Prednisolone is a similar drug of the new generation. An analogue of prednisolone without side effects. Indications for use

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Prednisolone for injection belongs to the group of glucocorticosteroids, the drug is intended for sufficient wide range applications and a fairly wide range of diseases. It is used both to treat asthma and to relieve anaphylactic shock or an allergy attack from an unidentified irritant. This is first aid to a person if anaphylactic shock and the opportunity to save his life. The drug is also used during radiotherapy courses and is considered a good anti-inflammatory agent.

The range of uses of the medicine is very wide; it is used and prescribed by doctors for the treatment of asthmatic diseases and allergic reactions.

About the drug

The drug three main pharmacological actions:

• Anti-inflammatory;
• Immunosuppressive;
• Antiallergic;
• Antishock;
• Antipruritic;

Prednisolone is a synthetic hormone, absolutely similar to the hormone produced by the human adrenal glands.

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Irina Martynova. Graduated from Voronezh State Medical University named after. N.N. Burdenko. Clinical resident and neurologist of the BUZ VO \"Moscow Polyclinic\".

When the adrenal glands malfunction, the hormone becomes smaller or stops being produced altogether. Lack of the hormone in the body can lead to quite sad consequences, and the drug has very strong pharmacological actions, therefore used in the treatment of really serious diseases or difficult situations threatening human life (anaphylactic shock, exacerbation of bronchial asthma). Use it only as part of complex therapy .

The drug is produced in India.

Release forms

There are several forms of release:

• . The cost of the ointment is only about 50 rubles. The main component is prednisolone, additional components: medical white paraffin, glycerin and stearic acid.
• Pills. The cost of the tablets is about 68 rubles. The main component is also prednisolone, additional components: milk sugar, potato starch, calcium stearate. Used to treat diseases of the musculoskeletal system.
• Prednisolone injections, which cost from 46 to 130 rubles. Main component: prednisolone sodium phosphate, additional components: water for injection, nicotinamide, sodium hydroxide.

Dosages and regimen of use

Dosage and application regimen differs depending on pharmacological form release and disease:

• Prednisolone in ampoules can be prescribed as droppers. In this case, the dosage and continuation of treatment is determined by the attending physician. Typically, droppers with the drug are prescribed to seriously ill patients, people with severe allergies or anaphylactic shock.
• For acute adrenal insufficiency, 300-400 mg per day is prescribed. (injections)
• For a severe allergic reaction, 100-200 mg per day is prescribed. Treatment time ranges from 10 to 16 days.
• For bronchial asthma, the course of treatment ranges from three to 16 days, the dosage is prescribed by the doctor. Self-medication is not recommended.
• For rheumatoid arthritis, an ointment may be prescribed in addition to the main medications.
• For skin allergic reactions, 1-2 tablets per day may be prescribed.

Injections can be administered intramuscularly and can make a solution for IVs.

Solution lasts for about a day, depending on susceptibility human body and diseases. One injection may be enough intramuscularly for several days, especially when treating allergic reactions and various diseases of the musculoskeletal system. The solution administered intramuscularly contains a fairly high dose of prednisolone, which has strong pharmacological properties. Injecting the solution is quite painful, but after a couple of hours (half an hour - two hours) relief comes.

Indications for use

Instructions for use indicate that the drug can be used to treat shock, accompanied by a decrease in blood pressure , acute adrenal failure, cerebral edema, asthma and rheumatoid arthritis. The drug is also used for allergies; severe allergic (anaphylactic) shock can also be treated with injections. The drug also treats hepatic coma.

The fact is that the adrenal glands stop producing the hormone in full, so the body needs an influx of synthesized hormone for normal functioning. The drug increases the synthesis of peptide inhibitors and reduces the level of PG, stabilizes lysosome membranes.

Due to this, many diseases with successful complex therapy and correct selection dosages are quickly reduced.

Contraindications

In shock conditions the drug is administered without taking into account contraindications(emergency situations such as anaphylactic shock, traumatic shock, severe allergic reaction). For longer treatment, the following must be taken into account:

• Presence of a stomach ulcer;
• Osteoporosis;
• Cushing's syndrome;
• Psychoses;
• Severe arterial hypertension;

The drug should not be used for smallpox, herpes, or herpes zoster; it is not recommended for active tuberculosis.

For acute renal failure and liver problems, Before taking it, you must consult a medical specialist.

Pregnant women in the first trimester and breastfeeding women are not recommended to take the drug. The drug is not recommended for children under 18 years of age, but in emergency situations it is likely to be used. However, when used for longer treatment, examination and consultation of several medical specialists are necessary.

Overdose and side effects

As side effects:

• Weight gain;
• Hypokalemia;
• Cushing's syndrome;
• Increased blood pressure;
• Nausea;
• Vomit;
• Diarrhea;
• Depression and hallucinations;

Manifestation side effects not necessarily, their appearance depends on the physical characteristics of the person.

In general, there are very few reported cases of side effects; the drug is well tolerated by patients even with long-term treatment. If the dosage is exceeded and an overdose occurs, nausea, vomiting, weakness, drowsiness, and dysfunction may occur. gastrointestinal tract, depression, hallucinations, sudden jump Blood pressure, swelling. To reduce an overdose, you must urgently rinse your stomach and seek medical help. ambulance. There is little information about the toxicity of the drug.

Interaction with substances

Interaction of the drug with alcohol and other drugs was noted for tablets and solution. Solution in combination with diuretics increases potassium excretion, and in combination with antidiabetic agents reduces glucose levels. Interaction with alcohol and alcohol-containing substances is extremely negative and can lead to uncontrolled side effects.

When combined with acetylsalicylic acid, the risk of bleeding in the stomach increases.

Storage

The medicine is stored for two years and is sold in pharmacies only with a prescription. You can use them as analogues (from 300 rubles), other analogues differ much more in composition and you should consult your doctor about them.

FAQ

Does it hurt to give an injection?? Painful sensations are present, but during the injection itself and the administration of the medicine there is practically no pain, painful sensations appear after a couple of hours, the pain in the gluteal muscle increases, but is quite tolerable. When inserting and puncturing the skin, pain is practically not felt, unlike B vitamins, magnesium and other drugs.

How long does it last?? In cases of shock, anaphylactic shock, or severe allergies, the injection acts almost instantly, and its effect lasts for a really long time. Sometimes just one injection is enough to completely get rid of all the consequences, and sometimes it is necessary to inject a full course for relief to occur. In general, the medicine lasts for about a couple of days.

Prednisolone is very often used by emergency physicians as a fast-acting, long-acting drug.

Reviews

Reviews from experts about prednisolone indicate that the drug is really effective in stressful and shock situations and effectively brings a person out of anaphylactic shock. This drug perfectly blocks the state of shock, literally returning a person from the other world. However, we should not forget about the many side effects of the drug and the danger of overdose. It is necessary to use the medicine wisely, not exceeding the prescribed dose, and do not use it if there are contraindications or hypersensitivity to one of the components.

On special forums, a lot of different reviews about the drug have been collected, both positive and negative.

Most patients note the extreme effectiveness of prednisolone, especially in stressful or shock situations. Many people note painful sensations some time after the injection in that area, itching, burning.

Many patients noted a significant improvement in their well-being after use for rheumatoid arthritis and diseases of the musculoskeletal system. They reduce pain, relieve most of the inflammation, and lower body temperature. On forums dedicated to children and their illnesses, mothers also note the effectiveness of the drug when administered intravenously to children.

In general, the reviews are positive character, proving the effectiveness of the drug. Negative feedback not so much, mostly either the dosage is exceeded or individual intolerance is revealed.

For allergic reactions and anaphylactic shock, it has established itself as a reliable and effective remedy that has a good targeted effect, especially if anaphylactic shock is caused by an unknown irritant and urgent medical care is necessary.

Prednisolone injections are a drug with enhanced biological activity that is used in emergency situations. Injections of the drug can have antiallergic, anti-inflammatory and immunosuppressive effects.

The form of the drug used determines the speed of its effect and the likelihood of adverse reactions. Prednisolone tablets are prescribed for long-term therapy, and the drug in ampoules is used when delay is dangerous. When administered intramuscularly, the medicine begins to act after a quarter of an hour, when intravenous injections- in 3 minutes.

Prednisolone injections, according to the instructions for use, are prescribed under the following clinical circumstances:

• Acute allergic manifestations;
• A complication of diffuse toxic goiter that threatens the patient’s life;
• Intractable attack of bronchial asthma;
• Shock condition that is not amenable to prescribed treatment;
• Renal, liver failure in an aggravated form;
• Rheumatic ailments;
• Hepatitis;
• Pathology of the adrenal cortex;
• Prevention of scar formation when damaged by cauterizing substances.

Besides emergency assistance, injections of the drug are included in complex treatment malignant neoplasms, chronic pulmonary, autoimmune and skin diseases, heart pathologies. Prednisolone injections are used in hematology and ophthalmological practice.

The dosage and duration of therapy should be determined by the doctor. It takes into account the severity of the disease, the patient’s health status, concomitant ailments and possible contraindications.

The average dose is 10-30 mg of the drug intramuscularly. From 30 to 200 mg is administered through an IV in emergency situations.

For children, the amount of medication is prescribed at the rate of 1-3 mg per 1 kg of body weight.

The drug is administered intravenously through a dropper or intramuscularly. After relief of the emergency condition, Prednisolone is taken in tablet form.

