Prednisolone is similar drugs of a 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 a fairly wide range of applications and a fairly wide range of diseases. It is used both for the treatment of asthma and for the relief of anaphylactic shock or an allergy attack from an unidentified irritant. This is the first aid to a person if anaphylactic shock occurs and the opportunity to save his life. Also, the drug is used in courses of radiotherapy, it is considered a good anti-inflammatory agent.

The spectrum of application of the drug is very wide, it is used and prescribed by doctors for the treatment of asthmatic diseases, allergic reactions.

About the drug

At the drug three main pharmacological actions:

Anti-inflammatory;
immunosuppressive;
Antiallergic;
Antishock;
Antipruritic;

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

Ask your question to a neurologist for free

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

When the adrenal glands fail, the hormone becomes less or it stops being produced altogether. The lack of a hormone in the body can lead to rather sad consequences, and the drug has very strong pharmacological effects, therefore it is used in the treatment of really serious diseases or serious situations that threaten human life (anaphylactic shock, exacerbation of bronchial asthma). use it only as part of complex therapy.

The drug is produced in India.

Release form

There are several forms of release:

. The cost of the ointment is only about 50 rubles. As part of the main component is prednisolone, additional components: medical white paraffin, glycerin and stearic acid.
Tablets. The cost of tablets is about 68 rubles. As part of the main component is also prednisolone, additional components: milk sugar, potato starch, calcium stearate. It is 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 scheme of application

Dosage and scheme of application differs depending on the pharmacological form of release and disease:

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

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

Solution works for about a day, depending on the susceptibility of the human body and disease. One injection may be enough intramuscularly for several days, especially in the treatment of 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. The injection of the solution is quite painful, but after a couple of hours (half an hour - two hours) relief comes.

Indications for use

The instructions for use say that with the help of the drug, shock can be treated, accompanied by a decrease in blood pressure, acute adrenal insufficiency, cerebral edema, asthma and rheumatoid arthritis. Also, the drug is used for allergies, severe allergic (anaphylactic) shock can also be treated with injections. With the help of the drug, hepatic coma is also treated.

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

Due to this, many diseases, with successful complex therapy and the correct selection of dosage, quickly decrease.

Contraindications

In a state of shock the drug is administered without taking into account contraindications(emergency situations such as anaphylactic shock, traumatic shock, severe allergic reaction). With longer treatment, it is necessary to consider:

The presence of a stomach ulcer;
Osteoporosis;
Cushing's syndrome;
psychoses;
Severe arterial hypertension;

Do not use the drug for smallpox, herpes, herpes zoster, not recommended for active tuberculosis.

In acute renal failure and liver problems, before taking it is necessary to consult with a medical specialist.

Pregnant women in the first trimester, lactating women are not recommended to take the drug. Children under 18 years of age taking the drug is not recommended, but in emergency situations it is likely to use. However, when used for a longer treatment, an examination, consultation of several medical specialists is necessary.

Overdose and side effects

As a side effect:

weight gain;
hypokalemia;
Cushing's syndrome;
Increased blood pressure;
Nausea;
Vomit;
Diarrhea;
depression and hallucinations;

The manifestation of side effects is optional, 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, disorders of the gastrointestinal tract, depression, hallucinations, a sharp jump in blood pressure, and edema are possible. To reduce an overdose, it is urgent to rinse the stomach and seek medical help in an ambulance. Little is known about the toxicity of the drug.

Interaction with substances

The interaction of the drug with alcohol and other drugs is noted for tablets and solution. Solution in combination with diuretic drugs increases potassium excretion, and in combination with antidiabetic agents reduces glucose levels. Interaction with alcohol and alcohol-containing substances is extremely negative, 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, it is dispensed in pharmacies exclusively by prescription. You can use it as analogues (from 300 rubles), other analogues differ much more in composition and you need to consult with your doctor about them.

Frequently asked Questions

Does it hurt to inject? Painful sensations are present, but with the injection itself and the administration of the medicine, there is practically no pain, painful sensations appear after a couple of hours, pain increases in the gluteal muscle, but it is quite tolerable. When you enter and puncture the skin, the pain is practically not felt, unlike B vitamins, magnesia and other drugs.

