Prednisolone

Prednisolone Brand Names

AK-Pred | AsmalPred | Econopred | Econopred Plus | Flo-Pred | Hydeltrasol | Inflamase Forte | Inflamase Mild | Millipred | Millipred DP | Millipred DP 12-Day | Millipred DP 6 Day | Ocu-Pred | Ocu-Pred A | Ocu-Pred Forte | Omnipred | Orapred | Orapred ODT | Pediapred | Pred Mild | Predalone | Pred-Forte | Prednoral | Pred-Phosphate | Prelone | Veripred-20

What is Prednisolone

Prednisolone is a synthetic glucocorticoid, and the active metabolite of prednisone.

The drug is available in systemic and ophthalmic dosage forms.

Prednisolone is used in many conditions in adult and pediatric patients, including allograft rejection, asthma, chronic obstructive pulmonary disease (COPD), systemic lupus erythematosus (SLE), rheumatoid and psoriatic arthritis, and many other allergic, dermatologic, ocular, and systemic inflammatory states.

Because the drug does not get hepatically activated, prednisolone is sometimes used in place of prednisone in patients with severe hepatic disease.

Prednisolone and its derivatives have very little mineralocorticoid activity and are therefore not used to manage adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly.

According to the Expert Panel of the National Asthma Education and Prevention Program, systemic corticosteroids may be added to other long-term maintenance medications in the management of uncontrolled severe persistent asthma.

Once stabilization of asthma is achieved, regular attempts should be made to reduce or eliminate the use of systemic corticosteroids due to the side effects associated with chronic administration.

Short courses of systemic corticosteroid treatment may be used in moderate to severe exacerbations of asthma or exacerbations of COPD.

If long-term therapy with prednisolone is required for any indication, the lowest possible effective dose should be used.

Prednisolone was first approved by the FDA in 1955.

Indications

1. acute interstitial nephritis (AIN)
2. acute lymphocytic leukemia (ALL)
3. Addison’s disease
4. adrenocortical insufficiency
5. allergic conjunctivitis
6. allergic rhinitis
7. anaphylaxis
8. angioedema
9. ankylosing spondylitis
10. anterior segment inflammation
11. asthma
12. atopic dermatitis
13. bacterial conjunctivitis
14. Bell’s palsy
15. berylliosis
16. bursitis
17. carpal tunnel syndrome
18. chorioretinitis
19. chronic lymphocytic leukemia (CLL)
20. chronic obstructive pulmonary disease (COPD)
21. Churg-Strauss syndrome
22. congenital adrenal hyperplasia
23. contact dermatitis
24. corneal ulcer
25. Crohn’s disease
26. dermatitis
27. dermatitis herpetiformis
28. dermatomyositis
29. eczema
30. endophthalmitis
31. eosinophilic pneumonia
32. epicondylitis
33. erythema multiforme
34. erythroblastopenia
35. exfoliative dermatitis
36. food allergy
37. gout
38. gouty arthritis
39. Graves’ ophthalmopathy
40. heart transplant rejection prophylaxis
41. hemolytic anemia
42. herpes zoster ocular infection
43. Hodgkin lymphoma
44. hypercalcemia
45. hypoplastic anemia
46. immune thrombocytopenic purpura (ITP)
47. iritis
48. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
49. Kawasaki disease
50. keratitis
51. kidney transplant rejection
52. kidney transplant rejection prophylaxis
53. laryngotracheobronchitis (croup)
54. Loeffler’s syndrome
55. lupus nephritis
56. mixed connective tissue disease
57. multiple myeloma
58. multiple sclerosis
59. mycosis fungoides
60. nephrotic syndrome
61. non-Hodgkin’s lymphoma (NHL)
62. optic neuritis
63. osteoarthritis
64. pemphigus
65. perennial allergies
66. pneumonitis
67. polyarteritis nodosa
68. polychondritis
69. polymyalgia rheumatica
70. polymyositis
71. postoperative ocular inflammation
72. proteinuria
73. pseudogout
74. psoriasis
75. psoriatic arthritis
76. pulmonary fibrosis
77. rheumatic carditis
78. sarcoidosis
79. seasonal allergies
80. seborrheic dermatitis
81. serum sickness
82. severe acute respiratory syndrome (SARS)
83. Stevens-Johnson syndrome
84. systemic lupus erythematosus (SLE)
85. temporal arteritis
86. tenosynovitis
87. thrombocytopenia
88. thyroiditis
89. trichinosis
90. tuberculosis infection
91. ulcerative colitis
92. urticaria
93. uveitis
94. vasculitis
95. vernal keratoconjunctivitis
96. Wegener’s granulomatosis

