Prednisolone, Inj/Oral
Corticosteroid, Systemic · Corticosteroid
Indications
Collagen and allergic conditions requiring systemic corticosteroid therapy.
Dosage
Adults: ORAL: Usual range: 5-60 mg daily. Elderly: Use lowest effective dose. Multiple sclerosis: 200 mg/day for 1 wk followed by 80 mg every other day for 1 mth. Rheumatoid arthritis: Initial: 5-7.5 mg daily; adjust dose as necessary. Children: ORAL: Autoimmune inflammatory disorders (including juvenile idiopathic arthritis, connective tissue disorders and systemic lupus erythematosus): 1 mth-18 yr, initially 1-2 mg/kg once daily (usual max 60 mg daily), then reduced after a few days if appropriate. Autoimmune hepatitis: 1 mth-18 yr, initially 2 mg/kg once daily (max 40 mg daily) then reduced to minimum effective dose. Corticosteroid replacement therapy: 12-18 yr, 2-2.5 mg/square meter daily in 1-2 divided doses adjusted according to response. Infantile spasms: 1 mth-2 yr, initially 10 mg 4 times daily for 14 days (if seizures not controlled after 7 days increase to 20 mg 3 times daily…
Administration
IM: Shake suspension well before withdrawing. Intra-articular: Attach a 20G-24G needle to empty syringe, using aseptic technique, so prescriber can remove a few drops of synovial fluid to confirm that needle is in the joint. The aspirating syringe is then exchanged with a prednisolone-filled syringe to inject drug into joint.
Adverse Effects
Endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children. Increased susceptibility to infection, increased severity of infection. Fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance. Myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures. Impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne. GI disturbance, peptic ulceration, acute pancreatitis, candidiasis. Psychiatric effects, neurological effects, insomnia. Diabetes, impaired glucose tolerance, weight gain, increased appetite. Ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma. Thromboembolism, leukocytosis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Systemic fungal infections unless specific anti-infective therapy is used. Head injury, stroke. Precautions: Active infections not controlled by antibiotics. Latent or active amoebiasis. History of TB, septicaemia, symptoms may be masked. Avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, Myasthaenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. WITHDRAWAL: Withdraw gradually. Withdrawal symptoms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.
Interactions
Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides. Oestrogens including oral contraceptives, somatropin. Carbamazepine, phenytoin, primidone, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.
Advice to Patient
Take with meals. Place orally disintegrating tablet on tongue, do not split, cut or break it. Do not stop taking medication abruptly, gradually lower down the dose then stop. Contact prescriber if there is worsening of condition, increased nervousness, unhealed injuries, sore throat, sleep disturbances, excessive body hair growth, changes in vision, loss of skin colour, rapid or sudden weight gain (>3 lb per week), swelling of face/hands/ankles/feet, black or dark coloured stools, difficulty in breathing, muscle weakness, joint pain, mood changes, constant abdominal pain or if there is no improvement in condition. Consult prescriber if you feel more stressed out than normal because dosage may need to be adjusted. Avoid alcohol, limit intake of caffeine and stimulants during therapy. If there is need, prescriber may recommend you vitamins, minerals or iron supplement. If you have…
Pharmacokinetics
Duration: 18-36 hrs. Absorption: Rapid; well-absorbed. Metabolism: Primarily hepatic. Half-life elimination: 2-4 hrs; decreased in children and prolonged in hepatic disease. Time to peak, plasma: 1-2 hrs; prolonged with food. Excretion: Primarily urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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