Contraindications

Prednisolone, according to the instructions for the use of intramuscular injections, is very effective, but has a whole list of contraindications and undesirables side effects. Injections are not prescribed if you are intolerant or hypersensitive to the ingredients of the medication. It is used with extreme caution:

1. In immunodeficiency conditions;
2. During the period of therapy and recovery from viral infectious diseases;
3. In patients with illnesses digestive tract;
4. After administration of the vaccine;
5. Patients with pathologies of the cardiovascular and endocrine systems;
6. In case of renal failure.

Prednisolone injections for pregnant women and young children are prescribed solely based on vital signs under direct medical supervision. During treatment with this medication, breastfeeding must be interrupted. The drug is not prescribed to children under 3 months and elderly people over 70 years of age.

The following side effects were observed during Prednisolone therapy:

• Muscular atrophy;
• Weight gain;
• Decreased ability of the body to process glucose;
• Adrenal gland dysfunction;
• Insulin-dependent diabetes mellitus;
• Increase in intracranial and blood pressure;
• Stomach ulcer or duodenum;
• Sinus rhythm disturbance;
• Inhibition of sexual development in adolescents,
• Corneal pathologies;
• Increased sweating;
• Convulsions;
• Migraine;
• Sleep disorders;
• Depression, confusion.

At the injection site, rashes, itching and other local allergic manifestations are possible.

Prednisolone is a synthetic glucocorticoid hormone (glucocorticosteroid), similar in its spectrum of therapeutic activity to those normally produced in the human body by the adrenal glands.

Glucocorticosteroids, including Prednisolone, are used orally in the form of tablets, systemically in the form of injections, and topically - ointment is applied to the skin and eyes. The drug has anti-inflammatory, antiallergic, antishock, antiexudative, antiproliferative, antipruritic and immunosuppressive effects.

In this article we will look at why doctors prescribe the drug Prednisolone, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Prednisolone, leave your feedback in the comments.

Composition and release form

Clinical and pharmacological group: GCS for oral administration.

• Active ingredient: 1 ml of solution contains prednisolone sodium phosphate in terms of prednisolone - 30 mg;
• Excipients: sodium hydrogen phosphate anhydrous, sodium dihydrogen phosphate dihydrate, propylene glycol, water for injection.

Release form: 1 ml or 2 ml of drug solution in an ampoule. 3, 5 or 10 ampoules per pack.

What is Prednisolone used for?

Inflammatory joint diseases:

• acute and subacute bursitis;
• epicondylitis;
• acute tendovaginitis;
• post-traumatic osteoarthritis.

Oncological diseases:

• acute and chronic leukemia;
• lymphomas;
• mammary cancer;
• prostate cancer;
• multiple myeloma.

Rheumatic diseases:

• rheumatoid arthritis, juvenile rheumatoid arthritis (in cases resistant to other treatment methods);
• psoriatic arthritis;
• ankylosing spondylitis;
• acute gouty arthritis;
• acute rheumatic fever;
• myocarditis (including rheumatic);
• dermatomyositis;
• systemic lupus erythematosus;
• granulomatous giant cell mesoarteritis;
• systemic scleroderma;
• periarteritis nodosa;
• relapsing polychondritis;
• polymyalgia rheumatica (Horton's disease);
• systemic vasculitis.

Endocrinological diseases:

• adrenal insufficiency: primary (Addison's disease) and secondary;
• adrenogenital syndrome (congenital adrenal hyperplasia);
• acute failure adrenal cortex;
• before surgery and during serious illnesses and injuries in patients with adrenal insufficiency;
• subacute thyroiditis.

Heavy allergic diseases resistant to other therapy:

• contact dermatitis;
• atopic dermatitis;
• serum sickness;
• hypersensitivity reactions to drugs;
• permanent or seasonal allergic rhinitis;
• anaphylactic reactions;
• angioedema.

Dermatological diseases:

• exfoliative dermatitis;
• bullous dermatitis herpetiformis;
• severe seborrheic dermatitis;
• severe erythema multiforme (Stevens-Johnson syndrome);
• mycosis fungoides;
• pemphigus;
• severe psoriasis;
• severe forms of eczema;
• pemphigoid.

Hematological diseases:

• acquired autoimmune hemolytic anemia;
• congenital aplastic anemia;
• idiopathic thrombocytopenic purpura (Werlhof's disease) in adults;
• hemolysis.

Liver diseases:

• alcoholic hepatitis with encephalopathy;
• chronic active hepatitis.

Neurological diseases:

• tuberculous meningitis with subarachnoid block;
• multiple sclerosis in the acute phase;
• myasthenia gravis.

Eye diseases (severe acute and chronic allergic and inflammatory processes):

• severe sluggish anterior and posterior uveitis;
• optic neuritis;
• sympathetic ophthalmia.

Respiratory diseases:

• bronchial asthma;
• berylliosis;
• Loeffler's syndrome;
• symptomatic sarcoidosis;
• fulminant or disseminated pulmonary tuberculosis (in combination with anti-tuberculosis chemotherapy);
• chronic pulmonary emphysema (resistant to treatment with aminophylline and beta-agonists).

During organ and tissue transplantation to prevent and treat graft rejection (in combination with other immunosuppressive drugs).

pharmachologic effect

Prednisolone is a synthetic analogue of the hormones cortisone and hydrocortisone secreted by the adrenal cortex. Prednisolone is 4-5 times more active than cortisone and 3-4 times more active than hydrocortisone when used orally. Unlike cortisone and hydrocortisone, prednisolone does not cause noticeable sodium and water retention and only slightly increases potassium excretion.

The drug has a pronounced anti-inflammatory, anti-allergic, anti-exudative, anti-shock, anti-toxic effect.

Instructions for use

The dosage regimen is set individually depending on the indications, the effectiveness of therapy and the patient’s condition. In accordance with the daily rhythm of secretion of endogenous glucocorticoids, the drug is recommended to be taken once a day in the morning. In some cases more is required frequent use drug. After achieving the desired therapeutic effect, it is recommended to gradually reduce the dose to the minimum effective.

1. Prednisolone tablets. At the beginning of treatment for acute and severe conditions, you should take 50–75 mg (10–15 tablets) per day, and for chronic diseases – 20–30 mg per day (4–6 tablets). After normalization of the condition, the dosage of Prednisolone is reduced to 5–15 mg per day and the tablets are continued. The duration of treatment is determined by the doctor and depends on the general condition of the person and the effectiveness of the therapy.
2. Prednisolone ampoules. In case of shock, 50–150 mg of Prednisolone (2–5 ml of 3% (30 mg/ml) solution) is administered at a time. The same amount of solution is reintroduced every 3 to 4 hours during the first 24 hours. After this, the doctor determines whether it is necessary to continue the Prednisolone injections or whether they can be stopped. In case of acute adrenal and liver failure, as well as allergic reactions, 100–200 mg of Prednisolone is administered every 8 hours. For status asthmaticus, 500–1200 mg of Prednisolone is administered once, on the second day the dosage is reduced to 300 mg, on the third day to 150 mg and on the fourth day to 100 mg. On days 5–6, Prednisolone can be discontinued if status asthmaticus does not recur.


3. Prednisolone ointment. The ointment is applied in a thin layer to the affected areas of the skin 1 - 3 times a day for 6 - 14 days. The use of the ointment should be discontinued as soon as the therapeutic effect is achieved. It is not recommended to apply the ointment under a tight bandage, as this may provoke absorption large quantity ointments into the bloodstream with the development of systemic side effects. The ointment should not be used for longer than 14 days without breaks.

Prednisolone in tablets and solution is optimally administered from 6 to 8 am, and during these hours all or most of the daily dose should be taken (at least 2/3). If a stressful situation occurs in a person taking glucocorticoids, Prednisolone should be administered until the effect of stress passes.

If a person has suffered from psychosis in the past, then high dosages of Prednisolone should only be taken under the supervision of a doctor.

Contraindications

Severe forms of hypertension (persistent rise in blood pressure), diabetes mellitus and Itsenko-Cushing's disease, pregnancy, stage III circulatory failure, acute endocarditis (inflammation of the internal cavities of the heart), psychosis, nephritis (inflammation of the kidneys), osteoporosis, gastric and duodenal ulcers intestines, recent operations, syphilis, active form of tuberculosis, old age.

Prednisolone is prescribed for diabetes mellitus with caution and only for absolute indications or for the treatment of insulin resistance (lack of response and insulin administration) associated with a high titer of anti-insulin antibodies. For infectious diseases and tuberculosis, the drug should be used only in combination with antibiotics or drugs for the treatment of tuberculosis.

special instructions

Treatment with Prednisolone should be discontinued gradually. Dose reduction is carried out by weekly reducing the dose used by ⅛ or taking the last dose every other day and reducing it by ⅕ (this method is faster).

At fast way on a day without Prednisolone, the patient is recommended to stimulate the adrenal glands using UHF or DQV on their projection, take ascorbic acid (500 mg/day), administer insulin in increasing doses (starting - 4 units, then increase it by 2 units for each dose; the highest dose is 16 units).

If Prednisolone is prescribed for bronchial asthma, it is recommended to switch to inhaled steroids. If the indication for use is an autoimmune disease, use mild cytostatics.

Side effects

The drug has certain side effects:

Weight gain, potassium deficiency (hypokalemia), growth retardation in children, Cushing's syndrome (moon face), increased blood pressure, thrombosis, muscle atrophy, thinning of the skin, digestive disorders, nausea. From the nervous system, manifestations such as depression, hallucinations, decreased visual acuity, general weakness, headache.