Side Effects

1. abdominal pain
2. acne vulgaris
3. acneiform rash
4. adrenocortical insufficiency
5. alopecia
6. amenorrhea
7. amnesia
8. anaphylactoid reactions
9. anemia
10. angina
11. angioedema
12. anorexia
13. anxiety
14. appetite stimulation
15. arrhythmia exacerbation
16. arthralgia
17. avascular necrosis
18. blurred vision
19. bone fractures
20. bradycardia
21. candidiasis
22. cardiac arrest
23. cardiomyopathy
24. cataracts
25. conjunctival hyperemia
26. conjunctivitis
27. constipation
28. Cushing’s syndrome
29. delirium
30. depression
31. diabetes mellitus
32. diaphoresis
33. diarrhea
34. dizziness
35. dysgeusia
36. dysmenorrhea
37. ecchymosis
38. edema
39. EEG changes
40. elevated hepatic enzymes
41. emotional lability
42. erythema
43. esophageal ulceration
44. euphoria
45. exfoliative dermatitis
46. exophthalmos
47. fever
48. fluid retention
49. foreign body sensation
50. gastritis
51. GI bleeding
52. GI perforation
53. glossitis
54. glycosuria
55. growth inhibition
56. hallucinations
57. headache
58. heart failure
59. hepatomegaly
60. hirsutism
61. hypercholesterolemia
62. hyperglycemia
63. hypernatremia
64. hypertension
65. hyperthyroidism
66. hypocalcemia
67. hypokalemia
68. hypotension
69. hypothalamic-pituitary-adrenal (HPA) suppression
70. hypothyroidism
71. immunosuppression
72. impaired cognition
73. impaired wound healing
74. increased intracranial pressure
75. infection
76. insomnia
77. irritability
78. keratitis
79. keratoconjunctivitis
80. lethargy
81. leukocytosis
82. lupus-like symptoms
83. malaise
84. mania
85. memory impairment
86. menstrual irregularity
87. metabolic alkalosis
88. myalgia
89. myocardial infarction
90. myopathy
91. nausea
92. neuritis
93. neutropenia
94. ocular hypertension
95. ocular infection
96. ocular irritation
97. ocular pain
98. ocular pruritus
99. optic neuritis
100. osteopenia
101. osteoporosis
102. palpitations
103. pancreatitis
104. papilledema
105. paresthesias
106. peptic ulcer
107. perineal pain
108. peripheral neuropathy
109. petechiae
110. phlebitis
111. physiological dependence
112. postmenopausal bleeding
113. pruritus
114. pseudotumor cerebri
115. psychosis
116. pulmonary edema
117. purpura
118. rash
119. restlessness
120. retinopathy
121. seizures
122. sinus tachycardia
123. skin atrophy
124. sodium retention
125. striae
126. stroke
127. syncope
128. telangiectasia
129. tendon rupture
130. thromboembolism
131. thrombosis
132. urticaria
133. vasculitis
134. vertigo
135. visual impairment
136. vomiting
137. weakness
138. weight gain
139. weight loss
140. withdrawal
141. xerosis

Monitoring Parameters

• blood glucose
• blood pressure
• growth rate
• ophthalmologic exam
• pulmonary function tests (PFTs)
• serum potassium
• weight

Contraindications

• abrupt discontinuation
• breast-feeding
• cataracts
• contact lenses
• corneal abrasion
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• diverticulitis
• fungal infection
• geriatric
• GI perforation
• glaucoma
• growth inhibition
• heart failure
• helminth infection
• herpes infection
• hypertension
• hyperthyroidism
• hypothalamic-pituitary-adrenal (HPA) suppression
• hypothyroidism
• immunosuppression
• increased intracranial pressure
• increased intraocular pressure
• infection
• measles
• myasthenia gravis
• myocardial infarction
• neonates
• neuromuscular disease
• ocular infection
• osteopenia
• osteoporosis
• peptic ulcer disease
• pregnancy
• psychosis
• renal disease
• seizure disorder
• sulfite hypersensitivity
• surgery
• thyroid disease
• tuberculosis
• ulcerative colitis
• vaccination
• varicella
• viral infection