How long does it last? In shock conditions, anaphylactic shock, a strong manifestation of allergies, the injection acts almost instantly, and its action 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 pierce the full course for relief to come. In general, the medicine works for about a couple of days.

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

Reviews

Reviews of experts about prednisolone indicate that the drug is really effective in stressful and shock situations, effectively removes a person from anaphylactic shock. Such a drug perfectly blocks the state of shock, literally returning a person from the next world. However, do 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 not to use if there are contraindications or hypersensitivity to one of the components.

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

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

A lot of patients noted a significant improvement in well-being after use in 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 diseases, mothers also note the effectiveness of the drug when administered intravenously to children.

In general, the reviews are positive, proving the effectiveness of the drug. There are not so many negative reviews, mostly either the dosage is exceeded, or individual intolerance is detected.

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

Prednisolone injections - a drug with enhanced biological activity, which is used in emergency situations. Injections of the drug can have an anti-allergic, anti-inflammatory and immunosuppressive effect.

The speed of its action and the likelihood of adverse reactions depend on the form of the drug used. Prednisolone tablets are prescribed for long-term therapy, and in ampoules the drug is used when delay is dangerous. When administered intramuscularly, the drug begins to act after a quarter of an hour, with intravenous injections - after 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;
A state of shock that is not amenable to the prescribed treatment;
Renal, liver failure in an aggravated form;
Rheumatic ailments;
Hepatitis;
Pathology of the adrenal cortex;
Prevention of cicatricial formations in case of damage by cauterizing substances.

In addition to emergency care, drug injections are included in the complex treatment of malignant neoplasms, chronic pulmonary, autoimmune and skin diseases, and heart pathologies. Prednisolone injections are used in hematology and ophthalmic 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 a dropper 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 stopping the emergency, 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 unwanted side effects. Injections are not prescribed for intolerance or hypersensitivity to the ingredients of the drug. It is used with extreme caution:

In immunodeficiency states;
During the period of therapy and recovery after viral infectious diseases;
In patients with diseases of the digestive tract;
After the introduction of the vaccine;
Patients with pathologies of the cardiovascular and endocrine systems;
With renal failure.

Prednisolone injections for pregnant women and young children are prescribed solely for vital signs under direct medical supervision. For the period of treatment with this medication, breastfeeding should be interrupted. Children under 3 months of age and elderly people over 70 years of age are not prescribed the drug.

During therapy with Prednisolone, the following side effects were noted:

Muscular atrophy;
weight gain;
Decreased ability of the body to process glucose;
Violation of the activity of the adrenal glands;
insulin-dependent diabetes mellitus;
Increase in intracranial and arterial pressure;
stomach or duodenal ulcer;
Violation of sinus rhythm;
Inhibition of sexual development in adolescents,
pathology of the cornea;
Increased sweating;
convulsions;
Migraine;
sleep disorders;
Depression, confusion.

Rashes, itching and other local allergic manifestations are possible at the injection site.

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

Glucocorticosteroids, including Prednisolone, are administered orally in the form of tablets, systemically in the form of injections, and locally - the ointment is applied to the skin and eyes. The drug has anti-inflammatory, anti-allergic, anti-shock, anti-exudative, anti-proliferative, antipruritic and immunosuppressive effects.

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

Composition and form of release

Clinico-pharmacological group: GCS for oral use.

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 the drug solution in an ampoule. 3, 5 or 10 ampoules in a pack.

What is Prednisolone used for?

Inflammatory diseases of the joints:

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 treatments);
psoriatic arthritis;
ankylosing spondylitis;
acute gouty arthritis;
acute rheumatic fever;
myocarditis (including rheumatic);
dermatomyositis;
systemic lupus erythematosus;
mesoarteritis granulomatous giant cell;
systemic scleroderma;
nodular periarteritis;
relapsing polychondritis;
polymyalgia rheumatica (Horton's disease);
systemic vasculitis.

Endocrinological diseases:

insufficiency of the adrenal cortex: primary (Addison's disease) and secondary;
adrenogenital syndrome (congenital adrenal hyperplasia);
acute insufficiency of the adrenal cortex;
before surgery and in severe diseases and injuries in patients with adrenal insufficiency;
subacute thyroiditis.

Severe allergic diseases resistant to other therapy:

contact dermatitis;
atopic dermatitis;
serum sickness;
drug hypersensitivity reactions;
persistent or seasonal allergic rhinitis;
anaphylactic reactions;
angioedema.

