Prednisolone is a synthetic glucocorticosteroid drug that has anti-inflammatory effects. It has anti-allergic, anti-shock, anti-inflammatory action.
Prednisolone is a dehydrated analogue produced by the adrenal cortex hormone hydrocortisone. Its activity is four times higher than the activity of hydrocortisone. It prevents the development of an allergic reaction (if the reaction has already begun, stops it), suppresses the activity of the immune system, reduces inflammation, increases the sensitivity of β2-adrenergic receptors to endogenous catecholamines, and has an anti-shock effect.
This drug is used only as part of complex therapy in order to relieve severe inflammation, edema, itching, exudation and proliferation in vasculitis, rheumatism, arthritis, myocarditis, pericarditis, dermatomyositis, glomerulonephritis, multiple sclerosis, pemphigus, psoriasis, systemic red wolfia, multiple sclerosis, pulpitis, psoriasis, systemic red heart disease, glomerulonephritis, multiple sclerosis, rheumatism, myocarditis, pericarditis. , tumors, scleroderma, periarteritis, asthma, angioedema, ankylosing spondylitis, drug allergies, shock, eczema, dermatitis, hepatitis, inflammatory pathologies of the eye and insufficient STI adrenal cortex.
Clinical and pharmacological group
GCS for oral administration.
Pharmacy sales terms
It is released on prescription.
How much do Prednisone tablets cost in pharmacies? The average price is at the level of 90 rubles.
Release form and composition
The tablets have a round flat cylindrical shape and white color. On one side, a chamfer is applied to conveniently break the tablet in half
- The composition of Prednisolone tablets: 1 or 5 mg of the active substance, colloidal silicon dioxide, magnesium stearate, stearic acid, starch (potato and corn), talc, lactose monohydrate.
The tablets are packaged in bottles of dark glass in the amount of 30 pieces. The carton pack contains one bottle of pills and instructions for the drug.
Prednisolone is a synthetic analogue of cortisone and hydrocortisone. It has anti-inflammatory, anti-allergic, anti-toxic effects. It also has an immunosuppressive and anti-shock effect. Does not cause water and sodium retention in the body, increases the production of potassium and hydrogen ions.
Anti-inflammatory effect is achieved by inhibition of accumulation of macrophages, stabilization of cell membranes in the area of inflammation. The action of prednisolone prevents the occurrence of edema, affects the synthesis of inflammatory mediators, arachidonic acid metabolism. Prednisolone increases blood glucose levels. In this regard, glycogen accumulates in the liver and insulin resistance occurs.
The action of prednisolone inhibits the production and release of adrenocorticotropic hormones, which leads to a decrease in the synthesis of glucocorticosteroid hormones by the adrenal cortex.
Indications for use
Systemic use is advisable when:
- multiple sclerosis;
- asthmatic status and asthma;
- granulomatous thyroiditis;
- autoimmune diseases;
- inflammatory diseases of the gastrointestinal tract;
- hypoglycemic conditions;
- nephrotic syndrome;
- small chorea, rheumatic fever, rheumatic carditis;
- diffuse connective tissue diseases;
- lung cancer (medication is prescribed in combination with cytostatics);
- interstitial lung tissue diseases (fibrosis, acute alveolitis, sarcoidosis, etc.);
- primary and secondary hypocorticism (including after adrenalectomy);
- congenital adrenal hyperplasia (VGN) or cortical dysfunction;
- diseases of the blood-forming organs and blood (leukemias, anemias and diseases associated with damage to the hemostasis system);
- eosinophilic and aspiration pneumonia, tuberculous meningitis, pulmonary tuberculosis (as a supplement to specific therapy);
- cerebral edema (post-radiation, developing in a tumor, after surgical intervention or trauma; in the abstract and Vidal reference book it is indicated that treatment of cerebral edema begins with parenteral forms of the drug);
- autoimmune and other skin diseases (including Dühring's disease, psoriasis, eczema, pemphigus, Lyell's syndrome, exfoliative dermatitis);
eye diseases (including autoimmune and allergic; including uveitis, allergic ulcerative keratitis, allergic conjunctivitis, sympathetic ophthalmia, choroiditis, iridocyclitis, non-purulent keratitis, etc.);
- acute and chronic diseases that are accompanied by inflammation in the joints and periarticular tissue (synovitis, nonspecific tendosynovitis, seronegative spondyloarthritis, epicondylitis, osteoarthritis (including post-traumatic), etc.);
- allergic diseases (including food or drug allergies, toxicoderma, serum sickness, atopic / contact dermatitis, pollinosis, allergic rhinitis, urticaria, Stevens-Johnson syndrome, angioedema;
- hypercalcemia developing on the background of oncological diseases.
