facial nerve paralysis. The 7th cranial nerve controls the muscles of the face, and although scientists do not know the exact cause of Bell's palsy, they think it may be due to nerve damage from an infection, for example, the flu, common cold viruses, and more serious infections like meningitis. The symptoms of Bell's palsy vary from person to person, but can include mild weakness to total paralysis, dry eye, dry mouth, eyelid drooping, drooling, mouth drooping, dry mouth, changes in taste, and excessive tearing in one eye. People with Bell's palsy usually don't need medical treatment, however, drugs like steroids, for example, prednisone seem to be effective in reducing swelling and inflammation are used when medical is necessary. Most people with Bell's palsy begin to recover within two weeks after the initial onset of symptoms. Full recovery may take three to six months.
Essential Mixed Cryoglobulinemia
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COPD (Chronic Obstructive Pulmonary Disease)
COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. Conditions that accompany COPD include chronic bronchitis, chronic cough, and emphysema. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
Pulmonary fibrosis is scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic inflammatory processes, infections, environmental agents, exposure to ionizing radiation, chronic conditions, and certain medications. Symptoms include shortness of breath, coughing, and diminished exercise tolerance. Treatment options are dependent on the type of pulmonary fibrosis; lung transplant and/or medications are options.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
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Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
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. The infection is treated with: antiviral agents, steroids, and pain medications.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Chronic Rhinitis and Post-Nasal Drip
Chronic rhinitis and post-nasal drip symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) usually is caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year-round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependent upon the type of rhinitis condition.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
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.
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of inflammation of the cartilage of various tissues of the body. Tissues containing cartilage that can become inflamed include the ears, nose, joints, spine, and windpipe (trachea). Tissues that have a biochemical makeup similar to that of cartilage such as the eyes, heart, and blood vessels, can also be affected. Nonsteroidal anti-inflammatory medications (NSAIDs) is used as treatment for mild cases of the disease. Steroid-related medications also are usually required.
Inflammatory Bowel Disease (Intestinal Problems of IBD)
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
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.
Bronchitis (Acute) Contagoius Symptoms, Causes, Treatment, and Recovery Time
Bronchitis is inflammation of the airways in the lung. Acute bronchitis is is short in duration (10 to 20 days) in comparison with chronic bronchitis, which lasts for months to years. Causes of acute bronchitis include viruses and bacteria, which means it can be contagious. Acute bronchitis caused by environmental factors such as pollution or cigarette smoke is not contagious. Common symptoms for acute bronchitis include nasal congestion, cough, headache, sore throat, muscle aches, and fatigue. Acute bronchitis in children also my include runny nose, fever, and chest pain. Treatment for acute bronchitis are OTC pain relievers, cough suppressants (although not recommended in children), and rest. Infrequently antibiotics may be prescribed to treat acute bronchitis.
Night Sweats (In Men and Women) Causes, Remedies, and Treatments
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. The causes of night sweats in most people are not serious, like menopause in women, sleep apnea, medications, alcohol withdrawal, and thyroid problems. However, more serious diseases like cancer and HIV also can cause night sweats. Your doctor will treat your night sweats depending upon the cause. You may experience other signs and symptoms that are associated with night sweats, which depend upon the cause, but may include, shaking, and chills with a fever caused by an infection like the flu or pneumonia; unexplained weight loss due to lymphoma; women in perimenopause or menopause may also have vaginal dryness, mood swings, and hot flashes during the day; and low blood sugar in people with diabetes. Other causes of night sweats include medications like NSAIDs (aspirin, acetaminophen, ibuprofen (Motrin, Advil), and naproxen (Aleve, Naprosyn), antidepressants, sildenafil (Viagra), and abuse of prescription or illegal drugs and drug withdrawal; hormone disorders like pheochromocytoma and carcinoid syndrome; idiopathic hyperhidrosis; infections like endocarditis, AIDs, and abscesses; alcoholism and alcohol withdrawal; drug abuse, addiction, and withdrawal; and stroke. A doctor or other health care professional can treat your night sweats after the cause has been diagnosed.
Eczema refers to skin inflammation. There are many different types of eczema that produce symptoms and signs that range from oozing blisters to crusty plaques of skin. Treatment varies depending upon the type of eczema the person has.
Spinal Cord Injury: Treatments and Rehabilitation
When vertebrae are broken or dislocated, the result can cause traumatic injury to the spinal cord. A spinal cord injury can have significant physiological consequences. One indication of the severity of a spinal cord injury are respiratory complications. Spinal cord injuries are classified as either. Rehabilitation and recovery of a spinal cord injury is dependant upon the type of injury.
Sacroiliac Joint Dysfunction (SI Joint Pain)
Sacroiliac joint (SI) dysfunction is a general term to reflect pain in the SI joints. Causes of SI joint pain include osteoarthritis, abnormal walking pattern, and disorders that can cause SI joint inflammation including gout, rheumatoid arthritis, psoriasis, and ankylosing spondylitis. Treatment includes oral medications, cortisone injections, and surgery.
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.
There are several types of thyroid disorders including hypothyroidism, hyperthyroidism, goiters, thyroid nodules, and thyroid cancer. Symptoms vary by condition. Diagnosis is made with blood tests, scans, ultrasound, or biopsy. Treatments depend on the disorder and can include medication or surgery.
Upper Respiratory Tract Infection (URTI)
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barr. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infections are based upon the cause. Generally, viral infections are treated symptomatically with over-the-counter (OTC) medication and home remedies.
Chronic Bronchitis (Symptoms, Causes, Treatment, Remedies)
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Seborrheic dermatitis is a chronic skin condition. Symptoms and signs include a red, scaling rash on the scalp, face, ears, and torso. Treatment often includes the use of a medicated shampoo and the application of a topical steroid lotion.
Contact dermatitis is a rash that occurs after exposure to an irritant. It can be allergic. Symptoms include a red, elevated rash at the site of contact with the irritating substance. Contact dermatitis treatment may involve: creams, application of cool water compresses, and applying topical steroids.
Is Eczema Contagious?
Eczema is a skin condition characterized by inflamed, rough skin patches that occasionally produce fluid-filled bumps that may ooze. There is no cure for eczema, though eczema may be treated with moisturization, eczema cream, and topical steroids.
Is Tonsillitis Contagious?
Tonsillitis is a common infection, especially in kids. Tonsillitis is caused by viruses and bacteria like the flu and herpes simplex virus, and Streptococcus bacteria. These viruses and bacterium are spread person to person. Symptoms of tonsillitis are a yellow or white coating on the tonsils, throat pain, pain when swallowing, and hoarseness.
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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