The above symptoms are possible, but they do not appear in every case. In general, the drug is well tolerated by patients, even with long-term use.

Overdose

With an overdose of Prednisolone, a sharp increase in side effects is observed. Due to the fact that mechanical blood purification does not give the desired result, drug relief of symptoms is recommended.

During pregnancy and lactation

Prednisolone is contraindicated at any stage of pregnancy and lactation. In the latter case, the use of the drug is possible only after complete cessation of breastfeeding throughout the entire duration of treatment and only when an urgent need arises.

Analogs

Analogs of Prednisolone in composition for dosage forms for systemic use: Prednisolone Nycomed (in ampoules), Prednisolone Nycomed in tablets, Prednisolone Bufus (solution), Medopred (solution), Prednisol (solution).

Prices

The average price of PREDNISOONE tablets in pharmacies (Moscow) is 100 rubles.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

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Prednisolone tablets belong to the pharmacological group of drugs - oral glucocorticosteroids for oral use. They have a pronounced anti-inflammatory pharmacological effect and are used for various systemic pathologies, primarily associated with autoimmune pathological process.

Prednisolone tablets have a round, flat-cylindrical shape and are white in color. There is a chamfer on one side for easy breaking of the tablet in half. The main active ingredient of the drug is prednisolone. Its content in 1 tablet is 5 mg. It also includes auxiliary components, which include:

• Magnesium stearate.
• Potato starch.
• Lactose.
• Gelatin.

The tablets are packaged in dark glass bottles in the amount of 30 pieces. The cardboard box contains one bottle of tablets and instructions for the drug.

The active ingredient of Prednisolone tablets is a synthetic chemical derivative of glucocorticosteroids (hormones of the adrenal cortex that perform various biological functions in organism). It has a pronounced anti-inflammatory effect, which is realized through several mechanisms:

• Inhibition (suppression) of the enzyme phospholipase A 2, which catalyzes the synthesis of prostaglandins from arachidonic acid at the site of the inflammatory reaction. Prostaglandins are the main mediators of inflammation. They are responsible for development pain, tissue swelling and hyperemia. By blocking the phospholipase A2 enzyme with prednisolone, the concentration of prostaglandins and the severity of the inflammatory reaction decreases.
• Inhibition of cell accumulation immune system in tissues that are responsible for the inflammatory process (leukocytes, lymphocytes, tissue macrophages).
• Blocking the binding of antibodies produced by B lymphocytes and plasma cells to specific receptors in tissues.

Prednisolone also has the ability to immunosuppress; it significantly reduces the functional activity of the immune system as a whole. However, the mechanism of this effect remains not fully understood to date. Prednisolone also enhances the reabsorption of water and sodium ions in the distal parts of the renal tubules, increases the catabolism (breakdown) of proteins in the human body, and inhibits the synthesis bone tissue, affects the redistribution of subcutaneous fatty tissue, increases the concentration of glucose in the blood.

and long-term intake of prednisolone into the human body, according to the feedback principle, the production of ACTH (adrenocorticotropic hormone) in the pituitary gland, which is responsible for the functional activity of the adrenal glands, decreases. Therefore, after long-term use of Prednisolone tablets for recovery normal operation a period of time of at least 1 month is required.

After taking a Prednisolone tablet orally, the active substance is quickly absorbed into the systemic bloodstream from the digestive tract, however, a longer period of time may be required for the development of the therapeutic effect (usually taking the tablets several times in accordance with the dosage). Prednisolone is evenly distributed in tissues, where it acts on various cell receptors, providing a therapeutic effect. The active substance is metabolized and excreted primarily by the liver.

Today there is a significant amount of medical indications to the use of Prednisolone tablets, these include:

• Endocrinological pathology – congenital adrenal hypoplasia (adrenogenital syndrome), primary or secondary insufficiency of the adrenal cortex, as replacement therapy before surgery in patients with adrenal insufficiency, autoimmune thyroiditis (inflammation thyroid gland due to the production of antibodies by the immune system to its cells).
• Heavy allergic pathology, which cannot be treated with other drugs - contact dermatitis, serum sickness, anaphylactic shock, angioedema, allergic rhinitis, hypersensitivity reaction to various drugs.
• Rheumatic systemic diseases in which connective tissue is affected due to an autoimmune process - rheumatism, rheumatoid arthritis, ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, acute gouty arthritis, systemic lupus erythematosus, systemic scleroderma, dermatomyositis, systemic vasculitis, mesoarteritis, periarteritis nodosa.
• Skin diseases - severe erythema multiforme (Stevens-Johnson disease), severe psoriasis, eczema, pemphigus, fungal skin lesions, seborrheic, exfoliative dermatitis, bullous dermatitis herpetiformis, pemphigoid.
• Pathology of the blood system - autoimmune hemolytic anemia (acquired), hemolysis (destruction of red blood cells), congenital aplastic anemia, Werlhof's disease (idiopathic thrombocytopenic purpura).
• Some liver diseases - chronic hepatitis in the active stage, alcoholic liver damage.
• Inflammatory joint pathology - bursitis in the acute and subacute stages, acute tendovaginitis, epicondylitis, osteoarthritis developing as a result of injury.
• Malignant neoplasms (oncological pathology) – breast cancer in women, prostate cancer in men, multiple myeloma, different kinds lymphomas, acute and chronic leukemias.
• Neurological pathology – tuberculous meningitis, myasthenia gravis (muscle weakness), multiple sclerosis in the active stage.
• Eye pathology – a severe form of sluggish posterior uveitis in the active stage, sympathetic ophthalmopathy, optic neuritis.
• Heart pathology – pericarditis.
• Diseases of the respiratory system - berylliosis, chronic emphysema, bronchial asthma, symptomatic sarcoidosis, disseminated pulmonary tuberculosis.

Prednisolone tablets are also used to prevent tissue rejection after organ transplantation in transplantology.

Since the drug is used primarily for the treatment of severe pathologies, the list of contraindications is small:

• Increased sensitivity to the active substance of the drug.
• The development of severe systemic fungal infections, in which additional suppression of the immune system leads to their progression.

Before prescribing Prednisolone tablets, the doctor must make sure that there are no contraindications.

Prednisolone tablets are intended for oral use. They are used orally, usually after meals, once a day, which is associated with the daily rhythm of glucocorticosteroid secretion by the adrenal cortex (sometimes, if necessary, the frequency of taking tablets can be increased). The dose is set by the doctor individually, which depends on the type, severity and characteristics of the pathological process in the patient’s body. After achieving the required therapeutic effect, the dose is gradually reduced until it is maintained. The average daily dose for an adult varies between 5-60 mg. The maximum daily dose should not exceed 200 mg (used for acute multiple sclerosis for 7 days, then the dose is gradually reduced to 80 mg per day). For children, the dosage is set at the rate of 0.14 mg of prednisolone per 1 kg of the child’s body weight. If you miss a pill, you should take it as quickly as possible.

If not long-term use Side effects of Prednisolone tablets are extremely rare. With longer use of the drug, the development of negative reactions from various organs and systems is possible:

• Digestive system - steroid ulcer of the stomach or duodenum, associated with the fact that prednisolone inhibits the synthesis of prostaglandins of the digestive tract, which perform protective function, perforation of an ulcer or bleeding from it, periodic nausea, vomiting, increased appetite, inflammation of the pancreas (pancreatitis), esophagus (esophagitis) with the formation of ulcers in it, disruption of the digestive process, increased gas formation in the intestines (flatulence).
• Nervous system - increased intracranial pressure, which is accompanied by congestive optic disc syndrome (more often develops in children), sleep disturbances, convulsions, severe dizziness, headache, fainting.
• Endocrine system - disruption of the functional activity of the adrenal cortex (adrenal insufficiency), suppression of the growth process in children, increased blood sugar (hyperglycemia), disruption menstrual cycle in women, the manifestation of latent (latent) diabetes mellitus, hirsutism (increased hair growth of the skin, which is especially noticeable in women).
• Water-electrolyte balance is the retention of water and salts in the body, accompanied by an increase in blood pressure, as well as the development of circulatory failure.
• Musculoskeletal system - muscle weakness, increased bone fragility (osteoporosis), which causes subsequent pathological fractures, including compression fractures of some vertebrae.
• Skin and subcutaneous tissue – thinning (atrophy) of the skin, stretch marks on it, impaired wound healing, erythema (redness of the skin), increased sweating(hyperhidrosis), the appearance of acne, pinpoint hemorrhages on the skin (petechiae).
• Eyes – cataracts, enlargement intraocular pressure, as a result of which glaucoma and exophthalmos subsequently develop.
• Higher nervous activity– symptoms of psychosis may appear, especially in the first 2 weeks after starting to take Prednisolone tablets, more often develops in women and in people with systemic lupus erythematosus.
• Metabolism is a negative nitrogen balance in the body, which is caused by increased destruction of proteins and an increase in body weight.
• Indicators laboratory research– decrease in the number of leukocytes (leukopenia), platelets (thrombopenia), increased calcium levels in the blood, urine, increased triglyceride levels, total cholesterol, as well as low and very low density lipoproteins.
• Allergic reactions - rarely, while taking Prednisolone tablets, the development of anaphylactic shock with multiple organ failure and a progressive decrease in blood pressure is possible.

