Prednisolone

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Prednisolone: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Prednisolone

ATX code: D07AA03

Active ingredient: Prednisolone (Prednisolone)

Producer: JSC “NPTs“Elfa”, JSC“Biosintez”(Russia), JSC“Borisov plant of medical preparations”(Republic of Belarus), M. J. Biopharm Pvt. Ltd (India), Warsaw Pharmaceutical Works Polfa (Poland), Gedeon Richter Plc. (Hungary)

Description and photo update: 19.10.2018

Prices in pharmacies: from 15 rubles.

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Prednisolone is a hormonal drug, glucocorticosteroid.

Release form and composition

Prednisolone is produced by many pharmaceutical companies, with the same dosage of the active substance, drugs may differ in appearance, content of auxiliary components and packaging.

Dosage forms of Prednisolone containing the active substance:

tablets: color - white, shape - flat-cylindrical; the active ingredient is prednisolone, in 1 tablet - 1 mg or 5 mg;
solution for injection (for intravenous and intramuscular administration): slightly opalescent or transparent, slightly colored or colorless; the active ingredient is prednisolone sodium phosphate (in terms of prednisolone), in 1 ml - 15 mg or 30 mg;
ointment for external use 0.5%: color - white; the active ingredient is prednisolone, in 1 g - 5 mg;
eye drops 0.5%: white suspension; the active ingredient is prednisolone acetate, in 1 ml - 5 mg.

Pharmacological properties

Pharmacodynamics

Prednisolone is a synthetic glucocorticoid, a dehydrated analog of hydrocortisone. It has anti-inflammatory, anti-allergic, desensitizing, anti-shock, anti-toxic and immunosuppressive, antipruritic and anti-exudative effects.

Interacting with specific cytoplasmic receptors, prednisolone forms a complex that penetrates the cell nucleus, stimulates the synthesis of messenger RNA (ribonucleic acid), inducing the biosynthesis of proteins (including lipocortin), mediating cellular effects. By inhibiting the enzyme phospholipase A2, lipocortin inhibits the release of arachidonic acid, as well as the synthesis of prostaglandins and leukotrienes, which contribute to inflammatory, allergic and other pathological processes.

Prednisolone inhibits the release of β-lipotropin by the pituitary gland, but does not reduce the concentration of circulating β-endorphin, inhibits the secretion of THT (thyroid-stimulating hormone) and FSH (follicle-stimulating hormone), increases the excitability of the central nervous system (central nervous system), reduces the number of lymphocytes, eosinophils, increases the number of blood cells by stimulating the production of erythropoietins.

Pharmacological action of the drug for systemic use (tablets, solution for injection in ampoules Prednisolone):

protein metabolism: reduces the content of globulins in the plasma, increasing the synthesis of albumin in the liver and kidneys (with an increase in the albumin / globulin ratio); enhances protein catabolism in muscle tissue;
lipid metabolism: stimulates the synthesis of triglycerides and higher fatty acids; redistributes fat deposits, moving them mainly to the area of the face, shoulder girdle, abdomen; can lead to the development of hypercholesterolemia;
carbohydrate metabolism: enhances the absorption of carbohydrates from the digestive tract (gastrointestinal tract); increases the flow of glucose from the liver into the blood by increasing the activity of glucose-6-phosphatase; increases the activity of PEPKK (phosphoenolpyruvate carboxykinase) and improves the synthesis of aminotransferases by activating gluconeogenesis; can lead to the development of hyperglycemia;
water and electrolyte balance: retains sodium and water in the body; stimulates the excretion of potassium by increasing mineralocorticoid activity; reduces the absorption of calcium in the gastrointestinal tract, leaches calcium from the bone tissue, increasing its excretion in the urine;
inflammatory processes: inhibits the release of inflammatory mediators by eosinophils and mast cells; induces the formation of lipocortin and a decrease in the number of mast cells that produce hyaluronic acid; reduces capillary permeability; stabilizes cell membranes and membranes of organelles (especially lysosomal membranes);
allergic reactions: inhibits the synthesis and secretion of allergy mediators, inhibits the release of histamine and other bioactive substances from sensitized mast cells and basophils; reduces the number of circulating basophils; inhibits the development of lymphoid and connective tissues; reduces the number of mast cells, T- and B-lymphocytes; inhibits the sensitivity of effector cells to allergy mediators; inhibits antibody production; changes the body's immune response;
obstructive respiratory diseases: inhibits inflammatory processes, prevents or inhibits the development of edema of the mucous membranes, inhibits eosinophilic infiltration of the submucous layer of the bronchial epithelium and deposits of immune complexes circulating in the mucous membrane of the bronchi; stops erosion and desquamation of the mucous membrane; increases the sensitivity of β-adrenergic receptors to endogenous catecholamines and exogenous sympathomimetics in small and medium-sized bronchi; reduces the viscosity of mucus by suppressing or reducing its production;
shock, intoxication: increases blood pressure (blood pressure) due to an increase in the concentration of circulating catecholamines and restoration of adrenergic receptor susceptibility to them, as well as narrowing of the lumen of blood vessels; reduces the permeability of the vascular wall, has a membrane-protective effect, activates liver enzymes involved in the metabolic processes of endo- and xenobiotics;
immunosuppressive (immunosuppressive) therapy: inhibits the proliferation of lymphocytes (especially T-lymphocytes), inhibits the migration of B-cells and the connection of T- and B-lymphocytes, inhibits the release of cytokines (interleukin-1 and -2, gamma-interferon) from lymphocytes and macrophages by reducing the formation of antibodies; during the inflammatory process inhibits connective tissue reactions and reduces the possibility of keloid tissue formation.

