Other names for this medication:
Adelcort, Adelone, Aersolin d, Ak-pred, Alertine, Alpicort, Apicort, Aprednislon, Bisuo a, Blephamide, Bronal, Capsoid, Cetapred, Chloramphecort-h, Compesolon, Cor tyzine, Corotrope, Cortan, Cortico-sol, Cortisal, Cortisol, Danalone, Decortin h, Delta-cortef, Deltacortenesol, Deltacortril, Deltahydrocortisone, Deltapred, Deltastab, Dermol, Dermosolon, Deturgylone, Dhasolone, Di-adreson-f, Dojilon, Dontisolon, Econopred, Emsolone, Encortolon, Estilsona, Fenicort, Fisiopred, Fisopred, Flo-pred, Frisolona forte, Glucortin, Gupisone, Hefasolon, Hexacorton, Hexy-solupred, Hydrocortancyl, Hydrocortidelt, Infectocortikrupp, Inflanefran, Inflanegent, Insolone, Intalsolone, Key-pred, Klismacort, Kohakusanin, Lenisolone, Lepicortinolo, Lidomex kowa, Linola-h n, Locaseptil-neo, Lygal, Mecortolon, Mediasolone, Medopred, Meprisolon, Metacortandralone, Meti-derm, Meticortelone, Minisolone, Nurisolon, Ocupred, Oftalmol, Omnipred, Ophtapred, Optipred, Optival, Orapred, Orapred odt, Panafcortelone, Paracortol, Parisilon, Pediacort, Pediapred, Pednisol, Precodil, Precortalon aquosum, Pred-clysma, Predacort, Predalone, Predate s, Predcor, Predenema, Predfoam, Predicort, Predinga, Predlone, Predmix, Prednefrin, Prednesol, Predni, Predni h tablinen, Predni-pos, Prednicortil, Prednigalen, Prednihexal, Predniliderm, Predniocil, Prednip, Prednis, Prednisolon caproate, Prednisolona, Prednisolonacetat, Prednisolonpivalat, Prednisolonum, Prednisolut, Prednizolons, Predohan, Predonema, Predonine, Predsim, Predsol, Predsolets, Preflam, Prelon, Prelone, Premandol, Prenin, Prenolone, Preson, Prezolon, Rectopred, Redipred, Riemser, Scheriproct, Scherisolona, Sintisone, Solone, Solpren, Solu-dacortina, Solu-decortin, Soluble prednisolone, Solupred, Sopacortelone, Sophipren, Spirazon, Spiricort, Sterolone, Ultracortenol, Vasocidin, Walesolone, Wysolone, Youmeton
Prednisolone is a hormonal drug, a glucocorticosteroid.
The formulation and composition of Prednisolone are produced by many pharmaceutical companies, with the same dosage of the active substance, the preparations can differ in appearance, in the content of the auxiliary components and in the package.
Dosage forms of Prednisolone with the active ingredient content:
➡tablets: color – white, form – planocylindrical;
➡active ingredient – Prednisolone, 1 tablet – 1 mg or 5 mg;
➡solution for injection (for intravenous and intramuscular administration):
➡slightly opalescent or transparent, slightly colored or colorless;
➡active ingredient – Prednisolone sodium phosphate (in terms of Prednisolone), in 1 ml – 15 mg or 30 mg;
➡ointment for external use 0,5%: color – white; active ingredient – Prednisolone, in 1 g – 5 mg;
➡eye drops 0.5%: white suspension; the active ingredient is Prednisolone acetate, in 1 ml – 5 mg.
Prednisolone is a synthetic glucocorticoid, a dehydrogenated analog of hydrocortisone. Has anti-inflammatory, anti-allergic, desensitizing, anti-shock, antitoxic and immunosuppressive, antipruritic and antiexsudative effect.
Interacting with specific cytoplasmic receptors, Prednisolone forms a complex penetrating into the nucleus of the cell, stimulates the synthesis of matrix RNA (ribonucleic acid), which induces protein biosynthesis (including lipocortin), mediating cellular effects.
