Prednisolone

DEA Class; Rx

Common Brand Names; Pediapred, FloPred, Orapred, Orapred ODT, Millipred, Millipred DP, Prelone Syrup, Veripred 20

Indicated for the treatment of Rheumatoid Arthritis.

Documented hypersensitivity

Systemic fungal infection, varicella, superficial herpes simplex keratitis

Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (<2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in maintenance of physiologic dosages (replacement therapy)

• Acne
• Adrenal suppression
• Delayed wound healing
• Diabetes mellitus
• GI perforation
• Glucose intolerance
• Hepatomegaly
• Hypokalemic alkalosis
• Increased transaminases
• Insomnia
• Menstrual irregularity
• Myopathy
• Neuritis
• Osteoporosis
• Peptic ulcer
• Perianal pruritus
• Pituitary adrenal axis suppression
• Pseudotumor cerebri (on withdrawal)
• Psychosis
• Seizure
• Ulcerative esophagitis
• Urticaria
• Vertigo
• Weight gain
• Increased IOP
• Ocular hypertension
• Conjunctival hyperemia
• Conjuctivitis
• Corneal ulcers
• Delayed wound healing
• Glaucoma
• Keratitis

Use with caution in cirrhosis, diabetes, ocular herpes simplex, hypertension, diverticulitis, following myocardial infarction, thyroid disease, seizure disorders, hypothyroidism, myasthenia gravis, hepatic impairment, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy

Thromboembolic disorders or myopathy may occur

Delayed wound healing is possible

Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

Parenteral forms (prednisolone sodium phosphate) have been discontinued

Suppression of hypothalamic-pituitary-adrenal axis may occur particularly in patients receiving high doses for prolonged periods or in young children; discontinuation of therapy should be done through slow taper

Posterior subcapular cataract formation associated with prolonged use of corticosteroids

Prolonged use of corticosteroids may increase risk of secondary infections

Increase in intraocular pressure associated with prolonged use of corticosteroids

Long-term use associated with fluid retention and hypertension

Development of Kaposi’s sarcoma associated with prolonged corticosteroid use

Acute myopathy associated with high dose of corticosteroids

Corticosteroid use may cause psychiatric disturbances

Based on findings from human and animal studies, corticosteroids, can cause fetal harm when administered to a pregnant woman

The drug has been found to be present in human milk following administration to lactating women; published reports suggest infant daily doses are estimated to be less than 1% of the maternal daily dose