Indications for the use of injections are emergency conditions, for example, an acute attack of food allergy or anaphylactic shock. After several days of parenteral use, the patient is usually transferred to a tablet form.
The indications for the use of tablets are of a chronic nature and in severe forms of pathology (for example, bronchial asthma).
Also, prednisolone solution and tablets are used to prevent transplant rejection and to relieve nausea / vomiting in patients receiving cytotoxic drugs.
With short-term systemic use of Prednisolone for health reasons, the only contraindication for its use is increased individual sensitivity to the existing or auxiliary components.
Taking tablets, intramuscular and intravenous administration of Prednisolone solutions are contraindicated in the following diseases and conditions:
- Myasthenia gravis;
- Acute psychosis;
- Obesity III - IV degrees;
- Itsenko-Cushing disease;
- Severe chronic renal or hepatic failure;
- Nephrourolithiasis (kidney stones);
- Low levels of protein in the blood;
- Immunodeficiency states;
- The post-vaccination period (8 weeks before and 2 weeks after vaccination);
- Lymphadenitis after BCG vaccination;
- Recently suffered myocardial infarction;
- Chronic heart failure in the stage of decompensation;
- Hypertonic disease;
- Hyperlipidemia (elevated cholesterol, HDL, LDL and TG in the blood);
- Infectious diseases in the active phase caused by viruses, fungi and bacteria (herpes simplex, herpes zoster, chicken pox, measles, amebiasis, strongyloidosis, systemic mycosis, tuberculosis);
- Diseases of the gastrointestinal tract (gastric ulcer and duodenal ulcer, esophagitis, gastritis, a newly created intestinal anastomosis, ulcerative colitis, diverticulitis);
- Pregnancy and breastfeeding period.
Use during pregnancy and lactation
In pregnancy, it can be used only if there is a threat to the life of the mother, since Prednisolone has a teratogenic effect. In experiments on rats and mice, the development of a wolf's mouth in pups born to a mother who received Prednisolone during pregnancy was shown.
When breastfeeding Prednisolone should also not be used, because the hormone enters the milk and can affect the body of the child. Therefore, if necessary, use in nursing mothers should transfer the child to an artificial mixture.
Prednisone for children
In children, Prednisolone is used only when it is urgently needed, when there is a threat to life or a serious illness that is not amenable to treatment with other medicines. When using tablets and solution in children younger than 14 years old, an intermittent scheme should be used, which consists in taking the drug for 3 days, after which a break for 4 days is made, etc.
Such an intermittent scheme reduces the risk of cessation of growth and development of the child. When using the ointment, you can not additionally carry out activities that enhance the absorption of the drug into the blood (for example, heating, tight bandages, etc.). The rest of the rules of application and precautions for children are the same as for adults.
Dosage and method of use
The instructions for use indicate that the dose of prednisolone and the duration of treatment is determined by the doctor individually, depending on the evidence and the severity of the disease.
- The entire daily dose of the drug is recommended to take a single or double daily dose - every other day, taking into account the circadian rhythm of endogenous glucocorticosteroid secretion in the range of 6 to 8 o'clock in the morning. A high daily dose can be divided into 2-4 doses, with a large dose taken in the morning. Tablets should be taken orally during or immediately after a meal, washed down with a small amount of liquid.
- In acute conditions and as a replacement therapy, adults are prescribed in the initial dose of 20-30 mg / day, the maintenance dose is 5-10 mg / day. If necessary, the initial dose may be 15-100 mg / day, supporting - 5-15 mg / day. For children from 3 years and older, the initial dose is 1-2 mg / kg of body weight per day in 4-6 doses, supporting - 0.3-0.6 mg / kg / day.
- When a therapeutic effect is obtained, the dose is gradually reduced - by 5 mg, then by 2.5 mg at intervals of 3-5 days, canceling the later stages first. With long-term use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped suddenly! The removal of the maintenance dose is carried out the slower, the longer glucocorticosteroid therapy has been used.
Under stressful effects (infection, allergic reaction, trauma, surgery, nervous stress) in order to avoid exacerbation of the underlying disease, the dose of Prednisolone should be temporarily increased (1.5-3, and in severe cases 5-10 times).
Features of power when taking Prednisolone
When taking Prednisolone is recommended to exclude from the diet fried and spicy foods, as well as fruits and sour juices that stimulate the secretion of hydrochloric acid. In addition, it is necessary to limit the amount of high-calorie foods high in carbohydrates and fats (their consumption during GCS therapy contributes to an increase in blood glucose levels and rapid weight gain), salt and liquid.