When applied externally (ointment), Prednisolone has anti-inflammatory, anti-allergic, antipruritic and anti-exudative effect; inhibits the formation of arachidonic acid, the formation and release of inflammatory mediators (prostaglandins, histamine, lysosomal enzymes, leukotrienes, etc.); suppresses inflammatory skin reactions, reduces vasodilation and increased vascular permeability in the focus of inflammation.

Pharmacokinetics

The absorption of prednisolone is high, with oral administration of Prednazolone tablets, the maximum concentration in the blood is reached after 1–1.5 hours. Up to 90% of the substance in plasma binds to proteins: albumin and cortisol-binding globulin - transcortin.

The drug is metabolized in the kidneys, liver, bronchi, small intestine. In oxidized forms, the substance is glucuronized or sulfated. Its metabolites are inactive.

T½ (half-life) is 2-4 hours, prednisolone is excreted in bile and urine by means of glomerular filtration, 80-90% is reabsorbed by the tubules, up to 20% is excreted unchanged by the kidneys.

After intravenous administration, T1 / 2 of prednisolone from plasma is 2–3 hours.

When applied topically, after absorption into the general bloodstream from the skin surface and from the conjunctival cavity, prednisolone binds to plasma proteins and is metabolized mainly in the liver; excreted in the urine unchanged ≥ 20%, T½ is about 3 hours.

Indications for use

Pills

endocrine pathologies: insufficiency of the adrenal cortex, primary and secondary (including the state after ectomy of the adrenal glands), VHKN (congenital hyperplasia of the adrenal cortex), de Quervain's thyroiditis (subacute thyroiditis);
diffuse connective tissue diseases: SLE (systemic lupus erythematosus), rheumatoid arthritis, scleroderma, dermatomyositis, periarteritis nodosa;
rheumatic fever (rheumatism), acute rheumatic heart disease;
joint inflammation in acute and chronic form: periarthritis of the shoulder scapula, ankylosing spondylitis, gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), Still's syndrome in adults, polyarthritis, juvenile arthritis, bursitis, synovitis, nonspecific tendosilinitis;
allergic diseases in acute and chronic course: hypersensitivity reactions to food and drugs, medicinal exanthema, urticaria, serum sickness, hay fever, allergic rhinitis, angioedema;
bronchial asthma, including status asthmaticus;
diseases of the hematopoietic system and blood diseases: acute lymphoid and myeloid leukemias, autoimmune hemolytic anemia, panmyelopathy, lymphogranulomatosis, agranulocytosis, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythrocytic anemia (erythroblastic) vascular
skin diseases: eczema, pemphigus, exfoliative / atopic dermatitis, psoriasis, contact dermatitis (with lesions of large areas of the skin), diffuse neurodermatitis, toxidermia, Lyell's syndrome (toxic epidermal necrolysis), seborrheic dermatitis, bullous herpetiformis dermatitis (Stevens Johnson syndrome) exudative erythema);
inflammatory and allergic eye diseases: allergic conjunctivitis, allergic corneal ulcers, sympathetic ophthalmia, sluggish anterior and posterior uveitis, severe, optic neuritis;
gastrointestinal diseases: ulcerative colitis, hepatitis, Crohn's disease, local enteritis;
multiple myeloma;
bronchogenic carcinoma (lung cancer): as part of complex treatment with cytostatics;
pulmonary pathologies: pulmonary fibrosis, acute pulmonary alveolitis, stage II – III sarcoidosis;
pulmonary tuberculosis, tuberculous meningitis;
aspiration pneumonia (as part of complex treatment with specific chemotherapy);
Leffler's syndrome not amenable to other treatments, beryllium disease;
impaired renal function of an autoimmune nature (including acute glomerulonephritis), nephrotic syndrome;
multiple sclerosis;
cerebral edema (including those associated with surgery, radiation therapy, head trauma or against the background of a brain tumor) after prior use of parenteral forms of Prednisolone;
hypercalcemia due to cancer;
nausea and vomiting associated with cytostatic therapy;
transplant rejection reaction during organ transplantation - with a preventive purpose.