Inhibiting the enzyme phospholipase A2, lipocortin inhibits the release of arachidonic acid, as well as the synthesis of prostaglandins and leukotrienes, which contribute to inflammatory, allergic and other pathological processes.
Prednisolone inhibits pituitary release of β-lipotropin, but the concentration of circulating β-endorphin does not decrease, it inhibits the secretion of thyrotropin-releasing hormone (TSH) and FSH (follicle-stimulating hormone), increases the excitability of the CNS (central nervous system), reduces the number of lymphocytes, eosinophils, increases the number of blood cells , stimulating the production of erythropoietins.
Pharmacological action of the drug in systemic use (tablets, solution for injections in ampoules Prednisolone):
▶protein metabolism: reduces the content of globulin in the plasma, increasing the synthesis in the liver and kidneys of albumins (with an increase in the ratio of albumin / globulin);
▶increases protein catabolism in muscle tissue;
▶lipid exchange: stimulates the synthesis of triglycerides and higher fatty acids;
▶redistributes fatty deposits, moving them mainly to the face, shoulder girdle, abdomen;
▶can lead to the development of hypercholesterolemia;
▶carbohydrate metabolism: enhances absorption from the digestive tract (gastrointestinal tract) carbohydrates;
▶increases the intake of glucose from the liver into the bloodstream by increasing the activity of glucose-6-phosphatase;
▶increases the activity of FEPKK (phosphoenolpyruvate carboxylase) and improves the synthesis of aminotransferases by activating gluconeogenesis;
▶can lead to the development of hyperglycemia;
▶water-electrolyte balance: delays sodium and water in the body;
▶stimulates the excretion of potassium due to the increase in mineralocorticoid activity;
▶reduces absorption of calcium in the digestive tract, flushes calcium from bone tissue, increasing its excretion in the urine;
▶inflammatory processes: inhibits the release of inflammatory mediators by eosinophils and mast cells;
▶induces the formation of lipocortin and the reduction in the number of mast cells producing hyaluronic acid;
▶reduces the permeability of capillaries;
▶stabilizes cell membranes and membranes of organelles (especially lysosomal);
▶allergic reactions: suppresses the synthesis and secretion of mediators of allergy, inhibits the release of histamine and other bioactive substances from sensitized mast cells and basophils;
▶reduces the number of circulating basophils; suppresses the development of lymphoid and connective tissues;
▶reduces the number of mast cells, T- and B-lymphocytes;
▶oppresses the sensitivity of effector cells to mediators of allergy;
▶inhibits antibody formation;
▶changes the immune response of the body;
▶obstructive diseases of the respiratory tract: inhibits inflammatory processes, prevents or depresses the development of edema of the mucous membranes, inhibits eosinophilic infiltration of the submucosal layer of the bronchi epithelium and the deposition of immune complexes circulating in the mucous membrane of the bronchi;
▶stops erosion and desquamation of the mucosa;
▶increases the sensitivity of β-adrenoreceptors to endogenous catecholamines and exogenous sympathomimetics in bronchi of small and medium caliber;
▶reduces the viscosity of mucus by suppressing or reducing its production;
▶shock states, intoxications: increases blood pressure (arterial pressure) due to the increase in the concentration of circulating catecholamines and the restoration of receptor responsiveness to them, as well as the narrowing of the lumen of blood vessels;
▶reduces the permeability of the vascular wall, has a membrane-protective effect, activates liver enzymes involved in metabolic processes of endo- and xenobiotics;
▶immunosuppressive (immunosuppressive) therapy: inhibits the proliferation of lymphocytes (especially T-lymphocytes), suppresses B-cell migration and T-B and B-lymphocyte binding, inhibits the release of cytokines (interleukin-1 and -2, gamma-interferon) from lymphocytes and macrophages , reducing the formation of antibodies;
▶during the inflammatory process inhibits connective tissue reactions and reduces the possibility of keloid tissue formation.