When cooking, you need to use products that contain potassium salts, calcium and protein (dietary meats, dairy products, fruits, hard cheeses, baked potatoes, prunes, apricots, nuts, zucchini, etc.).
Treatment should be completed gradually. Dose reduction is carried out, weekly reducing the dose used by ⅛ or taking the last dose every other day and reducing it at the same time by ⅕ (this method is faster).
With the fast method a day without Prednisolone, the patient is shown to stimulate the adrenal glands using UHF or DKV on their projection, taking ascorbic acid (500 mg / day), administering insulin in increasing doses (starting dose - 4 IU, then for each dose it is increased by 2 U, the highest dose - 16 U).
Insulin should be prick before breakfast, for 6 hours after the injection the person should remain under observation.
If Prednisolone is prescribed for bronchial asthma, it is recommended to switch to inhaled steroids. If the indication for use is an autoimmune disease - for mild cytostatics.
When taking the Prednisolone tablets for a long time, side effects are extremely rare. With longer use of the drug may develop negative reactions from various organs and systems:
- Metabolism - a negative nitrogenous balance in the body, which is caused by increased protein breakdown, weight gain.
- Skin and subcutaneous tissue - thinning (atrophy) of the skin, striae on it, impaired wound healing, erythema (redness of the skin), increased sweating (hyperhidrosis), acne, pinpoint hemorrhages on the skin (petechiae).
- Nervous system - an increase in intracranial pressure, which is accompanied by a syndrome of congestive optic nerve head (often develops in children), sleep disorders, convulsions, marked dizziness, headache, fainting.
- Water and electrolyte balance - the retention of water and salts in the body, accompanied by increased blood pressure, as well as the development of circulatory failure.
- Eyes - cataract, an increase in intraocular pressure, due to which glaucoma, exophthalmos subsequently develops.
- Higher nervous activity - symptoms of psychosis may appear, especially in the first 2 weeks after the start of taking the pills, it develops more often in women and in individuals with systemic lupus erythematosus.
- Musculoskeletal system - muscle weakness, increased bone fragility (osteoporosis), which is the cause of subsequent pathological fractures, including compression fracture of some vertebrae.
- Allergic reactions - rarely on the background of taking pills may develop anaphylactic shock with multiple organ failure and a progressive decrease in blood pressure.
- Endocrine system - a violation of the functional activity of the adrenal cortex (adrenal insufficiency), suppression of the growth process in children, increased blood sugar (hyperglycemia), impaired menstrual cycle in women, the manifestation of latent diabetes mellitus, hirsutism (increased ovolozhenenie skin, which especially noticeable in women).
- The digestive system is a steroid gastric or duodenal ulcer, associated with the fact that prednisolone inhibits the synthesis of prostaglandins of the digestive tract, which perform a protective function, perforation of the ulcer or bleeding from it, periodic nausea, vomiting, increased appetite, inflammation of the pancreas (pancreatitis). esophagitis) with the formation of ulcers in it, a violation of the digestive process, increased gas formation in the intestines (flatulence).
- Laboratory tests show a decrease in the number of leukocytes (leukopenia), platelets (thrombopenia), an increase in calcium in the blood, urine, an increase in triglyceride levels, total cholesterol, and low and very low density lipoproteins.
In the case of side effects, the doctor decides on the abolition of pills on an individual basis, depending on their type, nature and severity.
Occurs with prolonged use of prednisolone in high doses. It can be expressed by high blood pressure, peripheral edema. In addition, possible increased side effects.
Also, with prolonged use, Itsenko-Cushing syndrome may appear. Women may experience irregular menstruation and infertility. In men, impotence is possible. In children, growth may slow.
Before you start using the drug, read the specific instructions:
- The effect of the drug is enhanced in patients with hypothyroidism and liver cirrhosis.
- X-ray control of the osteo-articular system is shown (pictures of the spine, hand).
- During treatment should not be vaccinated due to a decrease in its effectiveness (immune response).
- Before starting treatment (if it is impossible due to the urgency of the condition - in the course of treatment) the patient should be examined to identify possible contraindications. Clinical examination should include a study of the cardiovascular system, x-ray examination of the lungs, examination of the stomach and duodenum, urinary system, organs of vision; control of blood count, glucose and electrolytes in the blood plasma.
- During treatment (especially long-term), it is necessary to observe an oculist, control blood pressure, water and electrolyte balance, as well as a picture of peripheral blood and blood glucose concentration.
- In order to reduce side effects, you can use antacids, as well as increase the intake of potassium ions (K +) in the body (diet, potassium preparations). Food should be rich in proteins, vitamins, with a limited content of fats, carbohydrates and salt.
