The action of prednisolone is through the inhibition of the activity of specific inflammatory cells, such as leukocytes and lymphocytes, and by reducing the production of inflammatory mediators, such as prostaglandins and leukotrienes. Prednisolone also has anti-inflammatory and immunosuppressant effects.
Spectrum
prednisolone has a broad spectrum of activity, including:
Anti-inflammatory: It reduces inflammation by inhibiting the activity of specific inflammatory cells, such as leukocytes and lymphocytes, and by reducing the production of inflammatory mediators, such as prostaglandins and leukotrienes.
Immunosuppressant: It suppresses the immune system, which can help to control autoimmune disorders, such as rheumatoid arthritis and lupus.
Anti-allergic: It blocks the release of certain chemicals in the body that cause allergic reactions, such as histamine and leukotrienes.
Anti-proliferative: It may inhibit cell growth and division, which can help treat certain types of cancer.
The first four weeks of treatment is 60 mg/m²/day or 2 mg/kg/day taken orally, divided into doses every 8 hours until urine is protein-free for three consecutive days. The treatment should not exceed 28 days, and the maximum daily dose should not exceed 80 mg
Subsequent four weeks: 40 mg/m²/day or 1-1.5 mg/kg/day orally every alternate day
Refer adult dosing
Frequency not defined
Adrenal suppression
Diabetes mellitus
Glucose intolerance
Hypokalemic alkalosis
Insomnia
Myopathy
Osteoporosis
Perianal pruritis
Pseudotumor cerebri
Seizure
Urticaria
Acne
Delayed wound healing
GI perforation
Hepatomegaly
Menstrual irregularity
Neuritis
Peptic ulcer
Psychosis
Vertigo
Black Box Warning:
prednisolone is a corticosteroid medication used to treat a variety of conditions such as allergies, inflammation, and autoimmune diseases. It works by reducing inflammation and suppressing the immune system.
Contraindications
Hypersensitivity to prednisolone or any other ingredients in the medication.
Active or recent history of tuberculosis, fungal, bacterial, viral infections, or ocular herpes simplex.
Active peptic ulcer disease or a history of peptic ulcer disease.
Uncontrolled hypertension
Severe heart failure or a history of heart failure
Diabetes Mellitus with ketoacidosis
Osteoporosis
Pregnancy or breastfeeding
Glaucoma or cataracts
Caution
Long-term prednisolone use can cause osteoporosis, diabetes, hypertension, weight gain, and other side effects. Regular bone density, blood sugar, blood pressure, and weight monitoring are recommended.
It can suppress the immune system and make patients more susceptible to infections. Patients should be advised to avoid close contact with people who have infections and to seek medical attention if they develop signs of infection.
It can cause or worsen mental health disorders like depression or psychosis. Patients should be monitored for changes in mood or behavior, and their mental health should be evaluated if necessary.
It can cause or worsen cataracts or glaucoma. Patients should have regular eye exams and be monitored for vision changes.
It can cause or worsen stomach or intestinal ulcers. Patients should be advised to avoid taking other medications that can cause ulcers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and report any symptoms of a stomach or intestinal problems.
It can cause or worsen high blood pressure. Patients should monitor their blood pressure regularly and be advised to avoid salt and maintain a healthy diet and lifestyle.
It should not be abruptly stopped; it should be tapered off under the direction of a healthcare provider to avoid withdrawal symptoms and other complications.
Pregnancy consideration: Insufficient data available
Lactation: Excretion of the drug in human breast milk is known
Pregnancy category:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
CategoryN: There is no data available for the drug under this category
Pharmacology
It binds to specific glucocorticoid receptors in the body, leading to gene expression changes and protein synthesis control. This leads to the suppression of inflammation and the control of the rate of protein synthesis, which is an integral part of the inflammatory response.
It also suppresses the migration of polymorphonuclear leukocytes (PMNs) and fibroblasts, cells that play an essential role in the inflammatory response. This can help reduce the number of cells present at the site of inflammation, which can help reduce inflammation and swelling.
It also reverses capillary permeability, which can help reduce fluid leakage from blood vessels at the site of inflammation. This can also help to reduce inflammation and swelling.
Pharmacodynamics
It has a wide range of effects on the body, and its effects are primarily dependent on the dose and duration of treatment. It should be used under the direction of a healthcare provider, and regular monitoring is necessary to avoid potential side effects and ensure the treatment’s effectiveness.
Pharmacokinetics
Absorption
It is rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1 hour. However, the duration of action is longer, 18-36 hours.
Distribution
It is highly protein-bound in the bloodstream, with a protein binding range of 65-91%. However, this percentage can be lower in elderly patients. The volume of distribution (Vd) is relatively small, at 0.22-0.7 L/kg.
Metabolism
It is extensively metabolized in the liver, but the specific metabolic pathways are not well understood.
Elimination/excretion
The elimination half-life of prednisolone is relatively short, at 3.6 hours in patients with normal renal function and 3-5 hours in patients with end-stage renal disease. The drug is not dialyzable, meaning it cannot be removed from the body by hemodialysis. The renal clearance of the drug is 9.5 mL/min, and it is excreted primarily in the urine.
Administration
It is a steroid medication often used to reduce inflammation and swelling in the body. It can be administered orally (by mouth) or intravenously (into a vein). The dosage and frequency of administration will depend on the condition being treated and the response to the medication.
It is essential to follow the dosing instructions provided by a healthcare provider and to not abruptly stop taking prednisolone, as this can cause withdrawal symptoms.
Patient information leaflet
Generic Name: prednisolone
Pronounced: (pred·ni·suh·lone)
Why do we use prednisolone?
prednisolone is sometimes used in the treatment of alcoholic liver disease because it has anti-inflammatory and immunosuppressive effects that can help to reduce liver inflammation and damage caused by the disease.
Alcoholic liver disease is a condition that occurs when excessive alcohol consumption leads to liver damage, inflammation, and scarring. The immune system is also involved in this process, as it responds to the inflammation and can further damage the liver tissue. prednisolone works by suppressing the immune response and reducing inflammation, which can help to slow down the progression of the disease and improve liver function.
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The first four weeks of treatment is 60 mg/m²/day or 2 mg/kg/day taken orally, divided into doses every 8 hours until urine is protein-free for three consecutive days. The treatment should not exceed 28 days, and the maximum daily dose should not exceed 80 mg
Subsequent four weeks: 40 mg/m²/day or 1-1.5 mg/kg/day orally every alternate day