Prednisolone with external application (ointment) has anti-inflammatory, antiallergic, antipruritic and anti-exudative effect; inhibits the formation of arachidonic acid, the formation and release of inflammatory mediators (prostaglandins, histamine, lysosomal enzymes, leukotrienes, etc.); suppresses inflammatory skin reactions, reduces vasodilation in the inflammation focus and increases vascular permeability.
Absorption of Prednisolone is high, with oral intake of tablets Prednazolone, the maximum concentration in the blood is reached after 1-1.5 hours. Up to 90% of the substance in the plasma binds to proteins: albumins and cortisol-binding globulin – transcortin.
The drug is metabolized in the kidneys, liver, bronchi, and small intestine. In oxidized forms, the substance is glucuronized or sulfated. Its metabolites are inactive.
T½ (half-life) is 2-4 hours, Prednisolone is excreted with bile and urine by glomerular filtration, 80-90% is reabsorbed by tubules, up to 20% is excreted unchanged by the kidneys. After intravenous injection of T1 Prednisolone from the plasma is 2-3 hours.
With topical application after absorption to the general bloodstream from the skin surface and from the conjunctival cavity, Prednisolone binds to plasma proteins and is metabolized predominantly in the liver; is excreted in the urine unchanged ≥ 20%, T½ is about 3 hours.
Indications for use Pills
↗endocrine pathologies: insufficiency of adrenal cortex primary and secondary (including post-ectomy state of adrenal glands), VGKN (congenital hyperplasia of the adrenal cortex), thyroiditis of de Kerven (subacute thyroiditis);
↗diffuse connective tissue diseases: SLE (systemic lupus erythematosus), rheumatoid arthritis, scleroderma, dermatomyositis, nodular periarteritis;
↗Rheumatic fever (rheumatic fever), acute rheumatic heart disease;
↗inflammation of the joints in acute and chronic form: humeroscapular periarthritis, Bechterew’s disease (ankylosing spondylitis), arthritis gouty and psoriatic, osteoarthritis (including post-traumatic), Still’s syndrome in adults, polyarthritis, juvenile arthritis, bursitis, synovitis, nonspecific tendosinovitis, epicondylitis;
↗allergic diseases in acute and chronic course: hypersensitivity reactions to food and medications, medicinal exanthemes, urticaria, serum sickness, pollinosis, allergic rhinitis, angioedema;
↗bronchial asthma, including asthmatic status;
↗diseases of the hematopoiesis and blood diseases system: acute lymphoid and myeloid leukemia, autoimmune hemolytic anemia, panmyelopathy, lymphogranulomatosis, agranulocytosis, thrombocytopenic purpura, secondary thrombocytopenia in adult patients, erythrocyte anemia (erythroblastopenia), erythroid (congenital) hypoplastic anemia;
↗skin diseases: eczema, pemphigus, exfoliative / atopic dermatitis, psoriasis, contact dermatitis (with lesions of large skin areas), diffuse neurodermatitis, toxicermy, Lyell’s syndrome (toxic epidermal necrolysis), seborrheic dermatitis, bullous herpetiform dermatitis, Stevens-Johnson syndrome (malignant exudative erythema);
↗eye diseases inflammatory and allergic: allergic conjunctivitis, allergic corneal ulcers, sympathetic ophthalmia, slow and severe uveitis of the anterior and posterior uveitis, optic neuritis;
↗Diseases of the digestive tract: ulcerative colitis, hepatitis, Crohn’s disease, local enteritis;
↗bronchogenic carcinoma (lung cancer): as part of complex treatment with cytostatics;
↗pulmonary pathologies: pulmonary fibrosis, acute pulmonary alveolitis, stage II-III sarcoidosis;
↗tuberculosis of the lungs, tuberculous meningitis;
↗aspiration pneumonia (as part of complex treatment with specific chemotherapy);
↗Leffler’s syndrome is not amenable to other types of treatment, berylliosis;
↗impaired renal function of an autoimmune nature (including acute glomerulonephritis), nephrotic syndrome;
↗multiple sclerosis; cerebral edema (including associated with surgery, radiation therapy, head trauma or a brain tumor) after prior application of parenteral forms of Prednisolone;
↗hypercalcemia due to oncological diseases; nausea and vomiting associated with cytotoxic therapy;
↗reaction of transplant rejection during organ transplantation – with a preventive purpose.
