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.

QUESTION
Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off. See AnswerWhich 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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Relapsing Polychondritis
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.
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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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Microscopic Colitis (Lymphocytic Colitis and Collagenous Colitis)
Microscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis is only visible when the colon's lining is examined under a microscope. The cause of microscopic colitis is not known. Symptoms of microscopic colitis are chronic watery diarrhea and abdominal pain or cramps.
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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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Still's Disease
Still's disease is a disorder characterized by inflammation with high fever spikes, fatigue, salmon-colored rash, and/or arthritis. Though there have been several theories regarding the cause(s) of Still's disease, the cause is not yet known. Many symptoms of Still's disease are often treatable with anti-inflammatory drugs.
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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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What Is 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.
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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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Primary Biliary Cirrhosis (PBC) Treatment
Primary biliary cirrhosis (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), and 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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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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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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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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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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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 in women of Asian descent and usually begins between 10-30 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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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.
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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.
Treatment & Diagnosis
- Buttock Pain
- Swollen Lymph Nodes (Lymphadenopathy)
- Joint Warmth
- Complex Regional Pain Syndrome (CRPS)
- Bell's Palsy
- Polymyositis
- Polymyalgia Rheumatica
- Graft Versus Host Disease (GVHD)
- Henoch-Schonlein Purpura
- Doctor: Checklist to Take To Your Doctor's Appointment
- Kawasaki Disease
- Juvenile Idiopathic Arthritis
- Eosinophilic Fasciitis
- 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
- ITP Symptoms and Causes
- Rheumatoid Arthritis (RA): 17 Warning Signs of Serious Complications
- Lupus Nephritis Treatment
- Indications for Drugs: Approved vs. Non-approved
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Corticosteroid Side Effects
- 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)?
- Generic Drugs, Are They as Good as Brand-Names?
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