Injection

Prednisolone in the form of a solution for parenteral use is used in case of emergency therapy in the following conditions requiring a rapid increase in the concentration of GCS (glucocorticosteroids):

shock (traumatic, burn, operational, cardiogenic, toxic) - if vasoconstrictor drugs, plasma-substituting drugs and other symptomatic treatment are ineffective;
allergic reactions in acute and severe forms, anaphylactic shock, blood transfusion shock, anaphylactoid reactions;
cerebral edema (including associated with surgery, radiation therapy, head trauma, or against the background of a brain tumor);
severe bronchial asthma, status asthmaticus;
diffuse connective tissue diseases: SLE, rheumatoid arthritis;
thyrotoxic crisis;
acute adrenal insufficiency;
acute hepatitis, hepatic coma;
poisoning with cauterizing fluids - to reduce inflammation and prevent scarring.

Ointment

Prednisolone ointment is used in the complex treatment of inflammatory and allergic skin diseases of non-microbial etiology, such as eczema, neurodermatitis, psoriasis, lupus erythematosus, erythroderma, as well as allergic, seborrheic and contact dermatitis.

Eye drops

blunt and acute eye injuries;
keratitis (provided the corneal epithelium is completely intact);
allergic blepharoconjunctivitis in a chronic course;
uveitis of the anterior segment of the eye, scleritis, episcleritis;
postoperative period (in case of prolonged symptoms of eyeball irritation).

Contraindications

With short-term systemic use of Prednisolone for life reasons, the only contraindication for its use is increased individual sensitivity to the active or auxiliary components.

With caution, Prednisolone in the form of tablets and solution is prescribed for the following conditions / diseases:

infections and invasions of a fungal, bacterial or viral nature (current or recently transferred, including recent contact with an infected person): herpes simplex, chickenpox, herpes zoster (in the viremic phase), measles, systemic mycosis, strongyloidosis, amebiasis, tuberculosis in active and latent phases. In severe infectious diseases, the use of prednisolone is possible only against the background of specific therapy;
perivaccinal period (8 weeks before vaccination and 2 weeks after), lymphadenitis after anti-tuberculosis vaccination with BCG (Bacillus Calmette - Guerin);
immunodeficiency conditions, including acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV);
gastrointestinal diseases: gastritis, gastric ulcer and duodenal ulcer, esophagitis, peptic ulcer in acute or latent course, recently formed intestinal anastomosis, diverticulitis, ulcerative colitis with the threat of abscess formation or perforation;
cardiovascular pathologies, including a recent myocardial infarction (in patients with acute / subacute myocardial infarction, a focus of necrosis may spread with a slowdown in the formation of scar tissue, which can lead to rupture of the heart muscle), arterial hypertension, uncompensated chronic heart failure, hyperlipidemia;
endocrine disorders: thyrotoxicosis, diabetes mellitus (including impaired carbohydrate tolerance), hypothyroidism, Itsenko-Cushing's disease, grade 3-4 obesity;
severe renal / hepatic failure, nephrourolithiasis;
hypoalbuminemia and conditions predisposing to its appearance;
systemic osteoporosis, myasthenia gravis, poliomyelitis (with the exception of bulbar encephalitis), acute psychosis, glaucoma (open-angle and closed-angle);
pregnancy.