Dermatological diseases:

exfoliative dermatitis;
bullous dermatitis herpetiformis;
severe seborrheic dermatitis;
severe erythema multiforme (Stevens-Johnson syndrome);
fungal mycosis;
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.

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

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

Respiratory diseases:

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

When transplanting organs and tissues to prevent and treat transplant 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 potent than cortisone and 3-4 times more potent than hydrocortisone when taken orally. Unlike cortisone and hydrocortisone, prednisolone does not cause a noticeable retention of sodium and water 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 1 time / day in the morning. In some cases, more frequent administration of the drug is required. After achieving the desired therapeutic effect, it is recommended to gradually reduce the dose to the minimum effective.

Prednisone tablets. At the beginning of therapy for acute and severe conditions, 50-75 mg (10-15 tablets) per day should be taken, 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 continue to be taken. The duration of treatment is determined by the doctor, and depends on the general condition of the person and the effectiveness of therapy.
Prednisone ampoules. In case of shock, 50-150 mg of Prednisolone is administered at a time (2-5 ml of a 3% (30 mg / ml) solution). Re-introduce the same amount of solution every 3-4 hours during the first day. After that, the doctor determines whether there is a need to continue injections of Prednisolone or whether they can be stopped. In acute insufficiency of the adrenal glands and liver, as well as in case of allergic reactions, 100-200 mg of Prednisolone is administered every 8 hours. In case of asthmatic status, 500-1200 mg of Prednisolone is administered once, on the second day the dosage is reduced to 300 mg, on the third day - up to 150 mg and on the fourth day - up to 100 mg. On the 5th - 6th day, Prednisolone can be canceled if the status asthmaticus has not recurred.

Ointment Prednisolone. On the affected areas of the skin, the ointment is applied in a thin layer 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 can provoke the absorption of a large amount of ointment into the bloodstream with the development of systemic side effects. The ointment should not be used for longer than 14 days without interruption.

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

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

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, peptic ulcer of the stomach and duodenum intestines, recent operations, syphilis, active form of tuberculosis, old age.

Prednisolone is prescribed in 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. In 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 completed gradually. Dose reduction is carried out by reducing the used dose by ⅛ weekly or by taking the last dose every other day and reducing it by ⅕ (this method is faster).

With the fast method, on the day without Prednisolone, the patient is shown stimulation of the adrenal glands using UHF or DKV 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; 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 - for 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, impaired digestion, nausea. From the side of the nervous system, manifestations such as depression, hallucinations, decreased visual acuity, general weakness, and headache are possible.

The above symptoms are possible, but they do not appear in every case. In general, the drug is well tolerated by patients, even with prolonged 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, it is recommended to relieve symptoms with medication.

During pregnancy and lactation

Prednisolone is contraindicated at any stage of pregnancy and during lactation. In the latter case, the use of the drug is possible only after the complete refusal of breastfeeding throughout the treatment and only if there is an urgent need.

Analogues

Prednisolone analogues 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 PREDNISOLONE tablets in pharmacies (Moscow) is 100 rubles.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

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

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

magnesium stearate.
Potato starch.
Lactose.
Gelatin.

Tablets are packaged in dark glass bottles in the amount of 30 pieces. The cardboard pack contains one vial with tablets and instructions for the preparation.

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

Inhibition (suppression) of the enzyme phospholipase A 2, which catalyzes the reaction of the synthesis of prostaglandins from arachidonic acid in the focus of the inflammatory reaction. Prostaglandins are the main mediators of inflammation. They are responsible for the development of pain, tissue swelling and hyperemia. By blocking the enzyme phospholipase A2, prednisolone reduces the concentration of prostaglandins and the severity of the inflammatory reaction.
Inhibition of the accumulation of cells of the immune system in tissues that are responsible for the inflammatory process (leukocytes, lymphocytes, tissue macrophages).
Blocking the process of 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 is still not fully understood. Prednisolone also enhances the reabsorption of water and sodium ions in the distal parts of the renal tubules, increases the catabolism (decay) of proteins in the human body, inhibits bone synthesis, affects the redistribution of subcutaneous fat, increases the concentration of glucose in the blood.

and long-term intake of prednisolone in 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, a period of at least 1 month is required to restore normal functioning.

