PREDNISOLONE

Synthetic steroidal anti-inflammatory medicine with medium duration of action

Dosage Forms

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Tablets

5 mg

Eye drops

0.5%
1%

Uses

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  • Acute asthma attack
  • Rescue course in chronic asthma
  • Neuropathy due to leprosy
  • Severe allergic reactions
  • Stevens-Johnson syndrome
  • Anaphylaxis
  • Immune reconstitution inflammatory syndrome (IRIS)
  • Inflammatory reactions during treatment of roundworm, sleeping sickness, toxocariasis, systemic tapeworm infestation, schistosomiasis, leprosy
  • Allergic eye reactions

Dose and Duration

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Acute asthma attack

Adult: 30–60 mg single dose or in 2–3 divided doses

Child 5–15 years: up to 40 mg daily

Child 1–4 years: up to 20 mg daily

Child <1 year: 1–2 mg/kg/day

After stabilisation, continue dose for 3 days

Rescue course in chronic asthma

Give a 3-day course

Adult: 40 mg-60 mg daily

Child 5–15 years: up to 40 mg daily

Child 1–4 years: up to 20 mg daily

Child <1 year: 1–2 mg/kg/day

Severe allergic and inflammatory reactions, Stevens-Johnson syndrome, anaphylaxis, IRIS

Up to 60 mg once daily in the morning for 5–10 days

Allergic eye reactions

Apply 1 drop every 1–2 hours until symptoms reduce; then apply 1 drop every 8 hours

Contraindications

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  • Active peptic ulcer disease
  • Acute viral infection (e.g. hepatitis, herpes zoster, herpes simplex)
  • Untreated systemic infections
  • Do not use eye drops for undiagnosed “red eye”
  • Do not use eye drops for glaucoma

Side Effects

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  • Stomach upset
  • Hiccups
  • Can cause or make peptic ulcers worse
  • Allergic reactions
  • Insomnia
  • Stops body's natural production of corticosteroids (after prolonged use or with high doses) causing: increased risk and severity of infections, Cushing’s syndrome, muscle wasting, moon face, acne, oedema, high blood pressure, bones easily fractures, thinning of skin and easy bruising, mental disturbances, diabetes mellitus, menstrual disturbances, inhibition of growth in children, glaucoma

Interactions

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  • Anti-diabetic medicines (reduced effectiveness of anti-diabetic medicines)
  • Carbamazepine (reduced prednisolone effect)
  • Phenobarbital (reduced prednisolone effect)
  • Phenytoin (reduced prednisolone effect)
  • Rifampicin (reduced prednisolone effect)
  • Live vaccines (e.g. BCG, polio, prednisolone impairs immune response)

Patient Instructions

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  • Take medicine in the morning with food for the once a day prescriptions
  • Take rescue course of prednisolone provided when patient feels worsening of chronic asthma symptoms

Pregnancy

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  • Can be used

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Where treatment lasts more than 10 days, initial high doses must be reduced as soon as possible
  • Always use the smallest effective dose
  • Give prednisolone rescue course for chronic asthma patients for them to keep at home
  • Do not stop medicine abruptly where treatment lasts more than 21 days; reduce dose gradually
  • Use hydrocortisone cream for mild allergic skin reactions instead of prednisolone
  • Use with caution in patients with hypertension and diabetes