Names and pronunciation
(pred-niss′oh-lone) Millipred, Orapred, Orapred ODT, Pediapred
Source page 1077
Loading InternPractice…
Individual generic drug information
Extracted information for prednisoLONE only.
(pred-niss′oh-lone) Millipred, Orapred, Orapred ODT, Pediapred
Source page 1077
Func. class.: Corticosteroid, synthetic
Source page 1077
Chem. class.: Glucocorticoid, immedi- ate acting
Source page 1077
Do not confuse: prednisoLONE/predniSONE
Source page 1077
ACTION: Decreases inflammation by the suppression of migration of polymorphonuclear leukocytes, fibroblasts; reversal to increase capillary permeability and lysosomal stabilization
Source page 1077
USES: Severe inflammation, immuno suppression, neoplasms, asthma
Source page 1077
Extracted information for prednisoLONE only.
CONTRAINDICATIONS: Hyper sensitivity, fungal infections, viral infection, varicella Precautions: Pregnancy, breastfeeding, children, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcer- ative colitis, HF, myasthenia gravis, abrupt discontinuation, children, acute MI, GI ulcers, hypertension, hepatitis, psychosis, thromboembolism, peptic ulcer disease, renal disease, Cushing syndrome
Source page 1077
SIDE EFFECTS CNS: Depression, headache, mood changes CV: Hypertension, circulatory collapse, thrombophlebitis, embolism, tachycardia EENT: Fungal infections, increased intra- ocular pressure, blurred vision GI: Diarrhea, nausea, abdominal distention, GI hemorrhage, increased appetite, pancreatitis INTEG: Acne, poor wound healing, ecchymosis, petechiae, sweating MS: Fractures, osteoporosis, weakness, arthralgia, myopathy, tendon rupture MISC: Hyperglycemia
Source pages 1077, 1078
INTERACTIONS Increase: tendon rupture—quinolones Increase: side effects—alcohol, salicy- lates, indomethacin, amphotericin B, digitalis, cycloSPORINE, diuretics Increase: prednisoLONE action—salicy- lates, estrogens, indomethacin, oral con- traceptives, ketoconazole, macrolide antibiotics Increase: prednisoLONE effect—CYP3A4 inhibitors Increase: toxicity—azole antifungals, cycloSPORINE, NSAIDs Decrease: prednisoLONE action—chole- styramine, colestipol, barbiturates, rifAMPin, ePHEDrine, phenytoin, theophylline Decrease: effects of anticoagulants, anti- convulsants, antidiabetics, ambenonium, neostigmine, isoniazid, toxoids, vaccines, anticholinesterases, salicylates, somatrem Decrease: prednisoLONE effect— CYP3A4 inducers Drug/Lab Test Increase: cholesterol, sodium, blood glu- cose, uric acid, calcium, urine glucose Decrease: calcium, potassium, T4, T3, thyroid 131I uptake test, urine 17-OHCS, 17-KS, PBI False negative: skin allergy tests
Source page 1078
Extracted information for prednisoLONE only.
DOSAGE AND ROUTES Most conditions • Adult: PO 5-60 mg per day as a single dose or divided doses • Infant/child/adolescent: PO 0.14-2 mg/kg or 4-60 mg/m2 per day in 3-4 di- vided doses Multiple sclerosis • Adult: PO 200 mg/day × 7 day, then 80 mg every other day × 1 mo Antiinflammatory • Adult: PO 5-60 mg/day as a single dose or in divided doses • Infant/child/adolescent: PO 0.14-2 mg/kg or 4-60 mg/m2 per day in 3-4 di- vided doses Acute asthma exacerbation • Adult/adolescent: PO 40-60 mg per day as a single dose or in 2 divided doses P for 3-10 days • Child 5-12 yr: PO 1-2 mg/kg (up to 60 mg) per day in 2 divided doses for 3-10 days • Infant/child ≤4 yr: PO 1-2 mg/kg (up to 30 mg) per day in 2 divided doses for 3-10 days
Source page 1077
Available forms: Tabs 5 mg; oral disin- tegrating tab 10, 15, 30 mg; oral sol 5 mg/5 mL, 10 mg/5 mL, 15 mg/5 mL, 25 mg/5 mL; oral suspension 15 mg/mL
Source page 1077
Administer: • Oral sol: use calibrated measuring de- vice • Orally disintegrating tabs: place on tongue; allow to dissolve, swallow or swallow whole; do not cut, split
Source page 1077
Extracted information for prednisoLONE only.
Assess: • Potassium, blood glucose, urine glu- cose while patient receiving long-term therapy; hypokalemia, hyperglycemia • Weight daily; notify prescriber if weekly gain of >5 lb • B/P q4hr, pulse; notify prescriber if chest pain occurs • I&O ratio; be alert for decreasing uri- nary output, increasing edema • Plasma cortisol levels with long-term therapy; normal level: 138-635 nmol/L SI units when drawn at 8 am • Infection: increased temperature, WBC, even after withdrawal of medication; prod- uct masks infection • Potassium depletion: paresthesias, fa- tigue, nausea, vomiting, depression, poly- uria, dysrhythmias, weakness • Edema, hypertension, cardiac symptoms • Mental status: affect, mood, behavioral changes, aggression • Adrenal insufficiency: nausea, vomit- ing, lethargy, restlessness, confusion, weight loss, hypotension before, during treatment baseline and periodically; HPA suppression may be precipitated by abrupt withdrawal • Beers: avoid in older adults with de- lirium or at high risk of delirium • Pregnancy/breastfeeding: not rec- ommended in pregnancy; cautious use in breastfeeding
Source page 1078
Evaluate: • Therapeutic response: ease of respira- tions, decreased inflammation
Source page 1078
CLINICAL CONSIDERATIONS
Source page 1078
Patient and caregiver information: • That emergency ID as steroid user should be carried • To notify prescriber if therapeutic re- sponse decreases; that dosage adjust- ment may be needed • Not to discontinue abruptly; that adre- nal crisis can result; to take product ex- actly as prescribed • To avoid OTC products: salicylates, cough products with alcohol, cold preparations unless directed by pre- scriber • About cushingoid symptoms: moon face, buffalo hump, rapid weight gain, excessive sweating, stretch marks • About the symptoms of adrenal in- sufficiency: nausea, anorexia, fatigue, dizziness, dyspnea, weakness, joint pain
Source page 1078
Extracted information for prednisoLONE only.
PHARMACOKINETICS PO: Peak 1-2 hr, duration 2 days
Source page 1078
Filter the extracted dose blocks for this individual drug.
Most conditions
• Infant/child/adolescent: PO 0.14-2 mg/kg or 4-60 mg/m2 per day in 3-4 di- vided doses Multiple sclerosis
Candidate age grouping · source page 1077
Most conditions
• Infant/child/adolescent: PO 0.14-2 mg/kg or 4-60 mg/m2 per day in 3-4 di- vided doses Acute asthma exacerbation
Candidate age grouping · source page 1077
Most conditions
• Child 5-12 yr: PO 1-2 mg/kg (up to 60 mg) per day in 2 divided doses for 3-10 days
Candidate age grouping · source page 1077
Most conditions
• Infant/child ≤4 yr: PO 1-2 mg/kg (up to 30 mg) per day in 2 divided doses for 3-10 days
Candidate age grouping · source page 1077