Drug Action
Prednisolone exerts predominantly glucocorticoid effects with minimal mineralocorticoid effects.
Source page 738
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Individual generic drug information
Extracted information for Prednisolone only.
Prednisolone exerts predominantly glucocorticoid effects with minimal mineralocorticoid effects.
Source page 738
Acute exacerbation of chronic obstructive pulmonary disease (if increased breathlessness interferes with daily activities) ▶BY MOUTH ▶Adult: 30 mg daily for 7–14 days Severe croup (before transfer to hospital) | Mild croup that might cause complications (before transfer to hospital) ▶BY MOUTH ▶Child: 1–2 mg/kg Mild to moderate acute asthma (when oral corticosteroid taken for more than a few days)| Severe or life- threatening acute asthma (when oral corticosteroid taken for more than a few days) ▶BY MOUTH ▶Child 1 month–11 years: 2 mg/kg once daily (max. per dose 60 mg) for up to 3 days, longer if necessary Mild to moderate acute asthma | Severe or life-threatening acute asthma ▶BY MOUTH ▶Child 1 month–11 years: 1–2 mg/kg once daily (max. per dose 40 mg) for up to 3 days, longer if necessary ▶Child 12–17 years: 40–50 mg daily for at least 5 days ▶Adult: 40–50 mg daily for at least 5 days Suppression of inflammatory and allergic disorders ▶BY MOUTH ▶Adult: Initially 10–20 mg daily, dose preferably taken in the morning after breakfast, can often be reduced within a few days but may need to be continued for several weeks or months; maintenance 2.5–15 mg daily, higher doses may be needed; cushingoid side- effects increasingly likely with doses above 7.5 mg daily ▶BY INTRAMUSCULAR INJECTION ▶Adult: 25–100 mg 1–2 times a week, as prednisolone acetate Suppression of inflammatory and allergic disorders (initial dose in severe disease) ▶BY MOUTH ▶Adult: Initially up to 60 mg daily, dose preferably taken in the morning after breakfast, can often be reduced within a few days but may need to be continued for several weeks or months Idiopathic thrombocytopenic purpura ▶BY MOUTH ▶Adult: 1 mg/kg daily, gradually reduce dose over several weeks Ulcerative colitis | Crohn’s disease ▶BY MOUTH ▶Adult: Initially 20–40 mg daily until remission occurs, followed by reducing doses, up to 60 mg daily, may be used in some cases, doses preferably taken in the morning after breakfast Neuritic pain or weakness heralding rapid onset of permanent nerve damage (during reversal reactions multibacillary leprosy) ▶BY MOUTH ▶Adult: Initially 40–60 mg daily, dose to be instituted at once Generalised myasthenia gravis (when given on alternate days) ▶BY MOUTH ▶Adult: Initially 10 mg once daily on alternate days, then increased in steps of 10 mg once daily on alternate days, increased to 1–1.5 mg/kg once daily on alternate days (max. per dose 100 mg) Generalised myasthenia gravis in ventilated patients (when given on alternate days) ▶BY MOUTH ▶Adult: Initially 1.5 mg/kg once daily on alternate days (max. per dose 100 mg) Generalised myasthenia gravis (when giving daily) ▶BY MOUTH ▶Adult: Initially 5 mg daily, increased in steps of 5 mg daily. maintenance 60–80 mg daily, alternatively maintenance 0.75–1 mg/kg daily, ventilated patients may be started on 1.5 mg/kg (max. 100 mg) on alternate days Ocular myasthenia ▶BY MOUTH ▶Adult: Usual dose 10–40 mg once daily on alternate days, reduce to minimum effective dose Reduction in rate of joint destruction in moderate to severe rheumatoid arthritis of less than 2 years’ duration ▶BY MOUTH ▶Adult: 7.5 mg daily Polymyalgia rheumatica ▶BY MOUTH ▶Adult: 10–15 mg daily until remission of disease activity; maintenance 7.5–10 mg daily, reduce gradually to maintenance dose. Many patients require treatment for at least 2 years and in some patients it may be necessary to continue long term low-dose corticosteroid treatment Giant cell (temporal) arteritis ▶BY MOUTH ▶Adult: 40–60 mg daily until remission of disease activity, the higher dose being used if visual symptoms occur; maintenance 7.5–10 mg daily, reduce gradually to maintenance dose. Many patients require treatment for at least 2 years and in some patients it may be necessary to continue long term low-dose corticosteroid treatment Polyarteritis nodosa | Polymyositis | Systemic lupus erythematosus ▶BY MOUTH ▶Adult: Initially 60 mg daily, to be reduced gradually; maintenance 10–15 mg daily Symptom control of anorexia in palliative care ▶BY MOUTH ▶Adult: 15–30 mg daily Pneumocystis pneumonia in moderate to severe infections associated with HIV infection ▶BY MOUTH ▶Adult: 50–80 mg daily for 5 days, the dose is then reduced to complete 21 days of treatment, corticosteroid treatment should ideally be started at the same time as the anti-pneumocystis therapy and certainly no later than 24–72 hours afterwards. The corticosteroid should be withdrawn before anti- pneumocystis treatment is complete Short-term prophylaxis of episodic cluster headache as monotherapy or in combination with verapamil during verapamil titration ▶BY MOUTH ▶Adult: 60–100 mg once daily for 2–5 days, then reduced in steps of 10 mg every 2–3 days until prednisolone is discontinued Proctitis ▶BY RECTUM USING RECTAL FOAM ▶Adult: 1 metered application 1–2 times a day for 2 weeks, continued for further 2 weeks if good response, to be inserted into the rectum, 1 metered application contains 20 mg prednisolone ▶BY RECTUM USING SUPPOSITORIES ▶Adult: 5 mg twice daily, to be inserted in to the rectum morning and night, after a bowel movement Distal ulcerative colitis ▶BY RECTUM USING RECTAL FOAM ▶Adult: 1 metered application 1–2 times a day for 2 weeks, continued for further 2 weeks if good response, to be inserted into the rectum, 1 metered application contains 20 mg prednisolone Rectal complications of Crohn’s disease ▶BY RECTUM USING SUPPOSITORIES ▶Adult: 5 mg twice daily, to be inserted in to the rectum morning and night, after a bowel movement Rectal and rectosigmoidal ulcerative colitis | Rectal and rectosigmoidal Crohn’s disease ▶BY RECTUM USING ENEMA ▶Adult: 20 mg daily for 2–4 weeks, continued if response good, to be used at bedtime
