Prednisolone

Drug Overview

Prednisolone is a synthetic corticosteroid primarily used to suppress immune responses and reduce inflammation. It mimics the action of endogenous cortisol in the body, regulating the immune system to alleviate symptoms of excessive inflammation or autoimmune diseases.

This medication is widely used in the treatment of various conditions, including rheumatoid arthritis, allergic dermatitis, acute asthma attacks, and more. Its mechanism of action includes inhibiting cytokine production, reducing tissue swelling, and decreasing immune system attacks on the body's own tissues.

Brand Names and Scientific Name

The scientific name is Prednisolone. Common brand names include:

• Prerelna (Prednisolone Sodium phosphate tablets)
• Other formulations may be labeled as "Prednisolone"

This medication is available in tablet, oral suspension, or injectable forms and must be used under a physician’s prescription.

Drug Classification

It belongs to the class of Glucocorticoids, categorized as "Immunosuppressants" and "Anti-inflammatory drugs." These drugs have broad physiological regulatory effects but must be used cautiously to avoid side effects.

Indications

Primarily used to treat autoimmune diseases such as systemic lupus erythematosus, multiple sclerosis relapses, severe allergic reactions, and organ transplant rejection. It can also be used for respiratory conditions like asthma exacerbations or skin diseases such as pemphigus.

Additionally, it is used for certain hematologic conditions (e.g., idiopathic thrombocytopenic purpura) and ocular inflammation. Use should be strictly under a doctor’s diagnosis; self-medication is not advised.

Common Side Effects

Short-term use may cause:

• Gastrointestinal discomfort (nausea, diarrhea)
• Insomnia or mood swings
• Easy bruising of the skin

Long-term use may lead to:

• Buffalo hump (fat accumulation on the neck)
• Hyperglycemia or hypertension

Serious side effects such as infections or psychiatric symptoms worsening require immediate medical attention.

Warnings and Precautions

Contraindications: Active tuberculosis, severe viral infections (such as chickenpox), uncontrolled peptic ulcer disease are strictly contraindicated. Use during pregnancy may increase fetal risks; women of childbearing age should follow medical instructions carefully.

Black box warnings include: Do not abruptly stop long-term use; taper gradually to avoid "Cushing's syndrome withdrawal reaction." Diabetic patients may experience blood sugar fluctuations and require close monitoring.

Drug Interactions

Concurrent use with anticoagulants (e.g., warfarin) may enhance anticoagulant effects, requiring dose adjustments. When used with diabetic medications, it may reduce blood sugar-lowering effects.

Use with enzyme inducers like rifampicin can decrease drug efficacy; inform your healthcare provider about all other medications or herbal supplements being used.

Dosage and Administration

Adult starting doses typically range from 5-60 mg daily, adjusted based on the condition. Pediatric doses are calculated based on weight, usually 0.1-2 mg/kg per day. Follow the "single morning dose" principle to minimize disruption of hormonal rhythms.

The oral suspension should be shaken well before use and taken with food to reduce gastrointestinal irritation. Topical ointments are for local use only and should not be applied over large areas or for prolonged periods.

Missed Dose Management

If a dose is missed on the day, take it as soon as remembered and adjust the next dose accordingly. If close to the next scheduled dose, skip the missed dose and do not double up to prevent overdose.

Overdose Management

Overdose may cause confusion, abdominal pain, or hypotension; seek immediate medical attention. Emergency treatment may include gastric lavage or administration of an antagonist; do not attempt self-treatment.

 

Frequently Asked Questions

Should Prednisolone be taken on an empty stomach or with food?

Prednisolone can be taken before or after meals, but if gastrointestinal discomfort occurs, it is recommended to take it with food to reduce irritation. If your doctor specifically instructs to take it on an empty stomach, follow their advice to ensure efficacy.

Does long-term use of Prednisolone cause osteoporosis? How can it be prevented?

Long-term use may increase the risk of bone loss. Regular monitoring of bone density is recommended, along with calcium and vitamin D supplementation as directed by your physician. Weight-bearing exercises like walking or strength training and avoiding smoking and alcohol can also help reduce risk.

Can I get vaccinated while using Prednisolone?

Some vaccines (such as live attenuated vaccines) may interact with steroids; inform your doctor before vaccination. Inactivated vaccines are generally safe but should be evaluated by your healthcare provider based on your medication stage and dosage.

What should I watch out for when using anticoagulants?

Prednisolone may enhance the effects of anticoagulants like warfarin, increasing bleeding risk. Your doctor will regularly monitor coagulation indices (such as INR) and adjust the medication accordingly. Do not change your medication plan without medical advice.

What are the consequences of suddenly stopping the medication? How should the dose be adjusted?

Sudden discontinuation after long-term use can cause "steroid withdrawal symptoms," such as fatigue, muscle pain, or relapse of the original disease. Tapering should be done gradually under medical supervision; do not stop abruptly on your own.