Ointment Prednisolone is contraindicated for use in bacterial, viral, fungal skin lesions, tuberculosis, syphilis, skin tumors, acne vulgaris, rosacea, post-vaccination skin reactions, open wounds, trophic ulcers, in children under 1 year of age and with increased individual sensitivity to its components.

The ointment is used with caution during pregnancy and lactation.

Contraindications to the use of Prednisolone eye drops:

increased intraocular pressure;
treelike keratitis caused by Herpes zoster, chickenpox, other viral diseases of the cornea and conjunctiva;
fungal, mycobacterial, acute purulent eye diseases;
corneal epitheliopathy;
hypersensitivity to the components of the drug.

Instructions for the use of Prednisolone: method and dosage

The dose of prednisolone and the duration of treatment are selected by the doctor on an individual basis, depending on the indications and severity of the disease.

Pills

Prednisolone tablets are taken orally with a small amount of liquid, in the morning (from 6 to 8 am) with breakfast or immediately after it.

Usually they take a daily dose every day, or a double dose every other day. The high daily dose is divided into 2-4 doses, most of it is taken in the morning.

In acute conditions and as a substitution treatment, adult patients are recommended to start with a dose of 20-30 mg / day; maintenance therapy is carried out at a dose of 5-10 mg / day, some diseases (for example, nephrotic syndrome, certain rheumatic diseases) require higher doses. Children's daily doses: initial - 1-2 mg / kg in 4-6 doses; supporting - 0.3-0.6 mg / kg.

It is necessary to stop treatment gradually, slowly reducing the dose. If there is a history of psychoses, therapy with high doses is carried out under the strict supervision of a specialist.

When prescribing, the daily secretory rhythm of GCS is taken into account: in the morning, take the whole dose at a time or most of it.

Injection

Prednisolone in the form of a solution is administered intravenously, usually the first injection is carried out in a stream, and the repeated injections are given by drip. If intravenous administration is impossible for any reason, the solution is administered intramuscularly in the same doses.

Application according to indications:

acute adrenal insufficiency: single dose - 100-200 mg; daily - 300-400 mg;
severe allergic reactions: daily dose - 100-200 mg, course duration - 3-16 days;
bronchial asthma: course dose - 75-675 mg, course duration - 3-16 days; in severe cases, it is possible to increase the course dose to 1400 mg or more;
status asthmaticus: starting daily dose of 500–1200 mg, followed by a gradual decrease to 300 mg and a transition to maintenance doses;
thyrotoxic crisis: 100 mg 2-3 times a day, if necessary, the daily dose can be increased to 1000 mg; the duration of the course depends on the therapeutic effect and is usually at least 6 days;
shock resistant to standard therapy: the initial dose, as a rule, is administered in a stream, then switched to drip infusion; if blood pressure does not rise within 10–20 minutes, repeat the jet injection. After withdrawal from the state of shock, drip administration is continued until blood pressure stabilizes. Single dose - 50-150 mg (in severe cases, increase to 400 mg); re-introduction is carried out after 3-4 hours; the daily dose varies from 300 to 1200 mg with a further gradual decrease;
acute hepatic / renal failure (acute poisoning, postoperative or postpartum periods, etc.): daily dose - 25–75 mg; according to indications, it can be increased to 300-1500 mg and more;
rheumatoid arthritis and SLE: 75–125 mg / day is administered for no more than 7–10 days in addition to systemic prednisolone;
acute hepatitis: daily dose - 75-100 mg, course duration - 7-10 days;
poisoning with cauterizing liquids, burns of the upper respiratory tract and digestive tract: a daily dose of 75 to 400 mg, depending on the severity of the condition, the duration of the course is 3–18 days.

Long-term prednisolone therapy should not be stopped suddenly. After relief of acute conditions, they switch to oral administration of the drug in the form of tablets with a gradual dose reduction.

Recommended dosage for children: from 2 to 12 months - at the rate of 2-3 mg / kg; from 1 to 14 years old - 1-2 mg / kg; the solution is injected intramuscularly, and when such an introduction is impossible - intravenously slowly (about 3 minutes). If necessary, you can re-enter the same dose after 20-30 minutes.

Ointment

The ointment is applied externally, applying a thin layer to the affected skin. To enhance the effect in limited areas, occlusive dressings can be used.

Recommended dosage: apply the ointment 1-3 times a day, the duration of the course is, as a rule, 6-14 days; in the aftercare process, it is allowed to use the drug once a day.

