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Last updated: Acute Kidney Injury…
on 10 Apr 2017

Prednisolone

  • Immunosuppression, anti-inflammatory

  • Tablets: plain 1 mg, 5 mg or 25 mg; enteric coated 2.5 mg or 5 mg,; soluble 5 mg tablets
  • Prednisolone 5 mg ≈  hydrocortisone 20 mg ≈ methyprednisolone 4 mg ≈ dexamethasone 750 micrograms

  • Hypersensitivity to any ingredients in the formulation
  • Systemic infections unless specific anti-infective therapy is employed

  • Diabetes mellitus, glaucoma, osteoporosis, peptic ulceration
  • Do NOT stop suddenly, if patient has been on drug more than 3 weeks. This risks acute hypoadrenalism (Addison's), and acute rejection if the drug is used in renal transplantation. Withdraw drug gradually

    Note: Adrenal atrophy can persist for years after stopping drug

  • Hypertension, fluid retention, increased appetite, diabetes mellitus, psychiatric disorders ('steroid psychosis'), growth retardation in children, 'Cushinoid facies', proximal myopathy, hirsutism, thinning of skin and adrenal suppression
  • Long term effects include osteoporosis leading to avascular necrosis of femoral head (leading to # neck of femur) and verterbral crush fractures). If a patient complains of hip pain, request an MRI

    Note: this can occur within first three months of use
     

  • Variable, depends on condition being treated. Take in the morning to reduce adrenal suppression
  • Usually, for renal transplant patients, doses start at 20mg in the morning and the dose gets reduced in clinic. This does however vary between transplant centres
  • When given as an immunosuppressant non-enteric coated tablets are advisable because of their more predictable absorption

  • As in normal renal function. Not dialysed

  • Antacids can reduce absorption, avoid taking at the same time of day
  • NSAIDs may increase the risk of gastric ulceration
  • Enhanced hypokalaemic effect with diuretics and antifungals

Prednisolone#5mg#see prescribing section#PO#8

  • If you have been taking prednisolone for more than 3 weeks, you must not stop taking it suddenly. If you need to stop treatment, speak with your doctor who will advise you on how to reduce your dose gradually
  • If you become ill or come into contact with anyone who has measles, shingles or chicken pox (or suspects they might have them) you must see your doctor as soon as possible
  • Warn patients re hirsutism and Cushinoid facies, especially women
  • If you have been given a steroid treatment card, carry it with you at all times
  • Take with food. Be aware that any infections you do get will be worse than normal. Avoid live vaccines – ask your pharmacist
  • The best time of the day to take prednisolone is in the morning with breakfast.