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Prednisolone

    Brands

    DEA Class; Rx

    Common Brand Names; Pediapred, FloPred, Orapred, Orapred ODT, Millipred, Millipred DP, Prelone Syrup, Veripred 20

    • Corticosteroids

    Prednisolone ophthalmic (Rx)

    Brand and Other Names: Pred Forte, Pred Mild, Inflamase Mild, Omnipred, Econopred Plus, Inflamase Forte
    • Classes: Corticosteroids, Ophthalmic

    Oral and ophthalmic glucocorticoid with very little mineralocorticoid activity; active metabolite of prednisone
    Used in many conditions in adult and pediatric patients, including asthma, COPD, SLE, rheumatoid and psoriatic arthritis, and many other allergic, dermatologic, ocular, and systemic inflammatory states
    If long-term therapy required, the lowest possible effective dose should be used

    Indicated for the treatment of Rheumatoid Arthritis.

    For primary (Addison’s disease) or secondary adrenocortical insufficiency or for the treatment of congenital adrenal hyperplasia.
    For the treatment of nonsuppurative thyroiditis.
    For the treatment of Multiple Sclerosis

    For the treatment of Acute Exacerbation of COPD (Off-label)

    For the treatment of Bells Palsy (Off-label)

    For the treatment of Ophthalmic Inflammatory Conditions

    Ocular corticosteroid, antiinflammatory agent

    Effective in iritis, keratitis, conjunctivitis, and many ocular inflammatory diseases; bacterial and viral infections require concomitant antibacterial and antiviral coverage, respectively

    Documented hypersensitivity

    Systemic fungal infection, varicella, superficial herpes simplex keratitis

    Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (<2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in maintenance of physiologic dosages (replacement therapy)

    • Acne
    • Adrenal suppression
    • Delayed wound healing
    • Diabetes mellitus
    • GI perforation
    • Glucose intolerance
    • Hepatomegaly
    • Hypokalemic alkalosis
    • Increased transaminases
    • Insomnia
    • Menstrual irregularity
    • Myopathy
    • Neuritis
    • Osteoporosis
    • Peptic ulcer
    • Perianal pruritus
    • Pituitary adrenal axis suppression
    • Pseudotumor cerebri (on withdrawal)
    • Psychosis
    • Seizure
    • Ulcerative esophagitis
    • Urticaria
    • Vertigo
    • Weight gain
    • Increased IOP
    • Ocular hypertension
    • Conjunctival hyperemia
    • Conjuctivitis
    • Corneal ulcers
    • Delayed wound healing
    • Glaucoma
    • Keratitis

    Use with caution in cirrhosis, diabetes, ocular herpes simplex, hypertension, diverticulitis, following myocardial infarction, thyroid disease, seizure disorders, hypothyroidism, myasthenia gravis, hepatic impairment, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy

    Thromboembolic disorders or myopathy may occur

    Delayed wound healing is possible

    Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

    Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

    Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

    Parenteral forms (prednisolone sodium phosphate) have been discontinued

    Suppression of hypothalamic-pituitary-adrenal axis may occur particularly in patients receiving high doses for prolonged periods or in young children; discontinuation of therapy should be done through slow taper

    Posterior subcapular cataract formation associated with prolonged use of corticosteroids

    Prolonged use of corticosteroids may increase risk of secondary infections

    Increase in intraocular pressure associated with prolonged use of corticosteroids

    Long-term use associated with fluid retention and hypertension

    Development of Kaposi’s sarcoma associated with prolonged corticosteroid use

    Acute myopathy associated with high dose of corticosteroids

    Corticosteroid use may cause psychiatric disturbances

    Based on findings from human and animal studies, corticosteroids, can cause fetal harm when administered to a pregnant woman

    The drug has been found to be present in human milk following administration to lactating women; published reports suggest infant daily doses are estimated to be less than 1% of the maternal daily dose

    Dosage must be individualized and is highly variable depending on the nature and severity of the disease, and on patient response. Although there is no absolute maximum dosage per se, psychiatric events occur more commonly in patients receiving 80 mg/day of prednisone or equivalent.

    Prednisolone acetate

    oral solution

    • 5mg/5mL
    • 10mg/5mL
    • 15mg/5mL
    • 20mg/5mL
    • 25mg/5mL

    tablet

    • 5mg

    tablet, dose pack

    • 5mg (6 days [21 tabs])
    • 5mg (12 days [48 tabs])

    tablet, orally disintegrating

    • 10mg
    • 15mg
    • 30mg

    ophthalmic suspension

    • 0.12%
    • 1%

    ophthalmic solution

    • 0.11%
    • 0.9%
    • 1%