Prednisolone in the form of a solution for parenteral use is used, if necessary, for emergency therapy with the following conditions requiring a rapid increase in the concentration of glucocorticosteroids:
↗shock (traumatic, burn, operating, cardiogenic, toxic) – if vasoconstrictive agents, plasma-substituting drugs and other symptomatic treatment are ineffective;
↗allergic reactions in acute and severe forms, anaphylactic shock, hemotransfusion shock, anaphylactoid reactions;
↗cerebral edema (including associated with surgery, radiation therapy, head trauma or a brain tumor);
↗severe form of bronchial asthma, asthmatic status;
↗diffuse connective tissue diseases: SLE, rheumatoid arthritis;
↗thyrotoxic crisis; acute adrenal insufficiency;
↗acute hepatitis, hepatic coma;
↗poisoning with cauterizing fluids – to reduce inflammation and prevent scar scarring.
Prednisolone ointment is used in the complex treatment of such inflammatory and allergic skin diseases of non-microbial etiology as eczema, neurodermatitis, psoriasis, lupus erythematosus, erythroderma, as well as allergic, seborrheic and contact dermatitis.
↗blunt and sharp eye trauma;
↗keratitis (under the condition of complete intact epithelium of the cornea);
↗allergic blepharoconjunctivitis in chronic course;
↗uveitis of the anterior segment of the eye, sclerites, episcleritis;
↗postoperative period (in case of prolonged symptoms of irritation of the eyeball).
With short-term systemic use of Prednisolone according to vital indications, the only contraindication for its use is an increased individual sensitivity to the acting or auxiliary components.
Precautions Prednisolone in the form of tablets and a solution is prescribed for the following conditions / diseases:
↘infection and invasion of fungal, bacterial or viral origin (current or recent, including recent contact with an infected person): herpes simplex, chicken pox, herpes zoster (in the viremic phase), measles, systemic mycosis, strongyloidiasis, amoebiasis, tuberculosis in the active and latent phases. In severe infectious diseases, the use of Prednisolone is possible only against specific therapy;
↘perivac vaccine (8 weeks before vaccination and 2 weeks after), lymphadenitis after TB vaccine BCG (Bacillus Calmette-Guerin);
↘immunodeficiency conditions, including Acquired Immunodeficiency Syndrome (AIDS) or human immunodeficiency virus (HIV);
↘Gastrointestinal diseases: gastritis, peptic ulcer of stomach and duodenum, esophagitis, peptic ulcer in acute or latent flow, newly formed intestinal anastomosis, diverticulitis, ulcerative colitis with the threat of abscessing or perforation;
↘cardiovascular pathologies, including the recently transferred myocardial infarction (in patients with acute / subacute myocardial infarction, the focus of necrosis may be spread with a delay in the formation of scar tissue, which may result in a rupture of the heart muscle), hypertension, uncompensated chronic heart failure, hyperlipidemia;
↘endocrine disorders: thyrotoxicosis, diabetes mellitus (including a violation of carbohydrate tolerance), hypothyroidism, Itenko-Cushing’s disease, obesity 3-4 degrees;
↘renal / hepatic failure of severe degree, nephrourolythiasis;
↘hypoalbuminemia and predisposing to its appearance;
↘systemic osteoporosis, myasthenia gravis, poliomyelitis (exception – bulbar encephalitis), acute psychosis, glaucoma (open-angle and zakratougolnaya);
Prednisolone ointment is contraindicated in bacterial, viral, fungal skin lesions, tuberculosis, syphilis, skin tumors, vulgar acne, rosacea, skin post-vaccination reactions, open wounds, trophic ulcers, in children under 1 year and with increased individual sensitivity to its components. With caution, ointment is used in pregnancy and lactation.
