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.
