Prednisolone(pred niss’ oh lone)
Prednisolone
Oral: Prelone
Prednisolone Acetate
Ophthalmic solution: Omnipred, Pred Forte, Pred Mild, ratio-Prednisolone (CAN)
Oral: Flo-Pred
Prednisolone Sodium Phosphate
Oral: Hydrocortone, Orapred, Orapred ODT, Pediapred
PREGNANCY CATEGORY C
PREGNANCY CATEGORY D (FLO-PRED)
Drug Classes
Anti-inflammatory
Corticosteroid (intermediate-acting)
Glucocorticoid
Hormone
Therapeutic Actions
Enters target cells and binds to intracellular corticosteroid receptors, thereby initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.
Indications
Systemic
Hypercalcemia associated with cancer
Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders
Hematologic disorders: Thrombocytopenia purpura, erythroblastopenia
Ulcerative colitis, acute exacerbations of MS and palliation in some leukemias and lymphomas
Trichinosis with neurologic or myocardial involvement
Prednisolone has weaker mineralocorticoid activity than hydrocortisone and is not used as physiologic replacement therapy
Ophthalmic
Inflammation of the lid, conjunctiva, cornea, and globe
Contraindications and Cautions
Contraindicated with corticosteroid sensitivity, infections (especially TB, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections), lactation, idiopathic thrombocytopenic purpura, pregnancy.
Use cautiously with renal or liver disease, hypothyroidism, ulcerative colitis with impending perforation, diverticulitis, active or latent peptic ulcer, inflammatory bowel disease, heart failure, hypertension, thromboembolic disorders, cataracts, glaucoma, psychiatric disturbances, osteoporosis, seizure disorders, diabetes mellitus.
Ophthalmic preparations
Contraindicated with acute superficial herpes simplex keratitis; fungal infections of ocular structures; vaccinia, varicella, and other viral diseases of the cornea and conjunctiva; ocular TB.
Available Forms
Tablets—5 mg; rapidly dissolving tablets—10, 15, 30 mg; oral syrup—15 mg/5 mL, 5 mg/5 mL; ophthalmic suspension—0.12%, 1%; oral suspension—5, 15 mg/5 mL
Dosages
Adults
Individualize dosage, depending on severity of condition and patient’s response. Administer daily dose before 9 AM to minimize adrenal suppression. If long-term therapy is needed, consider alternate-day therapy. After long-term therapy, withdraw drug slowly to avoid adrenal insufficiency. For maintenance therapy, reduce initial dose in small increments at intervals until the lowest dose that maintains satisfactory clinical response is reached.
Oral
Prednisolone: 5–60 mg/day PO.
Acute exacerbations of MS: 200 mg/day PO for 1 wk, followed by 80 mg every other day for 1 mo (prednisolone sodium phosphate).
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