Contraindications to the use of eye drops Prednisolone:
↘increased intraocular pressure;
↘dendritic keratitis caused by Herpes zoster, chicken pox, other viral diseases of the cornea and conjunctiva;
↘Fungal, mycobacterial, acute purulent eye diseases;
↘hypersensitivity to the components of the drug.
Instructions for use Prednisolone: method and dosage
The dose of Prednisolone and the duration of treatment are selected by the doctor individually, depending on the indications and severity of the disease.
Tablets Prednisolone is taken orally, washed down with a small amount of liquid, in the morning (from 6 to 8 o’clock in the morning) at breakfast or immediately after it. Usually take a daily dose daily, or a double dose – every other day. The high daily dose is divided into 2-4 admission, most of it is taken in the morning.
In acute conditions and as a substitute treatment for adults, it is recommended to start with a dose of 20-30 mg / day; maintenance therapy is carried out at a dose of 5-10 mg / day, some diseases (for example, nephrotic syndrome, individual rheumatic diseases) require higher doses.
Children’s daily doses: initial – 1-2 mg / kg in 4-6 receptions; maintenance – 0.3-0.6 mg / kg. Discontinue treatment gradually, slowly lowering the dose.
If there is a history of psychosis, high-dose therapy is administered under the strict supervision of a specialist. When appointing, the daily secretory rhythm of the GCS is taken into account: in the mornings, the whole dose is taken at a time or a large part of it.
Prednisolone in the form of a solution is administered intravenously, usually the first injection is done in struyno, and repeated injections are drip. If intravenous administration is impossible for any reason, the solution in the same doses is administered intramuscularly.
Application according to indications:
➲acute adrenal insufficiency: single dose – 100-200 mg; daily – 300-400 mg;
➲severe allergic reactions: daily dose – 100-200 mg, duration of the course – 3-16 days; bronchial asthma: course dose – 75-675 mg, duration of the course – 3-16 days;
➲in severe cases, it is possible to increase the exchange rate to 1400 mg and above;
➲asthmatic status: the starting daily dose is 500-1200 mg followed by a gradual decrease to 300 mg and the transition to maintenance doses;
➲thyrotoxic crisis: 100 mg 2-3 times a day, if necessary daily dose can be increased to 1000 mg;
➲the duration of the course depends on the therapeutic effect and is usually at least 6 days;
➲shock, resistant to standard therapy: the initial dose, as a rule, injected, then transferred to drip infusions;
➲if the blood pressure does not rise within 10-20 minutes, repeat the jet injection. After excretion from the state of shock, drip administration is continued until BP stabilizes. Single dose – 50-150 mg (in severe cases, increase to 400 mg);
➲repeated administration is carried out after 3-4 hours;
➲daily dose varies from 300 to 1200 mg with a further gradual decrease;
➲acute hepatic / renal failure (acute poisoning, postoperative or postpartum periods, etc.): daily dose – 25-75 mg; according to the indications, it is possible to increase it to 300-1500 mg or more;
➲rheumatoid arthritis and SLE: 75-125 mg / day administered for no more than 7-10 days in addition to the systemic intake of Prednisolone;
➲acute hepatitis: daily dose – 75-100 mg, duration of the course – 7-10 days;
➲poisoning with cauterizing liquids, burns of the upper respiratory tract and digestive tract: a daily dose of 75 to 400 mg, depending on the severity of the condition, the duration of the course is 3-18 days.
Do not suddenly stop prolonged therapy with Prednisolone. After relief of acute conditions, they switch to oral administration of the drug in the form of tablets with a gradual dose reduction.
Recommended dosage for children: from 2 to 12 months – at the rate of 2-3 mg / kg; from 1 to 14 years – 1-2 mg / kg; the solution is administered intramuscularly, and when such administration is not possible – intravenously slowly (about 3 minutes). If necessary, you can re-enter the same dose after 20-30 minutes.