Source pages 738, 739
▶With rectal use Abdominal or local infection. bowel perforation. extensive fistulas. intestinal obstruction. recent intestinal anastomoses
Source page 739
▶With rectal use Systemic absorption may occur with rectal preparations ▶With systemic use Duchenne’s muscular dystrophy (possible transient rhabdomyolysis and myoglobinuria following strenuous physical activity). systemic sclerosis (increased incidence of scleroderma renal crisis with a daily dose of 15 mg or more)
Source page 739
Palliative care For further information on the use of prednisolone in palliative care, see www.medicinescomplete. com/#/content/palliative/systemic-corticosteroids.
Source page 739
Extracted information for Prednisolone only.
SAFE PRACTICE ▶With systemic use Prednisolone has been confused with propranolol; care must be taken to ensure the correct drug is prescribed and dispensed.
Source page 739
→Appendix 1: corticosteroids
Source page 739
▶With intramuscular use Diarrhoea. dizziness. hiccups. Kaposi’s sarcoma. myocardial rupture (following recent myocardial infarction). scleroderma renal crisis. vomiting ▶With oral use Diarrhoea. dizziness. dyslipidaemia. lipomatosis. protein catabolism. scleroderma renal crisis
Source page 739
As it crosses the placenta 88% of prednisolone is inactivated. Monitoring ▶With systemic use Pregnant women with fluid retention should be monitored closely.
Source page 739
Prednisolone appears in small amounts in breast milk but maternal doses of up to 40 mg daily are unlikely to cause systemic effects in the infant. Monitoring ▶With systemic use Infant should be monitored for adrenal suppression if mother is taking a dose higher than 40 mg.
Source page 739
Endocrine system ▶With systemic use Manufacturer advises monitor blood pressure and renal function (s-creatinine) routinely in patients with systemic sclerosis—increased incidence of scleroderma renal crisis.
Source page 739
Extracted information for Prednisolone only.
There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution, enema Foam ▶Prednisolone (Non-proprietary) Prednisolone (as Prednisolone sodium metasulfobenzoate) 20 mg per 1 application Prednisolone 20mg/application foam enema | 14 dose P £187.00 DT = £187.00 Gastro-resistant tablet CAUTIONARY AND ADVISORY LABELS 5, 10, 25 ▶Prednisolone (Non-proprietary) Prednisolone 1 mg Prednisolone 1mg gastro-resistant tablets | 30 tablet P £2.23 DT = £2.23 Prednisolone 2.5 mg Prednisolone 2.5mg gastro-resistant tablets | 28 tablet P £1.29 DT = £1.26 | 30 tablet P £1.23–£6.15 Prednisolone 5 mg Prednisolone 5mg gastro-resistant tablets | 28 tablet P £3.79 DT = £1.68 | 30 tablet P £1.76–£6.29 ▶Deltacortril Enteric (Alliance Pharmaceuticals Ltd) Prednisolone 2.5 mg Deltacortril 2.5mg gastro-resistant tablets | 30 tablet P £1.16 Prednisolone 5 mg Deltacortril 5mg gastro-resistant tablets | 30 tablet P £1.19 ▶Dilacort (Crescent Pharma Ltd,Teva UK Ltd) Prednisolone 2.5 mg Dilacort 2.5mg gastro-resistant tablets | 28 tablet P £1.14–£1.85 DT = £1.26 Prednisolone 5 mg Dilacort 5mg gastro-resistant tablets | 28 tablet P £1.85 DT = £1.68 Soluble tablet CAUTIONARY AND ADVISORY LABELS 10, 13, 21 ▶Prednisolone (Non-proprietary) Prednisolone (as Prednisolone sodium phosphate) 5 mg Prednisolone 5mg soluble tablets | 30 tablet P £53.48 DT = £12.62 Tablet CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Prednisolone (Non-proprietary) Prednisolone 1 mg Prednisolone 1mg tablets | 28 tablet P £4.00 DT = £0.85 Prednisolone 2.5 mg Prednisolone 2.5mg tablets | 28 tablet P £3.91 Prednisolone 5 mg Prednisolone 5mg tablets | 28 tablet P £9.86 DT = £1.48 Prednisolone 10 mg Prednisolone 10mg tablets | 28 tablet P £15.62 Prednisolone 20 mg Prednisolone 20mg tablets | 28 tablet P £31.24 Prednisolone 25 mg Prednisolone 25mg tablets | 56 tablet P £78.10 DT = £78.09 Prednisolone 30 mg Prednisolone 30mg tablets | 28 tablet P £46.86 DT = £46.86 ▶Pevanti (Advanz Pharma) Prednisolone 2.5 mg Pevanti 2.5mg tablets | 30 tablet P £1.42 DT = £1.42 Prednisolone 5 mg Pevanti 5mg tablets | 30 tablet P £0.95 Prednisolone 10 mg Pevanti 10mg tablets | 30 tablet P £1.90 DT = £1.90 Prednisolone 20 mg Pevanti 20mg tablets | 30 tablet P £3.80 DT = £3.80 Prednisolone 25 mg Pevanti 25mg tablets | 56 tablet P £40.00 DT = £78.09 Suppository ▶Prednisolone (Non-proprietary) Prednisolone (as Prednisolone sodium phosphate) 5 mg Prednisolone sodium phosphate 5mg suppositories | 10 suppository P £90.05 DT = £89.45 Endocrine system Suspension for injection ▶Deltastab (Advanz Pharma) Prednisolone acetate 25 mg per 1 ml Deltastab 25mg/1ml suspension for injection ampoules | 10 ampoule P £68.72 Oral solution CAUTIONARY AND ADVISORY LABELS 10 ▶Prednisolone (Non-proprietary) Prednisolone 1 mg per 1 ml Prednisolone 5mg/5ml oral solution unit dose | 10 unit dose P £11.41 DT = £11.41 Prednisolone 10 mg per 1 ml Prednisolone 10mg/ml oral solution sugar-free | 30 ml P £55.50 DT = £55.50 Enema ▶Prednisolone (Non-proprietary) Prednisolone sodium phosphate 200 microgram per 1 ml Prednisolone 20mg/100ml rectal solution | 7 enema P £14.95 DT = £14.95 eiiii F 709