After oral administration of the Prednisolone tablet, the active substance is rapidly absorbed into the systemic circulation from the digestive tract, however, a longer period of time may be required for the development of a 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 mainly by the liver.

To date, there are a significant number of medical indications for the use of Prednisolone tablets, these include:

Endocrinological pathology - congenital adrenal hypoplasia (adrenogenital syndrome), primary or secondary insufficiency of the adrenal cortex, as a replacement therapy before surgery in patients with adrenal insufficiency, autoimmune thyroiditis (inflammation of the thyroid gland due to the production of antibodies by the immune system to its cells).
Severe allergic pathology that cannot be treated with other drugs - contact dermatitis, serum sickness, anaphylactic shock, angioedema, 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, Bechterew's disease (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 pathology of the joints - bursitis in the stage of acute and subacute course, acute tendovaginitis, epicondylitis, osteoarthritis, which develops as a result of trauma.
Malignant neoplasms (oncological pathology) - breast cancer in women, prostate cancer in men, multiple myeloma, various types of lymphomas, acute and chronic leukemia.
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.
Pathology of the heart - pericarditis.
Diseases of the respiratory system - berylliosis, chronic emphysema, bronchial asthma, symptomatic sarcaidosis, disseminated pulmonary tuberculosis.

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

Since the drug is used mainly for the treatment of severe pathology, the list of contraindications is small:

Hypersensitivity 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 for oral use. They are used orally, usually after meals, 1 time per day, which is associated with the daily rhythm of secretion of glucocorticosteroids 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 course of the pathological process in the patient's body. After reaching the desired 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. In case of missing a pill, it should be taken as soon as possible.

With a short-term intake of Prednisolone tablets, side effects develop extremely rarely. With longer use of the drug, the development of negative reactions from various organs and systems is possible:

The digestive system is a steroid ulcer of the stomach or duodenum, associated with the fact that prednisolone inhibits the synthesis of prostaglandins of the digestive tract, which perform a protective function, perforation of the ulcer or bleeding from it, periodic nausea, vomiting, increased appetite, inflammation of the pancreas (pancreatitis), esophagus ( esophagitis) with the formation of ulcers in it, a violation of the digestive process, increased gas formation in the intestine (flatulence).
Nervous system - increased intracranial pressure, which is accompanied by a syndrome of congestive optic disc (more often develops in children), sleep disturbances, convulsions, severe dizziness, headache, fainting.
Endocrine system - violation of the functional activity of the adrenal cortex (adrenal insufficiency), suppression of the growth process in children, increased blood sugar (hyperglycemia), menstrual irregularities 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 is the cause of subsequent pathological fractures, including compression fractures of some vertebrae.
Skin and subcutaneous tissue - thinning (atrophy) of the skin, striae on it, deterioration of wound healing, erythema (reddening of the skin), increased sweating (hyperhidrosis), the appearance of acne, pinpoint hemorrhages on the skin (petechiae).
Eyes - cataracts, an increase in intraocular pressure, as a result of which glaucoma subsequently develops, exophthalmos.
Higher nervous activity - symptoms of psychosis may appear, especially in the first 2 weeks after the start of taking Prednisolone tablets, it often develops in women and in persons with systemic lupus erythematosus.
Metabolism is a negative nitrogen balance in the body, which is caused by increased destruction of proteins, an increase in body weight.
Indicators of laboratory tests - a decrease in the number of leukocytes (leukopenia), platelets (thrombopenia), an increase in the level of calcium in the blood, urine, an increase in the level of triglycerides, total cholesterol, as well as low and very low density lipoproteins.
Allergic reactions - rarely, while taking Prednisolone tablets, anaphylactic shock may develop with multiple organ failure and a progressive decrease in blood pressure.