Ointment is applied externally, applying a thin layer on the affected skin.
To enhance the effect in limited areas, occlusive dressings can be used.
Recommended dosing: apply ointment 1-3 times a day, the duration of the course is, as a rule, 6-14 days; In the process of aftercare, the use of the drug once a day is allowed.
In order to prevent relapse and in the treatment of chronic diseases, the use of ointment continues for some time after the complete disappearance of all symptoms, but no longer than 14 days.
Areas with more dense skin (palms, feet, elbows), as well as places where the ointment is easily washed, can be lubricated more often.
The drug is buried in the conjunctival sac. The duration of the course is determined by the attending physician.
Standard therapeutic dosing regimen Prednisolone: 1-2 drops 2-4 times a day.
In order to relieve inflammatory symptoms due to trauma to the eyeball, instillation of Prednisolone is recommended to be performed once a day.
Pills, solution for injections
➢endocrine system: impaired glucose tolerance, steroid diabetes / manifestation of latent diabetes, suppression of adrenal cortex function, Itenko-Cushing syndrome (pituitary obesity, lunar face, hirsutism, increased blood pressure, amenorrhea, dysmenorrhea, striae, muscle weakness), delay in puberty in children;
➢digestive system: nausea / vomiting, steroid ulcer of stomach and duodenum, pancreatitis, erosive esophagitis, gastrointestinal perforation / digestion, digestive disorders, increase / decrease in appetite, hiccups, flatulence;
➢rarely – increased activity of hepatic enzymes; cardiovascular system: arrhythmia, development (with predisposition) or increased severity of diagnosed heart failure, characteristic of hypokalemia changes in electrocardiogram indicators, increased blood pressure, bradycardia (up to cardiac arrest), hypercoagulation, thrombosis;
➢with acute and subacute myocardial infarction – proliferation of the focus of necrosis and slowing the formation of scars, which may result in a rupture of the heart muscle;
➢nervous system: headache, dizziness, disorientation, euphoria, delirium, hallucinations, depression, manic-depressive psychosis, paranoia, nervousness or anxiety, increased intracranial pressure, vertigo, insomnia, pseudotumor of the cerebellum, convulsions;
➢sensory organs: increased intraocular pressure (possible damage to the optic nerve), posterior subcapsular cataract, propensity to secondary bacterial, fungal or viral infection of the eye, exophthalmos, trophic corneal pathologies, sudden loss of vision (due to parenteral administration to the neck, head, nasal concha, in the scalp the preparation can crystallize in the vessels of the eye);
➢Metabolism: increased calcium excretion, hypocalcemia, weight gain, increased protein breakdown (negative nitrogen balance), hyperhidrosis;
➢side effects due to mineralocorticoid activity – hypernatremia, peripheral edema as a result of fluid and sodium retention, hypokalemic syndrome manifested by hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue;
➢musculoskeletal: premature closure in children of epiphyseal zones with growth retardation and ossification processes, osteoporosis, steroid myopathy, rupture of muscle tendons, muscular atrophy;
➢very rarely – aseptic necrosis of the head of the hip and humerus, pathological bone fractures;
➢skin and mucous membranes: petechiae, ecchymosis, delayed wound healing, thinning of the skin, hypo- or hyperpigmentation, striae, steroid acne, propensity for pyoderma and candidiasis;
➢hypersensitivity reactions: skin rashes, itching, local allergic reactions, anaphylactic shock; local reactions (parenteral administration): at the injection site – numbness, burning, pain, tingling, infection;
➢rarely – scar formation, necrosis of surrounding tissues;
➢intramuscular injection (especially in the deltoid muscle) – atrophy of the skin and subcutaneous tissue;
➢Other reactions: leukocyturia, development / exacerbation of infections (the simultaneous use of immunosuppressants and vaccination contribute to the occurrence of this side effect), withdrawal syndrome.
Possible side effects due to the use of ointment Prednisolone: steroid acne, purpura, telangiectasia, burning, itching, irritation and dry skin.
