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Prednisone

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Prednisone, Deltasone, Rayos

  • 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. Multiple Sclerosis
  4. Bell's Palsy
  • Contraindications
  1. Severe liver disease
    1. Use Prednisolone instead (does not require first-pass metabolism for activation)
  • Mechanism
  1. See Systemic Corticosteroid
  2. Prednisone is a prodrug, activated by first pass metabolism in the liver to Prednisolone
    1. Prednisone and Prednisolone have identical dosing and activity
  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)
  • Adverse Effects
  1. See Systemic Corticosteroid
  • Safety
  1. See Systemic Corticosteroid
  2. Pregnancy Category C
  3. Considered safe in Lactation
  • Medications
  1. Prednisone (Deltasone) Tablets: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
  2. Prednisone Solution: 5 mg/5 ml
  3. Prednisone Concentrated Solution (Intensol): 5 mg/ml
  4. Prednisone Delayed Release Tablets (Rayos): 1 mg, 2 mg, 5 mg
  • Dosing
  • Adults
  1. See specific conditions for dosing protocols
  2. Prednisone dosing is equivalent to Prednisolone dosing
  3. Dosing: 5 to 60 mg orally daily (dosing and course depending on indication)
  • Pharmacokinetics
  1. Requires first pass metabolism through the liver, but has 1:1 bioavailablity in most cases
    1. Consider Prednisolone instead in severe liver disease
  2. Medium potency
  3. Medium anti-inflammatory potency
  4. Has Mineralocorticoid Activity
  5. Medium Half-Life (~36 hours)
  • Resources
  1. Prednisone (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=10fe5a3b-84dc-4600-87c2-b80c97ce18cf
  • 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]