If side effects develop, the doctor decides on discontinuing Prednisolone tablets on an individual basis, depending on their type, nature and severity.

Prednisolone tablets are prescribed only by a doctor; they are prescription drugs. The specialist must take into account special instructions regarding the use of the drug before prescribing it, these include:

• If a patient has a systemic fungal infection while taking Prednisolone tablets, its course may progress, since they suppress the activity of the immune system.
• When the patient’s body is exposed to stress factors, it is recommended to switch to parenteral forms of glucocorticosteroids, which are administered intravenously or intramuscularly.
• Sudden withdrawal of Prednisolone tablets is excluded, as this can lead to the development of acute adrenal insufficiency, so the dosage is reduced gradually.
• During the use of the drug, the manifestation of diabetes mellitus, as well as the latent course of amebiasis, is possible (in persons with signs of intestinal infection of the lower parts of the digestive tract, as well as those arriving from tropical countries, before prescribing Prednisolone tablets, a test for dysenteric amebiasis is required).
• Long-term use of Prednisolone tablets may result in the development of glaucoma, so periodic examination by an ophthalmologist is required, as well as measurement of intraocular pressure.
• The use of the drug in high doses requires periodic monitoring of blood pressure levels, as well as the patient’s weight.
• For patients with tuberculosis, the drug can be prescribed only if the disseminated form has a fulminant course.
• Vaccination of the patient with vaccines containing live but weakened pathogenic microorganisms (bacteria, viruses) during treatment with the drug is excluded.
• Against the background of liver cirrhosis, as well as in patients with concomitant hyperthyroidism (increased activity of the thyroid gland), the therapeutic effect of the drug is enhanced.
• Prednisolone tablets should be prescribed with caution to patients with hypoprothrombinemia, nonspecific ulcerative colitis, or the presence of an abscess (limited purulent cavity) of any location.
• With long-term use of the drug, the risk of developing osteoporosis (increased bone fragility) associated with calcium leaching increases significantly.
• Taking tablets after meals significantly reduces the risk of complications from the digestive system.
• When prescribing Prednisolone tablets, it is imperative to monitor their growth and development indicators.
• In men, the drug may lead to a decrease in the number of sperm per unit volume of semen.
• Pregnant women should use the drug with caution and only for health reasons.
• Prednisolone tablets can interact with a significant number of drugs from other pharmacological groups.
• Data on the effect of the drug on the speed of psychomotor reactions are not provided, however, due to possible development side effects from the nervous system during its use are better to avoid potentially dangerous species activities.

Prednisolone tablets are sold in pharmacies only with a doctor's prescription. Their independent use is not allowed.

The risk of overdose increases significantly with long-term use of Prednisolone. This is manifested by an increase in systemic blood pressure, the development of peripheral edema, and the appearance or intensification of side effects. In this case, the drug is temporarily stopped and then the dosage is reduced.

For Prednisolone tablets, structural analogs are the drugs Decortin, Prednisone, Medopred.

The shelf life of Prednisolone tablets is 3 years. They must be stored in a dry, dark, cool place, out of reach of children, in the original original packaging.

The average cost of Prednisolone tablets in Moscow pharmacies varies between 66-68 rubles.

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Indications for use of Prednisolone

Indications for prescribing Prednisolone are the following diseases of the spinal column:

• Injuries to nerves and joints in the spine
• Osteoarthritis
• Inflammation of the spinal cord or its membranes
• Osteochondrosis
• Arthritis of non-infectious origin
• Ankylosing spondylitis
• Swelling of muscles, nerves and other structures of the spinal column
• Lack of effect from drug therapy for the spine
• Injuries of the spine, its joints, blood vessels and nerves, as well as the spinal cord
• Expressed pain syndrome in the spine

Contraindications to the use of Prednisolone

Contraindications to prescribing Prednisolone are the following conditions in the patient:

• Lactation period
• During pregnancy (especially before 12 weeks of gestation)
• Tuberculosis
• Cushing's disease or syndrome
• Nephritis
• Hypertonic disease
• Allergy to the drug and its components
• Endocarditis, acute form
• Syphilis
• Heart failure stage 3
• Ulcers in the stomach or intestines

How Prednisolone works

Prednisolone is one of the most active drugs in this group. Among the effects of the drug on the human body, the main ones are anti-inflammatory, analgesic, decongestant and antitoxic. The drug also potentiates the effects of other medications prescribed for the treatment of spinal diseases.

Such properties of the drug are due to the fact that it affects hormone-receptor compounds, penetrates the cell nucleus, and reduces the production of certain enzymes and other chemical compounds.

Instructions for use of Prednisolone

Prednisolone in tablet form

The drug is taken orally with a sufficient amount of liquid. The first dose is usually 20-30 mg per dose, 1 time per day. As a maintenance dose, 5-10 mg per day is usually sufficient. The maximum daily dosage of the drug is 100 mg. The duration of treatment depends on the patient’s condition and is selected strictly individually. The dose of the drug must be reduced gradually over several days or weeks.

For children, if necessary, Prednisolone is prescribed 1 mg per kg of the child’s weight per day, divided into 4-6 doses. As a maintenance dosage, 300-600 mcg per kg of baby’s weight per day is sufficient.

Prednisolone in the form of a solution for injection

It can be administered either intramuscularly (deep into the gluteal muscle) or intravenously. The first injection is usually 30-45 mg. If necessary, do a second one the next day - 30-60 mg. After this, they switch to tablet form.

Children from 2 to 12 months are prescribed 2-3 mg per kg, from 1 year to 14 years - 1-2 mg per kg. Over 14 years old - adult dosage.

You can also do intra-articular injections - 10 mg of Prednisolone in one joint once.

Prednisolone in ointment form for external use

The ointment is applied to the affected area of ​​the spine 1-2 times a day. The course of treatment is 10-14 days.

Side effects of Prednisolone

Side effects of Prednisolone include the following manifestations in the patient:

• Increased body hair (hirsutism) in women
• Obesity
• Menstrual irregularities
• Pathological fractures due to increased bone fragility (with frequent and long-term use)
• Adrenal insufficiency
• Increased blood glucose
• Ulcerations on the mucous membrane of the gastrointestinal tract, especially in the stomach
• Sexual dysfunction

If such symptoms occur, symptomatic treatment is carried out. If the patient's health condition allows, then Prednisolone is discontinued.

No cases of overdose have been reported. If the prescribed dose is exceeded and any signs of intoxication occur, it is recommended to consult a doctor and take symptomatic treatment.

special instructions

During lactation, it is necessary to avoid breastfeeding for the entire period of treatment with Prednisolone. Prednisolone is contraindicated during pregnancy under 12 weeks. At a later date, it will only be possible if absolutely necessary.

Children are allowed to take Prednisolone, but they should adhere to the most precise dosages and take the drug only when absolutely necessary.

Alcoholic drinks do not affect the way Prednisolone works in the body.

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Composition and release form

The following types of medicine are produced:

• Solution for intravenous and intramuscular administration 30 mg/ml - 1 ml; 15 mg/ml - 2 ml.
• Tablets 1 and 5 mg.
• Ointment for external therapy 0.5%.
• Eye drops 0.5%.

The composition of Prednisolone in ampoules includes the active substance at a concentration of 30 mg/ml, as well as sodium pyrosulfate (additive E223), disodium edetate, nicotinamide, sodium hydroxide, and water.

Prednisolone tablets, which help the medicine for many indications, include: 1 or 5 mg of the active substance and excipients.

Prednisolone ointment contains 0.05 g of active substance, soft white paraffin, glycerin, stearic acid, methyl and propyl parahydroxybenzoate, Cremophor A25 and A6, purified water.

Pharmacological properties

The drug (ointment, drops, injections, tablets) Prednisolone, which helps with complex pathologies, has a pronounced anti-inflammatory, anti-allergic, anti-exudative, anti-shock, anti-toxic effect. The anti-inflammatory effect of prednisolone is achieved mainly with the participation of cytosolic glucocorticosteroid receptors.

The hormone-receptor complex, penetrating into the nucleus of the skin target cells (keratinocytes, fibroblasts, lymphocytes), enhances the expression of genes encoding the synthesis of lipocortins, which inhibit phospholipase A2 and reduce the synthesis of arachidonic acid metabolic products, cyclic endoperoxides, prostaglandins and thromboxane.

The antiproliferative effect of prednisolone is associated with inhibition of the synthesis of nucleic acids (primarily DNA) in the cells of the basal layer of the epidermis and fibroblasts of the dermis. The antiallergic effect of the drug is due to a decrease in the number of basophils, direct inhibition of the synthesis and secretion of biologically active substances.

When taken orally, it is well absorbed from the gastrointestinal tract. The maximum concentration in blood plasma is reached 90 minutes after administration.

Prednisolone - hormonal or not?

Prednisolone is a hormonal drug for local and systemic use average duration actions. The drug is 4-5 times more active than cortisone and 3-4 times more active than hydrocortisone when administered orally. Unlike cortisone and hydrocortisone, prednisolone does not cause noticeable sodium and water retention and only slightly increases potassium excretion.