Prolonged use and / or application of ointment on large surfaces can cause the development of hypercorticism due to the resorptive effect of Prednisolone. In such cases, the drug should be discontinued and consult a specialist.
If these side effects are aggravated or any other reactions not indicated in this manual occur, you should inform your doctor about them.
After instillation of Prednisolone, a transient burning sensation is possible.
The result of prolonged use may be an increase in intraocular pressure, and therefore preparations containing GCS, use no more than 10 days and under regular control of intraocular pressure.
Continuous use of the eye suspension for 3 months or more can cause the development of a posterolateral cataract.
A sign of systemic overdose of Prednisolone is an increase in dose-dependent side effects. It is recommended to carry out symptomatic treatment with a gradual dose reduction, if necessary until the drug is discontinued.
Overdosing with topical application (ointment, eye suspension) can cause local side effects in the form of allergic reactions, the occurrence of which requires immediate withdrawal of the drug.
Before the beginning of therapy, to identify possible contraindications, it is necessary to conduct a clinical examination of the patient, including lung fluoroscopy, examination of the gastrointestinal tract, cardiovascular system, vision and urinary system.
Before the start of treatment and during steroid therapy it is required to regularly monitor general blood counts, the concentration of electrolytes in plasma, the glucose content in urine and blood. Do not vaccinate during the use of GCS, especially in high doses, as its effectiveness will be reduced.
With tuberculosis Prednisolone is prescribed only in combination with anti-tuberculosis drugs. Systemic administration of medium and high doses of the drug may cause an increase in blood pressure. The use of Prednisolone in intercurrent infections associated with septic conditions should be carried out with the support of antibiotic therapy.
Long-term treatment with GCS requires the administration of potassium preparations to avoid hypokalemia. With chronic adrenocortical insufficiency (Addison’s disease) Prednisolone is contraindicated to be taken concomitantly with barbiturates in connection with the danger of the addisonic crisis. In the event of a sudden discontinuation of the drug, especially with high-dose therapy, there is a syndrome of cancellation of the SCS, accompanied by a worsening of appetite, nausea, retardation, generalized musculoskeletal pain, asthenia.
Reduce the likelihood of adrenal insufficiency and associated complications can be, by gradual abolition of Prednisolone. In connection with the fact that adrenal insufficiency after drug cancellation can last for months, any stressful situation in this period requires the resumption of hormone therapy.
The presence of hypothyroidism and / or cirrhosis in the patient may exacerbate the effect of GCS. Patients should be warned in advance about the need for them and their environment to avoid contact with infected measles, herpes and chicken pox. With the current systemic treatment of GCS, or if they have been used in the next 3 months, patients who do not receive vaccination require specific immunoglobulins.
In the case of replacement therapy of adrenal insufficiency due to a weak mineralocorticoid effect, Prednisolone is recommended to be used in combination with mineralocorticoids. When diabetes is required to monitor blood glucose and, if necessary, correction of the dosing regimen. Periodic x-ray control of the osteoarticular system is recommended (photos of hands, spine). In patients with infectious diseases of the kidneys and urinary tract in the latent course, Prednisolone can cause leukocyturia, clinically significant for diagnosis.
GCS increases the metabolites of 11- and 17-oxyketocorticosteroids. Like other local GCS, Prednisolone ointment can not be applied to the skin around the eyes because of the risk of developing glaucoma / cataracts, as well as open wound surfaces. In case of complication of the disease by the development of a secondary fungal or bacterial infection, a specific antibacterial / antimycotic drug should be added to the therapy with Prednisolone.
Drops Prednisolone is not recommended with contact lenses, you should remove the lenses before instillation and wear again not earlier than 15 minutes after the procedure. Long-term use of drops can increase intraocular pressure, so if used for 2 weeks or more, regular monitoring of intraocular pressure is required. SCS therapy can mask the symptoms of a current bacterial / fungal infection, the presence of which is an indication for the use of Prednisolone as part of a complex therapy with antibiotics for topical use.
