PREDNISOLONE and PREDNISONE oral

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

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 -