In order to prevent relapses and in the treatment of chronic diseases, the use of the ointment continues for some time after the complete disappearance of all symptoms, but not longer than 14 days.

Areas with denser skin (palms, feet, elbows), as well as areas where the ointment is easily rubbed off, can be lubricated more often.

Eye drops

The drug is instilled into the conjunctival sac. The duration of the course is determined by the attending physician.

Standard therapeutic dosage regimen of Prednisolone: 1-2 drops 2-4 times a day.

In order to relieve inflammatory symptoms due to trauma to the eyeball, instillation of prednisolone is recommended once a day.

Side effects

Tablets, solution for injection

endocrine system: impaired glucose tolerance, steroid diabetes / manifestation of latent diabetes, inhibition of adrenal cortex function, Itsenko-Cushing's syndrome (pituitary-type obesity, moon-like face, hirsutism, increased blood pressure, amenorrhea, dysmenorrhea, striae, muscular weakness) in children;
digestive system: nausea / vomiting, steroid stomach and duodenal ulcer, pancreatitis, erosive esophagitis, wall perforation / gastrointestinal bleeding, indigestion, increased / decreased appetite, hiccups, flatulence; rarely - increased activity of liver enzymes;
cardiovascular system: arrhythmias, development (in case of predisposition) or increased severity of diagnosed heart failure, changes in electrocardiogram indicators characteristic of hypokalemia, increased blood pressure, bradycardia (up to cardiac arrest), hypercoagulation, thrombosis; in acute and subacute myocardial infarction - the growth of the focus of necrosis and the slowing down of scar formation, which may result in a rupture of the heart muscle;
nervous system: headache, dizziness, disorientation, euphoria, delirium, hallucinations, depression, manic-depressive psychosis, paranoia, nervousness or anxiety, increased intracranial pressure, vertigo, insomnia, cerebellar pseudotumor, convulsions;
sensory organs: increased intraocular pressure (possible damage to the optic nerve), posterior subcapsular cataract, tendency to secondary bacterial, fungal or viral infection of the eyes, exophthalmos, trophic pathologies of the cornea, sudden loss of vision (due to parenteral administration to the neck, head, nasal concha, into the scalp, the drug can crystallize in the vessels of the eye);
metabolism: increased calcium excretion, hypocalcemia, weight gain, increased protein breakdown (negative nitrogen balance), hyperhidrosis; side effects due to mineralocorticoid activity - hypernatremia, peripheral edema as a result of fluid and sodium retention, hypokalemic syndrome manifested by hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue;
the musculoskeletal system: premature closure of the epiphyseal zones in children with retardation of growth and ossification processes, osteoporosis, steroid myopathy, rupture of muscle tendons, atrophy of muscle mass; very rarely - aseptic necrosis of the head of the hip and humerus, pathological bone fractures;
skin and mucous membranes: petechiae, ecchymosis, delayed wound healing, thinning of the skin, hypo- or hyperpigmentation, striae, steroid acne, a tendency to pyoderma and candidiasis;
hypersensitivity reactions: skin rash, itching, local allergic reactions, anaphylactic shock;
local reactions (parenteral administration): at the injection site - numbness, burning, pain, tingling, infections; rarely - scarring, necrosis of surrounding tissues; intramuscular injection (especially in the deltoid muscle) - atrophy of the skin and subcutaneous tissue;
other reactions: leukocyturia, development / exacerbation of infections (the occurrence of this side effect is facilitated by simultaneously used immunosuppressants and vaccination), withdrawal syndrome.

Ointment

Possible side effects due to the use of Prednisolone ointment: steroid acne, purpura, telangiectasia, burning, itching, irritation and dry skin.

Prolonged use and / or application of the ointment on large surfaces can cause the development of hypercortisolism due to the resorptive action of prednisone. In such cases, the use of the drug must be stopped and a specialist must be consulted.

In case of aggravation of the described side effects, or the appearance of any other reactions not listed in this instruction, you should inform your doctor about them.

Eye drops

After instillation of prednisone, a transient burning sensation is possible.

The result of prolonged use may be an increase in intraocular pressure, and therefore preparations containing GCS are used for no more than 10 days and under regular monitoring of intraocular pressure.

Continuous use of the ophthalmic suspension for 3 months or more can cause the development of posterior capsular cataract.