Source pages 739, 740
Extracted information for Prednisolone only.
Medicines for Children leaflet: Prednisolone for asthma www.medicinesforchildren.org.uk/prednisolone-asthma
Source page 739
Filter the extracted dose blocks for this individual drug.
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30 mg daily for 7–14 days
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Candidate age grouping · source page 738
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40–50 mg daily for at least 5 days
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Candidate age grouping · source page 738
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Initially 10–20 mg daily, dose preferably taken
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Candidate age grouping · source page 738
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25–100 mg 1–2 times a week, as prednisolone
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Candidate age grouping · source page 738
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Initially up to 60 mg daily, dose preferably taken
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Candidate age grouping · source page 738
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1 mg/kg daily, gradually reduce dose over several
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Candidate age grouping · source page 738
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Initially 20–40 mg daily until remission occurs,
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Candidate age grouping · source page 738
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Initially 40–60 mg daily, dose to be instituted at
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Candidate age grouping · source page 738
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Initially 10 mg once daily on alternate days, then
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Candidate age grouping · source page 738
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Initially 1.5 mg/kg once daily on alternate days
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Candidate age grouping · source page 738
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Initially 5 mg daily, increased in steps of 5 mg
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Candidate age grouping · source page 738
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Usual dose 10–40 mg once daily on alternate
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Candidate age grouping · source page 738
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7.5 mg daily
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Candidate age grouping · source page 738
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10–15 mg daily until remission of disease
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Candidate age grouping · source page 738
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40–60 mg daily until remission of disease
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Candidate age grouping · source page 738
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Initially 60 mg daily, to be reduced gradually;
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Candidate age grouping · source page 738
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15–30 mg daily
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Candidate age grouping · source page 738
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50–80 mg daily for 5 days, the dose is then
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Candidate age grouping · source page 739
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60–100 mg once daily for 2–5 days, then
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Candidate age grouping · source page 739
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1 metered application 1–2 times a day for
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Candidate age grouping · source page 739
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5 mg twice daily, to be inserted in to the rectum
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Candidate age grouping · source page 739
First line only; read the complete Indications and dose section above.
1 metered application 1–2 times a day for
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 739
First line only; read the complete Indications and dose section above.
5 mg twice daily, to be inserted in to the rectum
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Candidate age grouping · source page 739
First line only; read the complete Indications and dose section above.
20 mg daily for 2–4 weeks, continued if response
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Candidate age grouping · source page 739