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Therapeutic action
- Steroidal anti-inflammatory drug (corticosteroid)
Indications
- Symptomatic treatment of allergic and inflammatory diseases or reactions, e.g.:
- Pneumocystis carinii (jiroveci) pneumonia with severe hypoxia
- Certain severe forms of extra-pulmonary tuberculosis
- Severe immune reconstitution syndrome, following initiation of antiretroviral or anti tuberculous treatment
- Leprosy reactions
- Severe persistent asthma, in the event of treatment failure with high doses of inhaled corticoids
- Prevention of inflammatory reaction triggered by antiparasitic treatment (e.g. trichinellosis)
Forms and strengths
- 5 mg tablet and 5 mg soluble tablet
Dosage
The dose depends on indication, patient’s response and tolerance. If treatment lasts over 10 days, a high initial dose should be reduced as quickly as possible to the lowest effective maintenance dose.
- Child:
- Initial dose: 0.5 to 2 mg/kg once daily
- Maintenance dose: 0.25 to 0.5 mg/kg once daily
- Adult:
- Initial dose: 20 to 70 mg once daily
- maintenance dose: 5 to 15 mg once daily
- Administer preferably in the morning, with food.
Duration
- According to indication and clinical response. If the treatment lasts more than 3 weeks: do not stop abruptly, reduce the daily dose gradually.
Contra-indications, adverse effects, precautions
- Do not administer to patients with active peptic ulcer (except if ulcer under treatment); infections not controlled by a specific treatment; acute viral infection (e.g. hepatitis, herpes simplex or zoster).
- May cause (prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth retardation, increased susceptibility to infections, hypokalaemia, sodium and water retention (oedema and hypertension), osteoporosis.
- In the event of acute adrenal failure, use IV hydrocortisone.
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication; take tablets just after a feed and wait 4 hours before the next feed if possible.
Remarks
- 5 mg of prednisolone has the same anti-inflammatory activity as 5 mg of prednisone, 0.75 mg of dexamethasone and 20 mg of hydrocortisone.