Overdose

A sign of systemic overdose of prednisolone is an increase in dose-dependent side effects. It is recommended to carry out symptomatic treatment with a gradual dose reduction, if necessary, until the drug is discontinued.

Overdose when applied topically (ointment, eye suspension) can cause local side effects in the form of allergic reactions, the occurrence of which requires immediate discontinuation of the drug.

special instructions

Before starting therapy, in order to identify possible contraindications, it is necessary to conduct a clinical examination of the patient, including fluoroscopy of the lungs, examination of the gastrointestinal tract, cardiovascular system, the organ of vision and urinary system.

Before starting treatment and during steroid therapy, it is required to regularly monitor the general blood counts, the concentration of electrolytes in the plasma, the glucose in the urine and blood.

You should not vaccinate while using GCS, especially in high doses, since its effectiveness will be reduced.

With tuberculosis, Prednisolone is prescribed only in combination with anti-tuberculosis drugs.

Systemic administration of medium and high doses of the drug can cause an increase in blood pressure.

The use of prednisolone for intercurrent infections associated with septic conditions should be supported by antibiotic therapy.

Long-term treatment of corticosteroids requires the appointment of potassium preparations to avoid hypokalemia.

In chronic insufficiency of the adrenal cortex (Addison's disease), prednisolone is contraindicated to be taken simultaneously with barbiturates due to the risk of developing an Addison crisis.

In the case of a sudden discontinuation of the drug, especially with high-dose therapy, GCS withdrawal syndrome occurs, accompanied by a deterioration in appetite, nausea, lethargy, generalized musculoskeletal pain, asthenia.

It is possible to reduce the likelihood of adrenal insufficiency and associated complications by gradually withdrawing Prednisolone. Due to the fact that adrenal insufficiency after drug withdrawal can last for months, any stressful situation during this period requires the resumption of hormonal therapy.

The presence of hypothyroidism and / or liver cirrhosis in a patient may enhance the effect of GCS.

Patients should be warned in advance about the need for them and their environment to avoid contact with infected measles, herpes and chickenpox. With the current systemic treatment of GCS, or if they were used in the next 3 months, patients who have not been vaccinated need to take specific immunoglobulins.

In the case of replacement therapy of adrenal insufficiency due to the weak mineralocorticoid action, prednisolone is recommended to be used in combination with mineralocorticoids.

With diabetes mellitus, blood glucose control is required and, if necessary, the dosage regimen must be adjusted.

Periodic X-ray control of the osteoarticular system is recommended (pictures of the hands, spine).

In patients with infectious diseases of the kidneys and urinary tract in a latent course, prednisolone can cause leukocyturia, which is clinically significant for diagnosis.

GCS increase the content of metabolites of 11- and 17-oxyketocorticosteroids.

Like other topical corticosteroids, Prednisolone ointment should not be applied to the skin around the eyes due to the risk of developing glaucoma / cataracts, as well as to open wound surfaces.

In case of complication of the disease by the development of a secondary fungal or bacterial infection, a specific antibacterial / antimycotic drug should be added to prednisolone therapy.

It is not recommended to use Prednisolone drops with contact lenses; lenses should be removed before instillation and put on again no earlier than 15 minutes after the procedure. Long-term use of drops can increase intraocular pressure, therefore, if they are used for 2 weeks or more, regular monitoring of intraocular pressure is required.

GCS therapy can mask the symptoms of a current bacterial / fungal infection, the presence of which is an indication for the use of prednisolone as part of a combination therapy with topical antibiotics.

Influence on the ability to drive vehicles and complex mechanisms

According to the instructions, Prednisolone, used systemically, can cause dizziness and other adverse reactions that can affect coordination of movements, reaction speed and concentration, therefore, it is not recommended to drive vehicles and maintain mechanical equipment during therapy.

After instillation of the Prednisolone suspension, lacrimation is possible, and therefore the procedure should not be carried out immediately before performing potentially dangerous types of work.

There is no data on the effect of Prednisolone in the form of an ointment on the ability to drive vehicles and complex mechanisms.

Application during pregnancy and lactation

The use of prednisolone systemically and locally, in the form of eye drops during pregnancy, is possible for health reasons in case of a justified excess of the intended benefit to the mother over the potential risk to the fetus.