In the event of the development of side effects, the doctor decides on the abolition of 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 exposed to stress factors on the patient's body, it is recommended to switch to parenteral forms of glucocorticosteroids, which are administered intravenously or intramuscularly.
Sudden cancellation of Prednisolone tablets is excluded, as this can lead to the development of acute adrenal insufficiency, so the dosage is reduced gradually.
Against the background of the use of the drug, a manifestation of diabetes mellitus, as well as a latent course of amebiasis, is possible (in persons with signs of an intestinal infection of the lower digestive tract, as well as those arriving from tropical countries, a study on dysentery amoebiasis is mandatory before prescribing Prednisolone tablets).
Against the background of long-term use of Prednisolone tablets, glaucoma may develop, therefore, 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.
In patients with tuberculosis, the appointment of the drug is possible only with a fulminant course of the disseminated form.
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 cirrhosis of the liver, as well as in patients with concomitant hyperthyroidism (increased activity of the thyroid gland), the therapeutic effect of the drug is enhanced.
With caution, Prednisolone tablets are prescribed to patients with hypoprothrombinemia, with nonspecific ulcerative colitis, the presence of an abscess (limited purulent cavity) of any localization.
With prolonged 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.
In men, the drug can lead to a decrease in the number of spermatozoa per unit volume of semen.
For pregnant women, the drug is used 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 rate of psychomotor reactions are not provided, however, due to the possible development of side effects from the nervous system during its use, it is better to abandon potentially hazardous activities.

In pharmacies, Prednisolone tablets are dispensed only by 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 arterial pressure, the development of peripheral edema, the appearance or intensification of side effects. In this case, the drug is temporarily stopped, and then the dosage is reduced.

For Prednisolone tablets, the structural analogues 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 the reach of children in their original packaging.

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

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Indications for the use of Prednisolone

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

Injuries of nerves and joints on the spine
Osteoarthritis
Inflammation of the spinal cord or its membranes
Osteochondrosis
Arthritis of non-infectious origin
Bechterew's disease
Swelling of muscles, nerves and other structures of the spinal column
Lack of effect from drug therapy of the spine
Injuries of the spine, its joints, blood vessels and nerves, as well as the spinal cord
Severe pain in the spine

Contraindications to the use of Prednisolone

Contraindications to the appointment of Prednisolone are the following conditions in a patient:

lactation period
During pregnancy (especially before 12 weeks of gestation)
Tuberculosis
Itsenko-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

The principle of action of Prednisolone

Prednisolone is one of the most active drugs in this group. Among the actions of the drug on the human body, the main ones are anti-inflammatory, analgesic, decongestant and antitoxic. Also, the drug potentiates the action of other medicines prescribed for the treatment of diseases of the spine.

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

Instructions for use Prednisolone

prednisolone tablets

The drug is taken orally with a sufficient amount of liquid. The first dose is usually 20-30 mg per dose, once a 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 the course of treatment depends on the patient's condition and is selected strictly individually. It is necessary to reduce the dose of the drug gradually, over several days or weeks.

For children, if necessary, taking 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 enough.

Prednisolone in the form of a solution for injection

It can be administered both intramuscularly (deeply into the gluteal muscle) and intravenously by jet. The first injection is usually 30-45 mg. If necessary, do the next day the second - 30-60 mg. After that, they switch to the tablet form.

Children from 2 to 12 months are prescribed 2-3 mg per kg, from 1 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 the form of an ointment 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

The side effects of Prednisolone include the following manifestations in a 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
Increase in blood glucose
Ulceration 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 state of health allows, then taking Prednisolone is canceled.

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 refuse breastfeeding for the entire period of treatment with Prednisolone. In pregnancy up to 12 weeks, Prednisolone is contraindicated. At a later date, it is possible only in case of emergency.

Children are allowed to take Prednisolone, but you should adhere to the most accurate dosages and take the drug only if absolutely necessary.

Alcoholic drinks do not affect the work of Prednisolone in the body.

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Composition and form of release

Produce the following types of medication:

Solution for intravenous and intramuscular administration of 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 pyrosulfite (additive E223), disodium edetate, nicotinamide, sodium hydroxide, water for injections.

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

Prednisolone ointment contains 0.05 g of the 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 target cell of the skin (keratinocytes, fibroblasts, lymphocytes), enhances the expression of genes encoding the synthesis of lipocortins, which inhibit phospholipase A2 and reduce the synthesis of arachidonic acid metabolism products of 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 plasma concentration is reached 90 minutes after ingestion.

Prednisolone - hormonal or not?

Prednisolone is a hormonal drug for local and systemic use of medium duration of action. 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 a noticeable retention of sodium and water and only slightly increases potassium excretion.