Medicine Prednisolone: ​​what helps

Indications for use of tablets and solution for injection

Systemic use is advisable for:

• hepatitis;
• eosinophilic and aspiration pneumonia, tuberculous meningitis, pulmonary tuberculosis (as an addition to specific therapy);
• autoimmune and other skin diseases (including Dühring's disease, psoriasis, eczema, pemphigus, Lyell's syndrome, exfoliative dermatitis);
• multiple sclerosis;
• granulomatous thyroiditis;
• lung cancer (with cytostatics);
• acute and chronic diseases which are accompanied by inflammation in the joints and periarticular tissue;
• allergic diseases;
• cerebral edema;
• inflammatory diseases of the gastrointestinal tract;
• status asthmaticus and asthma;
• minor chorea, rheumatic fever, rheumatic carditis;
• developing against the background oncological diseases hypercalcemia.
• diseases of the hematopoietic organs and blood (leukemia, anemia and diseases associated with damage to the hemostatic system);
• congenital adrenal hyperplasia (CAH) or dysfunction of their cortex;
• diffuse diseases connective tissue;
• hypoglycemic conditions;
• nephrotic syndrome;
• autoimmune diseases;
• interstitial diseases of the lung tissue (fibrosis, acute alveolitis, sarcoidosis, etc.);
• primary and secondary hypocortisolism (including after adrenalectomy);
• eye diseases (including autoimmune and allergic; including uveitis, allergic ulcerative keratitis, allergic conjunctivitis, sympathetic ophthalmia, choroiditis, iridocyclitis, non-purulent keratitis, etc.).

Indications for the use of injections are emergency conditions, for example, acute attack food allergies or anaphylactic shock. After several days of parenteral use, the patient is usually transferred to the tablet form of Prednisolone.

Indications for the use of tablets are chronic and severe pathologies (for example, bronchial asthma).

Prednisolone solution and tablets are also used to prevent transplant rejection and relieve nausea/vomiting in patients receiving cytostatics.

Why are eye drops prescribed?

Eye drops are prescribed to relieve inflammation of a non-infectious nature affecting the anterior segment of the eye, as well as inflammation that develops after an eye injury or ophthalmic surgery.

Local use of Prednisolone is justified for the following eye diseases:

• iritis;
• scleritis;
• blepharitis;
• keratitis;
• episcleritis;
• sympathetic ophthalmia;
• iridocyclitis;
• blepharoconjunctivitis;
• allergic conjunctivitis;
• uveitis

Prednisolone ointment: what is it prescribed for?

As an external agent, prednisolone is used for allergies and for the treatment of inflammatory skin diseases non-microbial etiology. Indications for use of the ointment are as follows:

• dermatitis (contact, allergic and atopic);
• discoid lupus erythematosus;
• psoriasis;
• eczema;
• limited neurodermatitis;
• hives;
• erythroderma;
• toxicoderma.

Contraindications

The instructions prohibit the use of Prednisolone in the following cases:

• peptic ulcer of the stomach and duodenum;
• active form of tuberculosis;
• nephritis (kidney inflammation);
• acute endocarditis (inflammation of the internal cavities of the heart);
• severe forms of hypertension (persistent rise in blood pressure);
• diabetes mellitus and Itsenko-Cushing's disease;
• osteoporosis;
• recent operations;
• psychoses;
• old age;
• syphilis,
• circulatory failure stage III,
• pregnancy.

Prednisolone: ​​instructions for use

Injections

The solution is administered intravenously, intramuscularly and intraarticularly. The method of administration and dosage of Prednisolone (Prednisolone Nycomed, Prednisolone hemisuccinate) are selected individually by the attending physician, taking into account the type of pathology, the severity of the patient’s condition, and the location of the affected organ.

For severe and life-threatening conditions, the patient is prescribed pulse therapy using ultra-high doses for a short period of time. For 3-5 days, he is given 1-2 g of prednisolone daily by intravenous drip infusion. The duration of the procedure is from 30 minutes to 1 hour.

During treatment, the dosage is adjusted depending on the patient's response to therapy. It is considered optimal to administer Prednisolone intravenously. For intra-articular administration, ampoules with Prednisolone are used only in cases where the tissue inside the joint is affected by the pathological process.

Positive dynamics are a reason to transfer the patient to tablets or suppositories with prednisolone. Treatment with tablets is continued until stable remission develops. If it is not possible to administer Prednisolone intravenously, the medicine should be injected deep into the muscle. However, it should be borne in mind that with this method it is absorbed more slowly.

Depending on the pathology, the dose can range from 30-1200 mg/day. (with its subsequent decrease).

Children aged from two months to 1 year are administered from 2 to 3 mg/kg. Dosage for children from one to 14 years of age is 1-2 mg/kg (as a slow, 3-minute intramuscular injection). If necessary, after 20-30 minutes the medicine is re-administered in the same dose.

If a large joint is affected, 25 to 50 mg of prednisolone is injected into it. From 10 to 25 mg is injected into medium-sized joints, and from 5 to 10 mg into small joints.

Instructions for use of Prednisolone tablets

The patient is transferred to taking tablets, following the principle of gradual withdrawal of GCS.

If HRT is used, the patient is prescribed 20 to 30 mg of prednisolone per day. Maintenance dose - from 5 to 10 mg/day. For some pathologies - for example, with nephrotic syndrome - it is advisable to prescribe higher doses.

For children, the starting dose is 1-2 mg/kg/day. (it should be divided into 4-6 doses), maintenance - from 0.3 to 0.6 mg/kg/day. When prescribing, the daily secretory rhythm of endogenous steroid hormones is taken into account.

Using eye drops

Instillations of the drug are carried out 3 times a day, instilling 1-2 drops of solution into the conjunctival cavity of the affected eye. In the acute phase of the disease, the instillation procedure can be repeated every 2-4 hours.

For patients who have undergone ophthalmic surgery, drops are prescribed 3-5 days after surgery.

Prednisolone ointment: instructions for use

The ointment is a means of external therapy. It should be applied to the affected areas of the skin in a thin layer from 1 to 3 times a day. An occlusive dressing can be applied to limited pathological lesions to enhance the effect.

When used in children over one year of age, the drug should be used for the shortest possible course. You should also exclude measures that enhance the absorption and resorption of prednisolone (occlusive, fixing, warming dressings).

How long can you take Prednisolone?

Glucocorticosteroid therapy is aimed at achieving maximum effect with the lowest possible doses.

The duration of treatment depends on the patient's diagnosis and individual response to treatment. In some cases, the course lasts up to 6 days; with HRT it lasts for months. The duration of external therapy using Prednisolone ointment is usually from 6 to 14 days.

Side effect

Use of the drug may cause the following: negative reactions body:

• acne;
• convulsions;
• osteoporosis (very rarely - pathological bone fractures, aseptic necrosis heads of the humerus and femur);
• trophic changes in the cornea;
• disorientation;
• delayed sexual development in children;
• increased intracranial pressure;
• skin rash;
• hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
• insomnia;
• suppression of adrenal function;
• steroid ulcer of the stomach and duodenum;
• fluid and sodium retention in the body (peripheral edema);
• hallucinations;
• increased calcium excretion;
• nausea, vomiting;
• weight gain;
• decreased glucose tolerance;
• increased blood pressure;
• gastrointestinal bleeding and perforation of the gastrointestinal tract wall;
• ECG changes characteristic of hypokalemia;
• increased or decreased appetite;
• increased intraocular pressure with possible damage to the optic nerve;
• muscle tendon rupture;
• euphoria;
• striae;
• flatulence;
• Itsenko-Cushing syndrome (moon-shaped face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, stretch marks);
• increased sweating;
• dizziness;
• nervousness or restlessness;
• affective insanity;
• steroid diabetes mellitus or manifestation of latent diabetes mellitus;
• slower growth and ossification processes in children (premature closure of epiphyseal growth zones);
• arrhythmias;
• erosive esophagitis;
• development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination);
• anaphylactic shock;
• tendency to develop secondary bacterial, fungal or viral eye infections;
• hiccups;
• paranoia;
• withdrawal syndrome;
• depression;
• headache;
• bradycardia (up to cardiac arrest);
• indigestion;
• decreased muscle mass (atrophy);
• delayed wound healing.

Signs of withdrawal syndrome

One of the consequences of the use of GCS may be “withdrawal syndrome”. Its severity depends on functional state adrenal cortex. In mild cases, after stopping treatment with Prednisolone, malaise, weakness, fatigue, muscle pain, loss of appetite, hyperthermia, and exacerbation of the underlying disease are possible.

In severe cases, the patient may develop a hypoadrenal crisis, which is accompanied by vomiting, convulsions, and collapse. Without the introduction of GCS into short time death occurs from acute cardiovascular failure.

How to “get off” Prednisone?

Treatment with Prednisolone should be discontinued gradually. Dose reduction is carried out by weekly reducing the dose used by 1/8 or taking the last dose every other day and reducing it by 1/5 (this method is faster).

With the fast method, on a day without Prednisolone, the patient is shown stimulation of the adrenal glands using UHF or DQV on their projection, taking ascorbic acid (500 mg/day), administering insulin in increasing doses (starting - 4 units, then for each dose it is increased by 2 units; highest dose - 16 units).

Insulin should be injected before breakfast, and the person should remain under observation for 6 hours after the injection.

If Prednisolone is prescribed for bronchial asthma, it is recommended to switch to inhaled steroids. If the indication for use is an autoimmune disease, use mild cytostatics.

During pregnancy and breastfeeding

Prescribing GCS during pregnancy and women of childbearing age is permissible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus. Women of childbearing potential should be informed of the potential risks of GC therapy to the fetus.

