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Prednisolone

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Prednisolone, Pediapred, Orapred

  • See Also
  1. Systemic Corticosteroid
  2. Topical Corticosteroid
  3. Inhaled Corticosteroid
  4. Intranasal Steroid
  5. Intra-articular Corticosteroid
  6. Corticosteroid Associated Osteoporosis
  7. Stress Dose Steroid
  8. Steroid-Induced Hyperglycemia
  • Indications
  1. Acute Asthma Exacerbation
  2. Anti-inflammatory and Immunosuppresive Agent
  3. Nephrotic Syndrome
  4. Multiple Sclerosis
  5. Primary Adrenal Insufficiency
  • Mechanism
  1. See Systemic Corticosteroid
  2. Prednisolone, other than not requiring first-pass metabolism, is identical to its prodrug Prednisone
  3. Intermediate activity duration (longer than Hydrocortisone, shorter than Dexamethasone)
  4. Intermediate Glucocorticoid (5 fold more than Hydrocortisone) activity
  5. Low mineralcorticoid activity (half that of Hydrocortisone)
  • Medications
  1. Prednisolone (Prelone) Tablets: 5 mg
  2. Prednisolone (Orapred ODT) Orally Disintegrating Tablets: 10 mg, 15 mg, 30 mg
  3. Prednisolone (Prelone) Syrup: 15 mg/5 ml
  4. Prednisolone (Prelone, Pediapred) Solution: 5 mg/5 ml, 10 mg/5 ml, 15 mg/5 ml, 20 mg/5ml, 25 mg 5 ml
  5. Other non-systemic formulations
    1. See Ophthalmic Corticosteroid (for Prednisolone acetate drops)
  • Dosing
  1. General
    1. See specific conditions for dosing protocols
    2. Prednisone dosing is equivalent to Prednisolone dosing
  2. Adult
    1. Dose 5 to 60 mg orally daily
  3. Child
    1. Dose: 1-2 mg/kg/day (up to 60 mg/day) orally daily or divided twice daily
    2. Maximum: 60 mg per day
  • Pharmacokinetics
  1. Requires no first pass metabolism via the liver (unlike Prednisone)
  2. Medium potency
  3. Medium anti-inflammatory potency
  4. Has Mineralocorticoid Activity
  5. Medium Half-Life (~36 hours)
  • Adverse Effects
  1. See Systemic Corticosteroid
  • Safety
  1. See Systemic Corticosteroid
  2. Pregnancy Category C
  3. Considered safe in Lactation
  • Resources
  1. Prednisolone Table and Solutions (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3115aef0-fd50-4ec8-a064-3effb695f3f2
  2. Prednisolone Syrup (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=86652e2d-664a-4388-a611-c2a9aa4a4bc8
  3. Prednisolone ODT or Orapred ODT (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=1e379543-c4cf-4e72-953b-db15b7f0c2a1
  • References
  1. Swadron and Hope in Herbert (2018) EM:Rap 18(9):16-8
  2. Dvorin (2020) Am Fam Physician 101(2): 89-94 [PubMed]
  3. Lane (1998) Endocrinol Metab Clin North Am 27:465-83 [PubMed]