- The drug may exacerbate existing emotional instability or psychotic disorders. When referring to psychosis in history, Prednisolone in high doses is used under the strict supervision of a physician.
- In stressful situations during maintenance treatment (for example, surgery, trauma or infectious diseases), the dose of the drug should be adjusted due to the increased need for glucocorticosteroids. It should be carefully monitored for patients during the year after the end of long-term therapy with Prednisone due to the possible development of relative insufficiency of the adrenal cortex in stressful situations.
- When applying Prednisolone for intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously treat antibiotics with a bactericidal effect.
- In children during long-term treatment, careful monitoring of the dynamics of growth and development is necessary. Children who have been in contact with measles or chicken pox during the treatment period are treated with prophylactic specific immunoglobulins.
- Due to the weak mineralocorticosteroid effect, substitution therapy for adrenal insufficiency prednisone is used in combination with mineralocorticosteroids.
- In patients with diabetes mellitus, blood glucose should be monitored and, if necessary, correct therapy.
- In patients with latent infectious diseases of the kidneys and urinary tract can cause leukocyturia, which may have diagnostic value.
- Increases the content of metabolites 11 - and 17-hydroxykethocorticosteroids.
With a sudden cancellation, especially in the case of the previous use of high doses, the development of the "cancellation" syndrome (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness), as well as exacerbation of the disease, about which Prednisolone was prescribed, are possible.
Due to the high pharmacological activity of prednisone, like other corticosteroids, can weaken or enhance the action of many drugs / drugs. If necessary, the use of a solution, tablets or eye drops of Prednisolone in combination with other drugs, the attending physician should consider and take into account their possible interaction.
In connection with the possible pharmaceutical incompatibility of the Prednisolone solution with other drugs administered intravenously, it is recommended to administer it separately: by bolus or through another drip. Mixing solutions of prednisolone and heparin occurs with the formation of a precipitate.
We picked up some reviews of people using the drug Prednisolone:
- Olga My daughter had atypical jaundice, to which hepatitis was later added. Atypical jaundice is when direct and indirect bilirubin is almost 50/50. This not normal. Treatment for this disease is prescribed corticosteroids, and they include Prednisone. They drank pills on schedule, which the doctor wrote, gradually reducing the dose. A month later, biochemical analysis showed that bilirubin was normal.
- Lika. My granddaughter had an allergy with terrible edema. She was admitted to hospital and prescribed Prednisolone among other drugs. During use, her appetite increased, but her immunity decreased. It is impossible to stop taking it abruptly, you need to gradually reduce the dose. Gradually, the negative effects are gone. But most importantly, this drug helped her granddaughter cope with allergies.
- Leonid. For me, this medicine existed for a very long time, but then somehow forgot about it. Found analogues suitable. And actually yesterday I had an asthma attack. Very much strong ... No one expected this even. We were then at the dacha and did not take any special medicines, because knowing my body, in the fall of attacks less often than usual. It was very nice that my aunt had prednisone. Saved me then.
On the one hand, the overall reviews of Prednisolone are positive, since the drug effectively and quickly removed an acute, life-threatening condition associated with allergic reactions, angioedema, acute renal failure, etc. On the other hand, in all the reviews there is an indication that the drug is very serious, has a wide range of side effects that can appear after one injection, and after 10 injections, depending on the individual characteristics of the organism. Therefore, in the reviews, people respond positively, but recommend using it only in critical situations, when you need a quick effect or other drugs do not help.
Structural analogues of the active substance:
- Decortin H20;
- Decortin H5;
- Decortin N50;
- Prednisolone 5mg Yenafarm;
- Prednisolone bufus;
- Prednisolone hemisuccinate;
- Prednisone Nycomed;
- Prednisolone sodium phosphate;
- Sol-Decortin H25;
- Sol-Decortin H250;
- Sol-Decortin N50.
Before using analogues consult your doctor.
Prednisolone or dexamethasone?
Dexamethasone has 7 times more potent effects than Prednisolone, so it is prescribed only short courses in emergency conditions. In addition, all side effects of Dexamethasone are also much stronger than those of Prednisolone. Therefore, if a one-time administration of glucocorticoids is necessary for health reasons, then Dexamethasone should be preferred.
If it is necessary to take hormonal preparations by course, then Prednisolone is better suited for this purpose.
Storage conditions and shelf life
Store in a place protected from light and out of reach of children, at a temperature of: tablets - up to 25 ° C, ointment, injection solution - up to 15 ° C, the solution - do not freeze; eye drops - 15-25 ° С, opened vial should be used within 4 weeks.
Shelf life depends on the manufacturer (see packaging).