Prednisolone is excreted in breast milk and can cause undesirable effects in a breastfed baby (growth retardation or inhibition of the production of endogenous adrenal hormones). If it is necessary to use the drug during lactation, breastfeeding should be stopped.

During pregnancy, especially in the first trimester, prednisolone should be prescribed with extreme caution.

special instructions

Treatment with Prednisolone should be stopped slowly, gradually reducing the dose. For patients with a history of psychosis, high doses are allowed to be prescribed only under the strict supervision of a physician.

Analogues of the drug Prednisolone

Structural analogues of the active substance:

• Solyu-Decortin H25.
• Solyu-Decortin N50.
• Prednisolone 5 mg Yenapharm.
• Prednisolone Nycomed.
• Prednisolone buffus.
• Decortin N20.
• Decortin N5.
• Solyu-Decortin N250.
• Prednisolone sodium phosphate.
• Prednisolone-Ferein.
• Prednisol.
• Decortin H50.
• Medopred.
• Prednisolone hemisuccinate.

Similar drugs with a similar mechanism of action:

• Betamethasone.
• Triamcinolone.
• Kenalog.
• Flosteron.
• Dexamed.
• Hydrocortisone.
• Dexazone.
• Dexamethasone.
• Rectodelt.
• Lemod.
• Deltason.
• Medrol.
• Metipred.

Price

In Moscow and St. Petersburg, you can buy the drug Prednisolone for 26-110 rubles. Its price in Kyiv reaches 30-50 hryvnia. Pharmacies offer to purchase tablets in Minsk for 1-3 bel. rubles The price in Kazakhstan is 1200 tenge.

In this article you can read the instructions for using the hormonal drug Prednisolone. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Prednisolone in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Prednisolone analogues in the presence of existing structural analogues. Use for the treatment of shock and urgent conditions, allergic reactions, inflammatory manifestations in adults, children, as well as during pregnancy and breastfeeding.

Prednisolone- a synthetic glucocorticoid drug, a dehydrated analogue of hydrocortisone. It has anti-inflammatory, antiallergic, immunosuppressive effects, increases the sensitivity of beta-adrenergic receptors to endogenous catecholamines.

Interacts with specific cytoplasmic receptors (receptors for GCS are found in all tissues, especially in the liver) to form a complex that induces the formation of proteins (including enzymes that regulate vital processes in cells.)

Protein metabolism: reduces the amount of globulins in plasma, increases albumin synthesis in the liver and kidneys (with an increase in the albumin/globulin ratio), reduces synthesis and increases protein catabolism in muscle tissue.

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation occurs mainly in the shoulder girdle, face, abdomen), leading to the development of hypercholesterolemia.

Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract; increases the activity of glucose-6-phosphatase (increasing the flow of glucose from the liver into the blood); increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases (activation of gluconeogenesis); promotes the development of hyperglycemia.

Water-electrolyte metabolism: retains sodium and water in the body, stimulates the excretion of potassium (mineralocorticoid activity), reduces calcium absorption from the gastrointestinal tract, reduces bone mineralization.

The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils and mast cells; inducing the formation of lipocortins and reducing the number of mast cells producing hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes (especially lysosomal) and organelle membranes. Valid at all stages inflammatory process: inhibits the synthesis of prostaglandins at the level of arachidonic acid (lipocortin inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperoxides, leukotrienes, which promote inflammation, allergies, etc.), the synthesis of “proinflammatory cytokines” (interleukin 1, tumor necrosis factor alpha, etc. .); increases the resistance of the cell membrane to the action of various damaging factors.

The immunosuppressive effect is caused by the involution of lymphoid tissue, inhibition of the proliferation of lymphocytes (especially T-lymphocytes), suppression of the migration of B cells and the interaction of T and B lymphocytes, inhibition of the release of cytokines (interleukin-1, 2; interferon gamma) from lymphocytes and macrophages and decreased antibody formation.

The antiallergic effect develops as a result of a decrease in the synthesis and secretion of allergy mediators, inhibition of the release of histamine and other biologically active substances from sensitized mast cells and basophils, a decrease in the number of circulating basophils, T- and B-lymphocytes, mast cells; suppressing the development of lymphoid and connective tissue, reducing the sensitivity of effector cells to allergy mediators, inhibiting antibody formation, changing the body's immune response.

In obstructive diseases of the respiratory tract, the effect is due mainly to inhibition of inflammatory processes, prevention or reduction of the severity of swelling of the mucous membranes, reduction of eosinophilic infiltration of the submucosal layer of the bronchial epithelium and deposition of circulating immune complexes in the bronchial mucosa, as well as inhibition of erosion and desquamation of the mucosa. Increases the sensitivity of beta-adrenergic receptors of small and medium-sized bronchi to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by reducing its production.

Suppresses the synthesis and secretion of ACTH and, secondarily, the synthesis of endogenous glucocorticosteroids.

Inhibits connective tissue reactions during the inflammatory process and reduces the possibility of scar tissue formation.

Pharmacokinetics

Prednisolone is metabolized in the liver, partially in the kidneys and other tissues, mainly by conjugation with glucuronic and sulfuric acids. Metabolites are inactive. It is excreted in bile and urine by glomerular filtration and is 80-90% reabsorbed by the tubules.

Indications

• shock conditions (burn, traumatic, surgical, toxic, cardiogenic) - with the ineffectiveness of vasoconstrictors, plasma-substituting drugs and other symptomatic therapy;
• allergic reactions (acute severe forms), blood transfusion shock, anaphylactic shock, anaphylactoid reactions;
• cerebral edema (including due to a brain tumor or associated with surgery, radiation therapy or head trauma);
• bronchial asthma (severe form), status asthmaticus;
• systemic connective tissue diseases (systemic lupus erythematosus, scleroderma, periarteritis nodosa, dermatomyositis, rheumatoid arthritis);
• acute and chronic inflammatory diseases joints - gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, humeroscapular periarthritis, ankylosing spondylitis (Bechterew's disease), juvenile arthritis, Still's syndrome in adults, bursitis, nonspecific tenosynovitis, synovitis and epicondylitis;
• skin diseases - pemphigus, psoriasis, eczema, atopic dermatitis (common neurodermatitis), contact dermatitis (with lesions large surface skin), toxicerma, seborrheic dermatitis, exfoliative dermatitis, toxic epidermal necrolysis (Lyell's syndrome), bullous dermatitis herpetiformis, Stevens-Johnson syndrome;
• allergic eye diseases: allergic forms of conjunctivitis;
• inflammatory eye diseases - sympathetic ophthalmia, severe sluggish anterior and posterior uveitis, optic neuritis;
• congenital adrenal hyperplasia;
• diseases of the blood and hematopoietic system - agranulocytosis, panmyelopathy, autoimmune hemolytic anemia, acute lympho- and myeloid leukemia, lymphogranulomatosis, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia (erythrocyte anemia), congenital (erythroid) hypoplastic anemia;
• berylliosis, Loeffler's syndrome (unresponsive to other therapy); lung cancer(in combination with cytostatics);
• multiple sclerosis;
• prevention of graft rejection during organ transplantation;
• hypercalcemia due to cancer, nausea and vomiting during cytostatic therapy;
• multiple myeloma;
• thyrotoxic crisis;
• acute hepatitis, hepatic coma;
• reduction of inflammatory phenomena and prevention of cicatricial contractions (in case of poisoning with cauterizing liquids).

Release forms

Tablets 1 mg and 5 mg.

Solution for intravenous and intramuscular injection(injections in injection ampoules) 30 mg/ml.

Eye drops 0.5%.

Ointment for external use 0.5%.

Instructions for use and dosage

Injections

The dose of Prednisolone and the duration of treatment are determined by the doctor individually depending on the indications and severity of the disease.

Prednisolone is administered intravenously (drip or stream) in droppers or intramuscularly. The intravenous drug is usually administered first as a stream, then as a drip.

For acute adrenal insufficiency, a single dose of 100-200 mg for 3-16 days.

For bronchial asthma, the drug is administered depending on the severity of the disease and the effectiveness of complex treatment from 75 to 675 mg per course of treatment from 3 to 16 days; in severe cases, the dose can be increased to 1400 mg per course of treatment or more with a gradual dose reduction.

For status asthmaticus, Prednisolone is administered at a dose of 500-1200 mg per day, followed by a reduction to 300 mg per day and switching to maintenance doses.

In case of thyrotoxic crisis, 100 mg of the drug is administered in a daily dose of 200-300 mg; if necessary, the daily dose can be increased to 1000 mg. The duration of administration depends on the therapeutic effect, usually up to 6 days.

In case of shock that is resistant to standard therapy, Prednisolone is usually administered as a bolus at the beginning of therapy, after which it is switched to drip administration. If blood pressure does not increase within 10-20 minutes, repeat the injection of the drug. After recovery from the shock state, drip administration is continued until blood pressure stabilizes. A single dose is 50-150 mg (in severe cases - up to 400 mg). The drug is re-administered after 3-4 hours. The daily dose can be 300-1200 mg (with subsequent dose reduction).

In case of acute hepatic-renal failure (in acute poisoning, in the postoperative and postpartum periods, etc.), Prednisolone is administered at 25-75 mg per day; if indicated, the daily dose can be increased to 300-1500 mg per day or higher.

For rheumatoid arthritis and systemic lupus erythematosus, Prednisolone is administered in addition to systemic administration of the drug at a dose of 75-125 mg per day for no more than 7-10 days.