Medicine Prednisolone: what helps

Indications for the use of tablets and injection solution

Systemic use is advisable for:

hepatitis;
eosinophilic and aspiration pneumonia, tuberculous meningitis, pulmonary tuberculosis (as an adjunct 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 that are accompanied by inflammation in the joints and periarticular tissue;
allergic diseases;
swelling of the brain;
inflammatory diseases of the gastrointestinal tract;
status asthmaticus and BA;
minor chorea, rheumatic fever, rheumatic heart disease;
developing on the background of oncological diseases of hypercalcemia.
diseases of the hematopoietic organs and blood (leukemia, anemia and diseases associated with damage to the hemostasis system);
congenital adrenal hyperplasia (VGN) or dysfunction of their cortex;
diffuse connective tissue diseases;
hypoglycemic conditions;
nephrotic syndrome;
autoimmune diseases;
interstitial diseases of the lung tissue (fibrosis, acute alveolitis, sarcoidosis, etc.);
primary and secondary hypocorticism (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 urgent conditions, for example, an acute attack of a food allergy 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).

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

What are eye drops used for?

Drops in the eyes are prescribed to relieve inflammation of a non-infectious nature that affects the anterior segment of the eye, as well as inflammation that develops after an eye injury or ophthalmic surgery.

Local application of Prednisolone is justified in the following eye diseases:

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

Ointment Prednisolone: what is it prescribed for?

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

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

Contraindications

The instruction prohibits the use of Prednisolone in the following cases:

peptic ulcer of the stomach and duodenum;
active form of tuberculosis;
nephritis (inflammation of the kidneys);
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.

The drug 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 localization of the affected organ.

In severe and life-threatening conditions, the patient is prescribed pulse therapy using ultra-high doses for a short period of time. Within 3-5 days, 1-2 g of prednisolone is administered 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 tissues inside the joint are affected by the pathological process.

Positive dynamics is the reason for transferring the patient to tablets or suppositories with prednisolone. Treatment with tablets is continued until a stable remission develops. If it is impossible to administer IV prednisolone, the drug 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 may vary between 30-1200 mg / day. (with subsequent reduction).

Children aged 2 months to 1 year are administered 2 to 3 mg/kg. Dosage for children from one to 14 years old - 1-2 mg / kg (in the form of a slow, lasting 3 minutes, intramuscular injection). If necessary, after 20-30 minutes, the drug is administered again at the same dose.

If a large joint is affected, 25 to 50 mg of prednisolone is injected into it. From 10 to 25 mg are injected into the joints of medium size, from 5 to 10 mg into small ones.

Instructions for use of Prednisolone tablets

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

In the case of HRT, the patient is prescribed from 20 to 30 mg of prednisolone per day. Maintenance dose - from 5 to 10 mg / day. In 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.

Application of eye drops

Instillations with the drug are carried out 3 times a day, instilling 1-2 drops of the 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 for 3-5 days after surgery.

Ointment Prednisolone: instructions for use

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 rubles / day. An occlusive dressing can be applied to limited pathological foci to enhance the effect.

In the case of use in children older than one year of age, the drug should be used as short a course as possible. You should also exclude measures that enhance the absorption and resorption of prednisolone (occlusive, fixing, warming dressings).

How long can prednisolone be taken?

Therapy with glucocorticosteroids is aimed at achieving the maximum effect with the lowest possible doses.

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

Side effect

The use of the drug can cause the following negative reactions of the body:

acne;
convulsions;
osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur);
trophic changes in the cornea;
disorientation;
delayed sexual development in children;
increased intracranial pressure;
skin rash;
hypokalemia 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 excretion of calcium;
nausea, vomiting;
weight gain;
decreased glucose tolerance;
increase in blood pressure;
gastrointestinal bleeding and perforation of the gastrointestinal tract wall;
ECG changes characteristic of hypokalemia;
increase or decrease in appetite;
increased intraocular pressure with possible damage to the optic nerve;
muscle tendon rupture;
euphoria;
striae;
flatulence;
Itsenko-Cushing's syndrome (moon face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae);
increased sweating;
dizziness;
nervousness or anxiety;
affective insanity;
steroid diabetes mellitus or manifestation of latent diabetes mellitus;
growth retardation and ossification processes in children (premature closure of the epiphyseal growth zones);
arrhythmias;
erosive esophagitis;
the 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;
decrease in muscle mass (atrophy);
delayed wound healing.