Interactions

• Abatacept
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetazolamide
• Acetohexamide
• Adalimumab
• Albiglutide
• Aldesleukin, IL-2
• Alemtuzumab
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Altretamine
• Ambenonium Chloride
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Aminosalicylate sodium, Aminosalicylic acid
• Amiodarone
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Antithymocyte Globulin
• Antitumor antibiotics
• Aprepitant, Fosaprepitant
• Argatroban
• Arsenic Trioxide
• Asparaginase Erwinia chrysanthemi
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atenolol; Chlorthalidone
• Atracurium
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azathioprine
• Azilsartan; Chlorthalidone
• Basiliximab
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bepridil
• Bexarotene
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bivalirudin
• Boceprevir
• Bortezomib
• Bosentan
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Bupropion
• Bupropion; Naltrexone
• Butabarbital
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Carmustine, BCNU
• Ceritinib
• Certolizumab pegol
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorambucil
• Chlorothiazide
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Choline Salicylate; Magnesium Salicylate
• Cimetidine
• Cisatracurium
• Citalopram
• Clindamycin
• Clofarabine
• Codeine; Phenylephrine; Promethazine
• Conivaptan
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Deferasirox
• Denileukin Diftitox
• Denosumab
• Desmopressin
• Dextran
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Digoxin
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dofetilide
• Doxacurium
• Dronedarone
• Droperidol
• Dulaglutide
• Echinacea
• Econazole
• Efalizumab
• Elexacaftor; tezacaftor; ivacaftor
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Hydrochlorothiazide, HCTZ
• Ephedrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erlotinib
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Estramustine
• Estrogens
• Exenatide
• Fluconazole
• Fluoxymesterone
• Fosinopril; Hydrochlorothiazide, HCTZ
• Gallium Ga 68 Dotatate
• Gemcitabine
• Gentamicin
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycerol Phenylbutyrate
• Golimumab
• Guaifenesin; Phenylephrine
• Halofantrine
• Haloperidol
• Hemin
• Heparin
• Hetastarch
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Hydroxyurea
• Hylan G-F 20
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibritumomab Tiuxetan
• Idelalisib
• Incretin Mimetics
• Indapamide
• Inebilizumab
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Iohexol
• Iopamidol
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isoproterenol
• Isotretinoin
• Itraconazole
• Ivacaftor
• Ketoconazole
• L-Asparaginase Escherichia coli
• Lesinurad
• Lesinurad; Allopurinol
• Letermovir
• Levetiracetam
• Levomethadyl
• Linagliptin; Metformin
• Liraglutide
• Live Vaccines
• Lixisenatide
• Lomustine, CCNU
• Loop diuretics
• Lopinavir; Ritonavir
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Macimorelin
• Magnesium Salicylate
• Mannitol
• Mecasermin rinfabate
• Mecasermin, Recombinant, rh-IGF-1
• Meglitinides
• Melphalan
• Mepenzolate
• Mephobarbital
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methacholine
• Methazolamide
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methoxsalen
• Methyclothiazide
• Metolazone
• Metyrapone
• Micafungin
• Mifepristone
• Mitotane
• Mitoxantrone
• Mivacurium
• Moxifloxacin
• Muromonab-CD3
• Natalizumab
• Nateglinide
• Nelarabine
• Neostigmine
• Neuromuscular blockers
• Nicardipine
• Nonsteroidal antiinflammatory drugs
• Ocrelizumab
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Ondansetron
• Oritavancin
• Oxymetholone
• Ozanimod
• Pancuronium
• Pazopanib
• Pegaspargase
• Peginterferon Alfa-2a
• Penicillamine
• Phenobarbital
• Phenylephrine
• Phenylephrine; Promethazine
• Photosensitizing agents (topical)
• Physostigmine
• Pimozide
• Posaconazole
• Potassium
• Potassium Chloride
• Potassium Phosphate; Sodium Phosphate
• Potassium-sparing diuretics
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Primidone
• Propranolol
• Purine analogs
• Pyridostigmine
• Quetiapine
• Quinolones
• Rapacuronium
• Regular Insulin
• Repaglinide
• Rifabutin
• Rifampin
• Rifamycins
• Rifapentine
• Ritodrine
• Ritonavir
• Rituximab
• Rituximab; Hyaluronidase
• Rocuronium
• Salicylates
• Salsalate
• Sargramostim, GM-CSF
• Semaglutide
• SGLT2 Inhibitors
• Simeprevir
• Siponimod
• Sipuleucel-T
• Sodium Benzoate; Sodium Phenylacetate
• Sodium Chloride
• Sodium Phenylbutyrate
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Somatropin, rh-GH
• Succinylcholine
• Sulfonylureas
• Telaprevir
• Telbivudine
• Telithromycin
• Telotristat Ethyl
• Testosterone
• Tezacaftor; Ivacaftor
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• Thyroid hormones
• Tobramycin
• Tolazamide
• Tolbutamide
• Tositumomab
• Tranexamic Acid
• Tretinoin, ATRA
• Tuberculin Purified Protein Derivative, PPD
• Tubocurarine
• Tucatinib
• Vancomycin
• Vecuronium
• Vemurafenib
• Vigabatrin
• Vincristine Liposomal
• Voriconazole
• Vorinostat
• Warfarin
• Zafirlukast
• Zileuton