In acute hepatitis, Prednisolone is administered 75-100 mg per day for 7-10 days.

For poisoning with cauterizing liquids with burns of the digestive tract and upper respiratory tract, Prednisolone is prescribed at a dose of 75-400 mg per day for 3-18 days.

If intravenous administration is not possible, Prednisolone is administered intramuscularly in the same doses. After relief of the acute condition, Prednisolone tablets are prescribed orally, followed by a gradual reduction in the dose.

With long-term use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped suddenly!

Pills

It is recommended to take the entire daily dose of the drug as a single dose or a double daily dose every other day, taking into account the circadian rhythm of endogenous secretion of glucocorticosteroids in the interval from 6 to 8 a.m. A high daily dose can be divided into 2-4 doses, with a larger dose taken in the morning. The tablets should be taken orally during or immediately after meals with a small amount of liquid.

At acute conditions and as replacement therapy for adults, an initial dose of 20-30 mg per day is prescribed, the maintenance dose is 5-10 mg per day. If necessary, the initial dose can be 15-100 mg per day, maintenance - 5-15 mg per day.

For children, the initial dose is 1-2 mg/kg body weight per day in 4-6 doses, maintenance - 300-600 mcg/kg per day.

When a therapeutic effect is obtained, the dose is gradually reduced - 5 mg, then 2.5 mg at intervals of 3-5 days, first canceling later doses. With long-term use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped suddenly! The maintenance dose is discontinued more slowly the longer glucocorticosteroid therapy has been used.

In case of stressful effects (infection, allergic reaction, trauma, surgery, mental overload), in order to avoid exacerbation of the underlying disease, the dose of prednisolone should be temporarily increased (by 1.5-3, and in severe cases - by 5-10 times).

Side effect

• decreased glucose tolerance;
• steroid diabetes mellitus or manifestation of latent diabetes mellitus;
• suppression of adrenal function;
• Itsenko-Cushing syndrome (moon-shaped face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, stretch marks);
• delayed sexual development in children;
• nausea, vomiting;
• steroid ulcer of the stomach and duodenum;
• erosive esophagitis;
• gastrointestinal bleeding and perforation of the gastrointestinal tract wall;
• increased or decreased appetite;
• indigestion;
• flatulence;
• hiccups;
• arrhythmias;
• bradycardia (up to cardiac arrest);
• ECG changes characteristic of hypokalemia;
• increased blood pressure;
• disorientation;
• euphoria;
• hallucinations;
• affective insanity;
• depression;
• paranoia;
• increased intracranial pressure;
• nervousness or restlessness;
• insomnia;
• dizziness;
• headache;
• convulsions;
• increased intraocular pressure with possible damage to the optic nerve;
• tendency to develop secondary bacterial, fungal or viral eye infections;
• trophic changes in the cornea;
• increased calcium excretion;
• weight gain;
• increased sweating;
• fluid and sodium retention in the body (peripheral edema);
• hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
• slower growth and ossification processes in children (premature closure of epiphyseal growth zones);
• osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur);
• muscle tendon rupture;
• decreased muscle mass (atrophy);
• delayed wound healing;
• acne;
• striae;
• skin rash;
• anaphylactic shock;
• development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination);
• withdrawal syndrome.

Contraindications

For short-term use for health reasons, the only contraindication is hypersensitivity to prednisolone or the components of the drug.

The drug contains lactose. Patients with rare diseases should not take the drug hereditary diseases such as lactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.

Use during pregnancy and breastfeeding

During pregnancy (especially in the 1st trimester) it is used only for health reasons.

Since glucocorticosteroids pass into breast milk, if it is necessary to use the drug during breastfeeding, it is recommended to stop breastfeeding.

special instructions

Before starting treatment (if impossible due to the urgency of the condition, during treatment), the patient should be examined to identify possible contraindications. Clinical examination should include examination of the cardiovascular system, x-ray examination of the lungs, examination of the stomach and duodenum, urinary system, and organs of vision; control of blood formula, glucose and electrolytes in blood plasma. During treatment with prednisolone (especially long-term), observation by an ophthalmologist, monitoring of blood pressure, water and electrolyte balance, as well as peripheral blood patterns and blood glucose levels are necessary.

In order to reduce side effects You can prescribe antacids, and also increase the intake of potassium in the body (diet, potassium supplements). Food should be rich in proteins, vitamins, and limit the content of fats, carbohydrates and table salt.

The effect of the drug is enhanced in patients with hypothyroidism and liver cirrhosis.

The drug may worsen existing emotional instability or psychotic disorders. If a history of psychosis is indicated, prednisolone in high doses is prescribed under the strict supervision of a physician.

In stressful situations during maintenance treatment (eg, surgical operations, trauma or infectious diseases), the dose of the drug should be adjusted due to the increased need for glucocorticosteroids.

Patients should be carefully monitored for a year after the end of long-term therapy with prednisolone due to the possible development of relative insufficiency of the adrenal cortex in stressful situations.

With sudden withdrawal, especially in the case of previous use of high doses, withdrawal syndrome may develop (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness), as well as an exacerbation of the disease for which prednisolone was prescribed.

During treatment with prednisolone, vaccination should not be carried out due to a decrease in its effectiveness (immune response).

When prescribing prednisolone for intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously treat with bactericidal antibiotics.

In children during long-term treatment Prednisolone requires careful monitoring of growth dynamics. Children who during the treatment period were in contact with patients with measles or chickenpox are prescribed specific immunoglobulins prophylactically.

Due to the weak mineralocorticoid effect, prednisolone is used in combination with mineralocorticoids for replacement therapy for adrenal insufficiency.

In patients with diabetes mellitus, blood glucose levels should be monitored and therapy adjusted if necessary.

X-ray monitoring of the osteoarticular system (images of the spine, hand) is indicated.

Prednisolone in patients with latent infectious diseases kidneys and urinary tract can cause leukocyturia, which may have diagnostic value.

In Addison's disease, simultaneous administration of barbiturates should be avoided - there is a risk of developing acute adrenal insufficiency (Addisonian crisis).

Drug interactions

The simultaneous administration of prednisolone with inducers of hepatic microsomal enzymes (phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration.

Co-administration of prednisolone with diuretics (especially thiazide and carbonic anhydrase inhibitors) and amphotericin B may lead to increased excretion of potassium from the body.

The simultaneous administration of prednisolone with sodium-containing drugs leads to the development of edema and increased blood pressure.

Co-administration of prednisolone with amphotericin B increases the risk of developing heart failure.

The simultaneous administration of prednisolone with cardiac glycosides worsens their tolerability and increases the likelihood of developing ventricular extrasystole(due to hypokalemia caused).

Simultaneous administration of prednisolone with indirect anticoagulants - prednisolone enhances the anticoagulant effect of coumarin derivatives.

The simultaneous administration of prednisolone with anticoagulants and thrombolytics increases the risk of bleeding from ulcers in the gastrointestinal tract.

The simultaneous administration of prednisolone with ethanol (alcohol) and non-steroidal anti-inflammatory drugs increases the risk of erosive and ulcerative lesions in the gastrointestinal tract and the development of bleeding (in combination with NSAIDs in the treatment of arthritis, it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect).

The simultaneous administration of prednisolone with paracetamol increases the risk of hepatotoxicity (induction of liver enzymes and the formation of a toxic metabolite of paracetamol).

The simultaneous administration of prednisolone with acetylsalicylic acid accelerates its elimination and reduces its concentration in the blood (when prednisolone is discontinued, the level of salicylates in the blood increases and the risk of side effects increases).

The simultaneous administration of prednisolone with insulin and oral hypoglycemic drugs and antihypertensive drugs reduces their effectiveness.

The simultaneous administration of prednisolone with vitamin D reduces its effect on the absorption of calcium in the intestine.

The simultaneous administration of prednisolone with growth hormone reduces the effectiveness of the latter, and with praziquantel - its concentration.

The simultaneous administration of prednisolone with m-anticholinergics (including antihistamines and tricyclic antidepressants) and nitrates increases intraocular pressure.

The simultaneous administration of prednisolone with isoniazid and mexiletine increases the metabolism of isoniazid and mexiletine (especially in “fast” acetylators), which leads to a decrease in their plasma concentrations.

Co-administration of prednisolone with carbonic anhydrase inhibitors and amphotericin B increases the risk of developing osteoporosis.

The simultaneous administration of prednisolone with indomethacin - displacing prednisolone from its connection with albumin, increases the risk of developing its side effects.

The simultaneous administration of prednisolone with ACTH enhances the effect of prednisolone.

The simultaneous administration of prednisolone with ergocalciferol and parathyroid hormone prevents the development of osteopathy caused by prednisolone.

The simultaneous administration of prednisolone with cyclosporine and ketoconazole - cyclosparine (inhibits metabolism) and ketoconazole (reduces clearance) increases toxicity.

The appearance of hirsutism and acne is facilitated by the simultaneous use of other steroid hormonal drugs (androgens, estrogens, anabolic steroids, oral contraceptives).

The simultaneous administration of prednisolone with estrogens and oral estrogen-containing contraceptives reduces the clearance of prednisolone, which may be accompanied by an increase in the severity of its therapeutic and toxic effects.

Concomitant administration of prednisolone with mitotane and other inhibitors of adrenal function may necessitate an increase in the dose of prednisolone.

At simultaneous use with live antiviral vaccines and against the background of other types of immunization increases the risk of viral activation and the development of infections.