Withdrawal symptoms

One of the consequences of the use of GCS can be a “withdrawal syndrome”. Its severity depends on the functional state of the adrenal cortex. In mild cases, after stopping treatment with Prednisolone, malaise, weakness, fatigue, muscle pain, loss of appetite, hyperthermia, 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, death from acute cardiovascular failure occurs in a short time.

How to "get off" with Prednisolone?

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

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

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

During pregnancy and lactation

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

Prednisolone is excreted in breast milk and can cause undesirable effects in a breast-fed child (growth retardation or inhibition of the production of endogenous adrenal hormones). If necessary, the use of the drug during lactation should stop breastfeeding.

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. 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 for the active substance:

Solu-Decortin H25.
Solu-Decortin H50.
Prednisolone 5 mg Jenafarm.
Prednisolone Nycomed.
Prednisolone Bufus.
Decortin H20.
Decortin H5.
Solyu-Decortin H250.
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.
Dexazon.
Dexamethasone.
Rektodelt.
Lemod.
Deltason.
Medrol.
Metipred.

Price

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

In this article, you can read the instructions for the use of a medicinal hormonal drug Prednisolone. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Prednisolone in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Prednisolone 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 lactation.

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

Interacts with specific cytoplasmic receptors (there are receptors for corticosteroids 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 enhances protein catabolism in muscle tissue.

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

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

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

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 that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes (especially lysosomal) and organelle membranes. It acts on all stages of the inflammatory process: it inhibits the synthesis of prostaglandins at the level of arachidonic acid (lipocortin inhibits phospholipase A2, inhibits the liberation of arachidonic acid and inhibits the biosynthesis of endoperoxides, leukotrienes, which contribute to inflammation, allergies, etc.), the synthesis of "pro-inflammatory 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 due to the involution of lymphoid tissue, inhibition of the proliferation of lymphocytes (especially T-lymphocytes), suppression of B-cell migration 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 production.

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, and changing the body's immune response.

In obstructive diseases of the respiratory tract, the action is mainly due to the inhibition of inflammatory processes, the prevention or decrease in the severity of edema of the mucous membranes, the decrease in eosinophilic infiltration of the submucosal layer of the bronchial epithelium and the 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.

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

Pharmacokinetics

Prednisolone is metabolized in the liver, partly in the kidneys and other tissues, mainly by conjugation with glucuronic and sulfuric acids. Metabolites are inactive. Excreted in the bile and urine by glomerular filtration and 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), hemotransfusion shock, anaphylactic shock, anaphylactoid reactions;
cerebral edema (including against the background of 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 of the joints - gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, humeroscapular periarthritis, ankylosing spondylitis (Bekhterev's disease), juvenile arthritis, Still's syndrome in adults, bursitis, nonspecific tendosynovitis, synovitis and epicondylitis ;
skin diseases - pemphigus, psoriasis, eczema, atopic dermatitis (common neurodermatitis), contact dermatitis (with damage to a large surface of the skin), toxidermia, 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 (erythrocytic anemia), congenital (erythroid) hypoplastic anemia;
berylliosis, Leffler's syndrome (unresponsive to other therapies); lung cancer (in combination with cytostatics);
multiple sclerosis;
prevention of transplant rejection during organ transplantation;
hypercalcemia against the background of oncological diseases, nausea and vomiting during cytostatic therapy;
myeloma;
thyrotoxic crisis;
acute hepatitis, hepatic coma;
reduction of inflammation and prevention of cicatricial narrowing (in case of poisoning with caustic fluids).

Release form

Tablets 1 mg and 5 mg.

Solution for intravenous and intramuscular administration (injections in ampoules for injection) 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 set by the doctor individually, depending on the indications and the severity of the disease.

Prednisolone is administered intravenously (drip or jet) in droppers or intramuscularly. In / in the drug is usually administered first in a jet, then drip.

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

In 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 may be increased to 1400 mg per course of treatment or more with a gradual dose reduction.

With asthmatic status, Prednisolone is administered at a dose of 500-1200 mg per day, followed by a decrease to 300 mg per day and a transition to maintenance doses.