Influence on ability to manage motor transport and complex mechanisms
According to the instructions, Prednisolone used systemically can cause dizziness and other side reactions that can affect coordination of movements, reaction speed and concentration of attention, so it is not recommended to drive vehicles and maintain mechanical equipment during therapy.
After instillation of Prednisolone suspension, lacrimation is possible, and therefore it is not necessary to carry out the procedure immediately before carrying out potentially hazardous activities. Data on the effects of Prednisolone in the form of an ointment on the ability to drive vehicles and complex mechanisms is not available.
Application in pregnancy and lactation
The use of Prednisolone systemically and topically, in the form of eye drops during pregnancy is possible according to vital indications in case of justifiable excess of the intended benefit for the mother over the potential risk to the fetus.
Long-term systemic therapy of GCS in pregnant women does not exclude the possibility of impaired fetal growth. The use of Prednisolone in the third trimester increases the risk of atrophy of the adrenal cortex of the fetus, so that a newborn may require replacement therapy. Apply Prednisolone topically as short as possible, the ointment should be applied to small areas of the skin surface.
GCS is excreted in breast milk, so when used during breastfeeding it is necessary to take precautions, in particular, not apply ointment on the breast skin shortly before feeding. If you need systemic use of the drug during lactation, or apply to the skin ointment Prednisolone in large doses and / or for an extended period, breast-feeding should be interrupted for the duration of therapy.
Application in childhood
In pediatrics, GCS is used only under absolute indications, under the careful supervision of a physician, since they are capable of causing a slowdown in growth in children and adolescents.
Usually, the risk of developing such side effects helps to avoid or minimize the use of Prednisolone every other day. Children who are in the process of treatment in contact with infected measles or chickenpox require specific immunoglobulins for prevention.
The ratio of the area to the body weight in children is greater than in adults, so they are more at risk of suppressing the function of the hypothalamic-pituitary-adrenal system and the development of hypercortisy syndrome due to the use of any GCS for local use. In infants, diapers, diapers and skin folds can have an effect similar to occlusive dressing, thereby increasing systemic resorption of Prednisolone.
In childhood and adolescence, Prednisolone should be applied at the lowest effective dose, the maximum possible short course, and necessarily under the supervision of a specialist.
For violations of kidney function Tablets and solution
Prednisolone is not prescribed for patients with severe renal failure and with nephrourolythiasis.
For violations of liver function
Tablets and solution Prednisolone is not prescribed for patients with severe hepatic insufficiency.
Application in the elderly
With the use of GCS in the elderly, the incidence of adverse reactions increases.
In connection with high pharmacological activity, Prednisolone, like other GCS, can weaken or enhance the action of many drugs / drugs.
If you need to use a solution, tablets or eye drops of Prednisolone in combination with other drugs, the attending physician should consider and take into account their possible interaction. There is no data on the drug interaction of the ointment.
In connection with the possible pharmaceutical incompatibility of the solution of Prednisolone with other drugs administered intravenously, it is recommended to administer it separately: bolus, or through another dropper. Mixing of solutions of Prednisolone and heparin occurs with the formation of a precipitate.
Terms and conditions of storage
Store in a place protected from light and out of reach of children, at a temperature of: tablets – up to 25 ° C, ointment, injection solution – up to 15 ° C, do not freeze the solution; eye drops – 15-25 ° C, open the bottle for 4 weeks.
The shelf life depends on the manufacturer (see the packaging).
Reviews of Prednisolone
According to reviews, Prednisolone in systemic administration (tablets, injections) is quite effective, but patients complain of a large number of side effects. It is difficult to stop receiving after a long course of therapy because of withdrawal syndrome, so you should strictly follow the requirement for a gradual cessation of treatment.
There are complaints about painful injections. It is noted that in emergency cases, parenteral administration of Prednisolone quickly suppresses critical conditions and can save life. Application of the drug in topical forms (ointment, eye drops) practically does not cause side effects, and reviews about them are mostly positive.