With simultaneous use of prednisolone with antipsychotics(neuroleptics) and azathioprine increases the risk of developing cataracts.

The simultaneous administration of antacids reduces the absorption of prednisolone.

When used simultaneously with antithyroid drugs, the clearance of prednisolone decreases and with thyroid hormones increases.

When used concomitantly with immunosuppressants, the risk of developing infections and lymphoma or other lymphoproliferative disorders associated with the Epstein-Barr virus increases.

Tricyclic antidepressants may increase the severity of depression caused by taking glucocorticosteroids (not indicated for the treatment of these side effects).

Increases (with long-term therapy) the content of folic acid.

Hypokalemia caused by glucocorticosteroids can increase the severity and duration of muscle blockade due to muscle relaxants.

In high doses, it reduces the effect of somatropin.

Analogs medicinal product Prednisolone

Structural analogues of the active substance:

• Decortin H20;
• Decortin H5;
• Decortin H50;
• Medopred;
• Prednisole;
• Prednisolone 5 mg Yenapharm;
• Prednisolone bufus;
• Prednisolone hemisuccinate;
• Prednisolone Nycomed;
• Prednisolone-Ferein;
• Prednisolone sodium phosphate;
• Solyu-Decortin H25;
• Solyu-Decortin N250;
• Solyu-Decortin N50.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

pharmachologic effect

GKS. Suppresses the functions of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of ​​inflammation. It disrupts the ability of macrophages to phagocytose, as well as to form interleukin-1. Helps stabilize lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of ​​inflammation. Reduces capillary permeability due to the release of histamine. Suppresses fibroblast activity and collagen formation.
Inhibits the activity of phospholipase A 2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.
Reduces the number of circulating lymphocytes (T- and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed into the lymphoid tissue; suppresses the formation of antibodies.
Prednisolone suppresses the release of ACTH and b-lipotropin by the pituitary gland, but does not reduce the level of circulating b-endorphin. Inhibits the secretion of TSH and FSH.
When directly applied to blood vessels, it has a vasoconstrictor effect.
Prednisolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, prednisolone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from protein metabolism products. An increase in blood glucose levels activates the release of insulin.
Prednisolone inhibits the uptake of glucose into fat cells, which leads to activation of lipolysis. However, due to increased insulin secretion, lipogenesis is stimulated, which promotes fat accumulation.
It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. To a lesser extent than hydrocortisone, it affects the processes of water- electrolyte metabolism: promotes the excretion of potassium and calcium ions, retention of sodium and water ions in the body. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term GCS therapy. As a result of the catabolic effect, growth suppression in children is possible.
In high doses, prednisolone can increase the excitability of brain tissue and help lower the seizure threshold. Stimulates excess production of hydrochloric acid and pepsin in the stomach, which leads to the development of peptic ulcers.
When used systemically, the therapeutic activity of prednisolone is due to its anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.
When applied externally and locally, the therapeutic activity of prednisolone is due to its anti-inflammatory, antiallergic and antiexudative (due to the vasoconstrictor effect) effect.
Compared with hydrocortisone, the anti-inflammatory activity of prednisolone is 4 times greater, mineralocorticoid activity is 0.6 times less.

Pharmacokinetics

When taken orally, it is well absorbed from the gastrointestinal tract. The maximum plasma concentration is observed after 90 minutes. In plasma, most of the prednisolone is bound to transcortin (cortisol-binding globulin). Metabolized primarily in the liver.
The half-life is approximately 200 minutes. Excreted unchanged by the kidneys - 20%.

Indications

For oral and intramuscular use: rheumatism; rheumatoid arthritis; dermatomyositis; periarteritis nodosa; scleroderma; Bekhterev's disease; bronchial asthma, status asthmaticus; acute and chronic allergic diseases; Addison's disease, acute adrenal insufficiency, adrenogenital syndrome; hepatitis, hepatic coma, hypoglycemic conditions, lipoid nephrosis; agranulocytosis, various shapes leukemia, lymphogranulomatosis, thrombocytopenic purpura, hemolytic anemia; chorea; pemphigus, eczema, itching, exfoliative dermatitis, psoriasis, prurigo, eczema, seborrheic dermatitis, lupus erythematosus, erythroderma, psoriasis, alopecia.
For use in ophthalmology: allergic, chronic and atypical conjunctivitis and blepharitis; inflammation of the cornea with intact mucosa; spicy and chronic inflammation anterior segment choroid, sclera and episclera; sympathetic inflammation of the eyeball; after injuries and operations with prolonged irritation of the eyeballs.
For intra-articular administration: chronic polyarthritis, post-traumatic arthritis, osteoarthritis of large joints, rheumatic lesions individual joints, arthrosis.
For infiltration administration into tissues: epicondylitis, tendovaginitis, bursitis, humeroscapular periarthritis, keloids, sciatica, Dupuytren's contracture, rheumatic and similar lesions of joints and various tissues.

Dosage regimen

When taken orally for replacement therapy in adults, the initial dose is 20-30 mg/day, the maintenance dose is 5-10 mg/day. If necessary, the initial dose can be 15-100 mg/day, maintenance - 5-15 mg/day. Daily dose should be reduced gradually. For children, the initial dose is 1-2 mg/kg/day in 4-6 divided doses, maintenance dose is 300-600 mcg/kg/day.
When administered intramuscularly, the dose, frequency and duration of use are determined individually. When administered intra-articularly into large joints a dose of 25-50 mg is used, for medium-sized joints - 10-25 mg, for small joints - 5-10 mg. For infiltration into tissue, depending on the severity of the disease and the size of the affected area, doses from 5 to 50 mg are used.
Used locally in ophthalmology 3 times a day, the course of treatment is no more than 14 days; in dermatology - 1-3 times/day.

Side effect

From the endocrine system: Itsenko-Cushing syndrome, weight gain. Hyperglycemia up to the development of steroid diabetes, depletion (up to atrophy) of the function of the adrenal cortex.
From the digestive system: increased acidity gastric juice, ulcerogenic effect on the gastrointestinal tract.
Metabolism: increased excretion of potassium, sodium retention in the body with the formation of edema, negative nitrogen balance.
From the outside of cardio-vascular system: arterial hypertension.
From the blood coagulation system: increased blood clotting.
From the musculoskeletal system: osteoporosis, aseptic bone necrosis.
From the organ of vision: steroid cataract, provoking latent glaucoma.
From the side of the central nervous system: mental disorders.
Effects due to immunosuppressive effects: decreased resistance to infections, delayed wound healing.
When used externally: possible appearance of steroid acne, purpura, telangiectasia, as well as burning, itching, irritation, dry skin; with prolonged use and/or when applied to large surfaces of the skin, a resorptive effect may develop.
When applied topically: a slight burning sensation is possible.

Contraindications

Peptic ulcer stomach and duodenum, osteoporosis, Itsenko-Cushing syndrome, tendency to thromboembolism, renal failure, severe arterial hypertension, systemic mycoses, viral infections, vaccination period, active form of tuberculosis, glaucoma, productive symptoms during mental illness. Hypersensitivity to prednisolone.
Infiltration injection into lesions of the skin and tissues during chicken pox, specific infections, mycoses, with a local reaction to vaccination.
In ophthalmology - viral and bacterial eye diseases, primary glaucoma, diseases of the cornea with damage to the epithelium. In dermatology - bacterial, viral, fungal skin lesions, tuberculosis, syphilis, skin tumors.

Pregnancy and lactation

During pregnancy (especially in the first trimester) it is used only for health reasons. If it is necessary to use it during lactation, the expected benefits of treatment for the mother and the risk for the child should be carefully weighed.

special instructions

Not intended for intravenous administration. During the day, it is recommended to use it taking into account the circadian rhythm of endogenous secretion of GCS in the interval from 6 to 8 am.
Use with caution in patients with a history of psychosis; nonspecific infections subject to simultaneous chemotherapy or antibiotic therapy. For diabetes mellitus, use is possible only with absolute readings or to prevent suspected insulin resistance. For latent forms of tuberculosis, prednisolone can only be used in combination with anti-tuberculosis drugs.
During treatment (especially long-term), observation by an ophthalmologist, monitoring of blood pressure and water-electrolyte balance, as well as peripheral blood patterns and blood sugar levels are necessary; In order to reduce side effects, you can prescribe anabolic steroids, antibiotics, and also increase the intake of potassium in the body (diet, potassium supplements). It is recommended to clarify the need for ACTH administration after a course of treatment with prednisolone (after skin test!). In Addison's disease, concomitant use with barbiturates should be avoided.
After cessation of treatment, withdrawal syndrome, adrenal insufficiency, and exacerbation of the disease for which prednisolone was prescribed may occur.
It should not be used externally for more than 14 days. If used for acne vulgaris or rosacea, an exacerbation of the disease is possible.

Prednisolone in the form of tablets, solution for injection, dry substance for injection, eye drops, ointments is included in the List of Vital and Essential Drugs.

Drug interactions

With the simultaneous use of prednisolone with anticoagulants, the anticoagulant effect of the latter may be enhanced; with salicylates - the likelihood of bleeding increases; with diuretics - possible aggravation of electrolyte metabolism disorders; with antidiabetic drugs - the rate of decrease in blood sugar decreases; with cardiac glycosides - the risk of developing glycoside intoxication increases; with rifampicin - weakening of the therapeutic effect of rifampicin.