Prednisolone

Pronunciation

Prednisolone 5mg

Introduction

Prednisolone is a steroid with anti-inflammatory and immunosuppressant effects. It is used to treat a wide range of inflammatory and autoimmune conditions.

Indications include:

• Multiple Sclerosis
• Asthma
• Inflammatory bowel disease
• Dermatitis
• Rheumatoid arthritis

Equivalent anti-inflammatory doses of steroids

Prednisolone 5 mg is equivalent to	Betamethasone 750 micrograms
	dexamethasone 750 micrograms
	hydrocortisone 20 mg
	methylprednisolone 4 mg
	triamcinolone 4 mg

Generic Name	HA Code	Classification
Prednisolone 5mg	PRED02	P1S1S3

Mechanism of Action

Immunosuppression agent, Steroid replacement agent, Anti-inflammatory agent

Dosage

Dosages of steroids vary widely in different diseases and in different patients.

When long-term steroid therapy is used in some chronic diseases, the adverse effects of treatment may be great. To minimize side-effects the maintenance dose should be kept as low as possible.

Steroids are used both topically (by rectum or eye) and systemically (by mouth or intravenously).

Whenever possible local treatment with creams, intra-articular injections, inhalations, eye-drops or enemas should be used in preference to systemic treatment.

The suppressive action of a steroid on cortisol secretion is least when it is given as a single dose in the morning.

Oral: initially, up to 10-20 mg daily (severe disease, up to 60 mg daily), preferably taken in the morning after breakfast; can often be reduced within a few days but may need to be continued for several weeks or months. Maintenance, usual range: 2.5 – 15 mg daily

Child and infant dose: Usually indicated for mild to moderate acute asthma,

1 month to 11 years old: 1-2mg/kg once daily, max 40 mg daily

Child 12-17 years old: 40-50 mg daily for at least 5 days

By intramuscular injection, prednisolone acetate 25 – 100 mg once or twice weekly

For intra-articular injection, 5 to 25 mg of prednisolone acetate.

Prednisolone acetate and prednisolone sodium phosphate are also used in the topical treatment of allergic and inflammatory conditions of the eyes or ears, usually as drops containing 0.5 or 1%.

Side Effects

Short-term use include nausea and feeling tired. More severe side effects include psychiatric problems including euphoria, nightmares, insomnia, irritability, confusion, suicidal thoughts and behavioral disturbances. This may occur in about 5% of people.

Long-term steroid use can lead to:

Adrenal suppression
Steroid-induced diabetes
Osteoporosis, muscle wasting and weakness	which is a danger, particularly in the elderly, as it can result in osteoporotic fractures for example of the hip or vertebrae
Susceptibility to infection
Cushing’s syndrome	moon face, striae, and acne
Endocrine side effects	menstrual irregularities and amenorrhea, hirsutism, weight gain, hyperlipidemia
Neuropsychiatric side effects	aggravation of schizophrenia, aggravation of epilepsy, insomnia, irritability, mood changes
Dermatological effects	easy bruising, impaired wound healing, and thinning of skin
Ophthalmic effects	glaucoma, corneal or scleral thinning and exacerbation of ophthalmic viral or fungal disease

Side-effects can be minimized by using lowest effective dose for minimum period possible.