Long-term systemic therapy of GCS in pregnant women does not exclude the possibility of impaired fetal growth. The use of prednisone in the third trimester increases the risk of atrophy of the fetal adrenal cortex, and therefore the newborn may require replacement therapy.

It is recommended to apply prednisolone topically for the shortest possible course, the ointment should be applied to small areas of the skin surface.

GCS is excreted in breast milk, therefore, when used during breastfeeding, precautions are required, in particular, do not apply ointment to the skin of the breast shortly before feeding. If it is necessary to use the drug systemically during lactation, or if Prednisolone ointment is applied to the skin in large doses and / or for an extended period, breastfeeding should be interrupted during therapy.

Pediatric use

In pediatrics, GCS are used only for absolute indications, under the close supervision of a physician, since they can cause growth retardation in children and adolescents. Usually, the risks of developing such side effects can be avoided or minimized by the appointment of prednisone every other day.

Children who have been in contact with infected measles or chickenpox in the course of treatment need specific immunoglobulins for prevention.

The value of the ratio of area to body weight in children is greater than in adults, therefore they are more at risk of suppression of the function of the hypothalamic-pituitary-adrenal system and the development of hypercortisolism due to the use of any GCS for local use. However, in infants, diapers, diapers, and skin folds can have a similar effect to an occlusive dressing, thereby increasing the systemic resorption of prednisolone.

In childhood and adolescence, Prednisolone should be used in the minimum effective dose, in the shortest possible course, and always under the supervision of a specialist.

With impaired renal function

Prednisolone tablets and solution are not prescribed for patients with severe renal failure and with nephrourolithiasis.

For violations of liver function

Prednisolone tablets and solution are not prescribed for patients with severe hepatic impairment.

Use in the elderly

When using GCS in old age, the frequency of adverse reactions increases.

Drug interactions

Due to the high pharmacological activity, prednisolone, like other corticosteroids, can weaken or enhance the effect of many drugs / drugs. If it is necessary to use Prednisolone solution, tablets or eye drops in combination with other drugs, the attending physician should consider and take into account their possible interaction.

There are no data on drug interactions of the ointment.

Due to the possible pharmaceutical incompatibility of the Prednisolone solution with other drugs administered intravenously, it is recommended to administer it separately: by bolus, or through another dropper. Mixing solutions of prednisolone and heparin occurs with the formation of a precipitate.

Analogs

The analogues of Prednisolone are: drugs for systemic use - Dexazone, Betamethasone, Medopred, Prednisol, Hydrocortisone, Dexamed, Dexamethasone, Lemod, Medrol, Kenalog, Flosteron, Deltason, Rectodelt, Metipred, Triamcinolone; ointments - Hydrocortisone, Prednisolone-Ferein; eye drops - Dexamethasone, Hydrocortisone, Dexapos, Oftan Dexamethasone, Maxidex, Dexoftan, Dexamethasonlong, Prenacid, Ozurdex.

Terms and conditions of storage

Store in a place protected from light and out of reach of children, at a temperature: tablets - up to 25 ° C, ointment, solution for injection - up to 15 ° C, solution - do not freeze; eye drops - 15-25 ° С, use the opened bottle within 4 weeks.

The expiration date depends on the manufacturer (look at the packaging).

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Prednisolone

According to reviews, Prednisolone with systemic use (tablets, injections) is quite effective, but patients complain of a large number of side effects. Discontinuation after a long course of therapy due to withdrawal syndrome is difficult, therefore, the requirement for a gradual discontinuation of treatment should be strictly observed. There are complaints about painful injection. At the same time, it is noted that in emergency cases, parenteral administration of prednisolone quickly relieves critical conditions and can save lives.

The use of the drug in dosage forms for topical use (ointment, eye drops) practically does not cause side effects, and reviews about them are mostly positive.

The price of Prednisolone in pharmacies

Estimated price for Prednisolone:

tablets 5 mg (100 pcs. in a package) - from 60 rubles;
solution for injection (Prednisolone in ampoules of 30 mg, 3 pcs. in a package) - 20-60 rubles;
ointment 0.5% (10 g in a tube) - from 13 rubles;
eye drops 0.5% (10 ml) - 780-850 rubles.

Prednisolone: prices in online pharmacies

Drug name

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Prednisolone ointment d / nar. approx. 0.5% tube 15g

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Prednisolone bufus 30 mg / ml solution for intravenous and intramuscular administration 1 ml 10 pcs.

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!