Powder for injection, 10mg, 25 mg (as sodium phosphate or sodium succinate) in vial.
Prednisolone is a synthetic glucocorticoid with weak mineralocorticoid properties. Its therapeutic effects result from inhibition of macrophage accumulation, suppression of capillary wall permeability and reduction of fibroblast proliferation and collagen deposition. It is readily absorbed from the gastrointestinal tract, it is extensively protein- bound and has a plasma half- life of about 8 hours
Bullous pemphigoid and pemphigus
Severe atopic and contact dermatitis
Severe lichen planus
Dosage and administration
All doses are suitable for adults and children. The lowest dosage to produce an acceptable clinical response should be used. The dosage depends on the disease, its severity and the response to treatment. A single day dose given early in the morning may reduce the magnitude of the side effects.
Prednisolone is indicated in the management of all conditions deemed likely to benefit from short or long term glucocorticoid therapy. These include:
Allergic states Severe, incapacitating allergies unresponsive to conventional treatment; asthma, serum sickness, drug hypersensitivity reactions
Rheumatic disorders: Usually given as an adjunctive therapy for short term administration during an acute episodes or exacerbation of rheumatoid arthritis, psoriatic arthritis.
Skin conditions: Life- threatening or incapacitating skin conditions such as pemphigus and exfoliative dermatitis
Neoplastic disease: Leukemia and lymphomas in adults, acute leukemia of childhood
Gastrointestinal disease: During acute exacerbation in ulcerative colitis and regional ileitis (Crohn’s disease)
Respiratory disease: Sarcoidosis (especially with hyperkalemia), fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculosis chemotherapy
Haematological disorders: Various blood dyscrasias eg. Selected cases of haemolytic anaemia, thrombocytopenic purpura
- Known hypersensitivity to corticosteroids
- Prednisolone should not be used, except in life threatening situations, in patients with active bacterial, viral or fungal infections
- Patients with ocular herpes simplex due to the possibility of perforation
Use in pregnancy:
Systemic corticosteroid preparations should not be administered during pregnancy unless the need of the mother outweighs any possible risk of harm to the fetus. Adrenal development may be impaired and an association with cleft palate and other fetal abnormalities has been described, particularly in the case of fluorinated compounds. Dosage should be kept as low as possible.
Corticosteroids are excreted in small amount in breast milk. However doses up to 40 mg daily of prednisolone are likely to cause systemic effects in the infant.
Adverse effects are dependent on the dosage and duration of treatment. Doses in excess of 20 mg daily are immunosuppressive. Infections contracted during therapy can be fatal in the absence of effective treatment. Quiescent tuberculosis may be reactivated. Long term treatment at dosage in excess of normal physiological requirements (approximately 10 mg daily) is liable to result in
- Stunting of growth in children
- Features of hypercorticalism
- Spinal osteoporosis and vertebral collapse
- Aseptic osteonecrosis
- Subcapsular cataracts and glaucoma
- Development or aggravation of peptic ulcers
- Diabetes mellitus
- Depression and psychosis, with risk of suicide
- Raised intracranial pressure and convulsions, particularly in children
- Increased coagulability of blood
- Delayed tissue healing
- Antacids can reduce the absorption of prednisolone if given in high doses
- Rifampicin, rifabutin, carbamazepine, phenobarbital, phenytoin, primidone, carbimazole and aminoglutethimide enhance the metabolism of corticosteroids and its therapeutic may be reduced
- Ciclosporin increase the plasma concentration of prednisolone
- The renal clearance of salicylates is increased by corticosteroids
- NSAIDs may increase the risk of GIT ulceration
- The efficacy of coumarin anticoagulant may be enhanced by concurrent corticosteroids
- Concomitant administration of diuretics that inhibit the reabsorption of potassium increases the risk of hypokalemia