PREDNISOLONE and PREDNISONE oral

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    Last updated: September 2022

     

    Prescription under medical supervision

     

    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.

    Storage

     
    –  Below 25 °C
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