Prednisolone
ORAPRED
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.
FDA-approved for
- inflammation (~1955)
FDA label
Read the full label on DailyMed ↗
| 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
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
NO BOXED WARNINGS
Principal riskAdrenal suppression with prolonged use
Cost, est. cash$4–$300/month
Generic entry1983
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHyperglycemia, infection, osteoporosis and potentially severe mood, sleep or psychotic effects.
Mechanism of action: Prednisolone ballicule
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Memory aids: mascots and interaction avatars
Active glucocorticoid, the form prednisone is converted to
