Prednisolone

ORAPRED

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Pronunciation: pred-NIS-oe-loen

Prednisolone ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Prednisolone ballicule

Prednisolone ORAPRED mascot mnemonic cartoon — Visual mnemonic: Prednisolone mascot
**“Solo prednisone”**
Active glucocorticoid, the form prednisone is converted to

What it isActive glucocorticoid-receptor agonist; systemic treatment of inflammatory and immune disorders.

Why it mattersUnlike prednisone, it requires no hepatic activation and is available in child-friendly liquid formulations.

What it changesHyperglycemia, infection, mood effects and bone loss accumulate with exposure; prolonged use suppresses the adrenal axis and requires tapering.

Prednisolone molecular structure (skeletal formula) — Molecular structure: Prednisolone

Prednisolone prescription history

Animated chart of estimated U.S. prescriptions per year, Corticosteroids (systemic) (1950–2026). Prednisolone enters in 1955 (estimated).

FDA-approved for

inflammation (~1955)

Principal riskAdrenal suppression with prolonged use

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability3 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityHyperglycemia, infection, osteoporosis and potentially severe mood, sleep or psychotic effects.

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

FDA dosing	Population	Start	Target	Max
Corticosteroid-responsive disorders	Adult	5 mg QD	individualized to lowest effective dose	60 mg/day

Renal Undefined

Hepatic Undefined

Instructions

Individualize dose to disease and response
After long-term therapy, withdraw gradually — do not stop abruptly
Alternate-day therapy: twice the usual daily dose every other morning to reduce adrenal suppression

Available strengths

sol 5, 10, 15, 20, 25 mg/5 mL
tab 5 mg
ODT 10, 15, 30 mg
drops 0.9 %
susp 0.12, 1 %

Contraindications

Systemic fungal infections

Cautions

Adrenal suppression; risk with abrupt withdrawal
Increased susceptibility to and masking of infection
Do not give live vaccines (e.g., smallpox) during therapy; blunted immunization response
May reactivate latent tuberculosis

Adverse reactions

Fluid/sodium retention, hypertension, hypokalemia
CHF in susceptible patients
Muscle weakness, steroid myopathy, osteoporosis, vertebral fracture
Peptic ulcer with perforation/hemorrhage
Impaired wound healing, thin skin
Cushingoid state, growth suppression in children, hyperglycemia
Posterior subcapsular cataracts, glaucoma

Pregnancy No adequate human studies; weigh benefit vs risk; observe infants of treated mothers for hypoadrenalism

Lactation Undefined

Cost

Prednisolone (ORAPRED)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/unit	CostPlus
5 mg/5 mL	sol	per unit	$0.55/mL	not offered
10 mg/5 mL	sol	per unit	$2.43/mL	offered
15 mg/5 mL	sol	per unit	$0.57/mL	offered
20 mg/5 mL	sol	per unit		offered
25 mg/5 mL	sol	per unit	$0.79/mL	not offered

Generic entry1983

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Memory aids: interaction avatars

CYP3A4 substrate

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Self-check

Prednisolone: Does it require hepatic activation?
No.
Prednisolone: Why does prolonged use require tapering?
Adrenal-axis suppression.