With a thyrotoxic crisis, 100 mg of the drug is administered at 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 shock resistant to standard therapy, prednisolone is usually administered by 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 jet administration of the drug. After removing from the state of shock, continue drip administration 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 acute hepatic-renal failure (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 and above.

In rheumatoid arthritis and systemic lupus erythematosus, Prednisolone is administered in addition to the 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 at 75-100 mg per day for 7-10 days.

In case of poisoning with caustic fluids 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 stopping the acute condition, Prednisolone is prescribed orally in tablets, followed by a gradual decrease in the dose.

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

Tablets

The entire daily dose of the drug is recommended to take a single or double daily dose every other day, taking into account the circadian rhythm of endogenous secretion of glucocorticosteroids in the range from 6 to 8 am. A high daily dose can be divided into 2-4 doses, while in the morning you should take a large dose. Tablets should be taken orally during or immediately after a meal with a small amount of liquid.

In acute conditions and as replacement therapy, adults are prescribed an initial dose of 20-30 mg per day, 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 of body weight per day in 4-6 doses, the maintenance dose is 300-600 mcg / kg per day.

Upon receipt of a therapeutic effect, the dose is gradually reduced - 5 mg, then 2.5 mg at intervals of 3-5 days, first canceling later doses. With prolonged use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped abruptly! Cancellation of the maintenance dose is carried out the slower, the longer the glucocorticosteroid therapy was used.

Under stressful influences (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's syndrome (moon face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae);
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;
increase or decrease in appetite;
indigestion;
flatulence;
hiccups
arrhythmias;
bradycardia (up to cardiac arrest);
ECG changes characteristic of hypokalemia;
increase in blood pressure;
disorientation;
euphoria;
hallucinations;
affective insanity;
depression;
paranoia;
increased intracranial pressure;
nervousness or anxiety;
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 excretion of calcium;
weight gain;
increased sweating;
fluid and sodium retention in the body (peripheral edema);
hypokalemia syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
growth retardation and ossification processes in children (premature closure of the epiphyseal growth zones);
osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur);
muscle tendon rupture;
decrease in muscle mass (atrophy);
delayed wound healing;
acne;
striae;
skin rash;
anaphylactic shock;
the 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 preparation contains lactose. Patients with rare hereditary diseases such as lactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take the drug.

Use during pregnancy and lactation

During pregnancy (especially in the 1st trimester), they are used only for health reasons.

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

special instructions

Before starting treatment (if it is 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, organs of vision; control of the blood count, glucose and electrolytes in the blood plasma. During treatment with prednisolone (especially long-term), it is necessary to observe an ophthalmologist, control blood pressure, the state of water and electrolyte balance, as well as pictures of peripheral blood and blood glucose levels.

In order to reduce side effects, you can prescribe antacids, as well as increase the intake of potassium in the body (diet, potassium preparations). Food should be rich in proteins, vitamins, with limited content of fats, carbohydrates and salt.

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

The drug may increase existing emotional instability or psychotic disorders. When indicating a history of psychosis, prednisone in high doses is prescribed under the strict supervision of a physician.

In stressful situations during maintenance treatment (for example, surgery, trauma or infectious diseases), the dose of the drug should be adjusted due to an increase in the 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, the development of a withdrawal syndrome (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness) is possible, 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 with prednisolone, careful monitoring of growth dynamics is necessary. Children who during the period of treatment were in contact with patients with measles or chickenpox are prescribed specific immunoglobulins prophylactically.

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

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

X-ray control of the osteoarticular system (spine, hand) is shown.

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

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

drug interaction

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

The simultaneous appointment of prednisolone with diuretics (especially thiazide and carbonic anhydrase inhibitors) and amphotericin B can lead to increased excretion of potassium from the body.

The simultaneous appointment of prednisolone with sodium-containing drugs leads to the development of edema and an increase in blood pressure.

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

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

The simultaneous appointment of prednisolone with indirect anticoagulants - prednisolone enhances the anticoagulant effect of coumarin derivatives.

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

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

The simultaneous appointment of prednisolone with acetylsalicylic acid accelerates its excretion and reduces the concentration in the blood (with the abolition of prednisolone, the level of salicylates in the blood increases and the risk of side effects increases).

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

Co-administration of prednisolone with vitamin D reduces its effect on Ca absorption in the intestine.

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

The simultaneous appointment of prednisolone with m-anticholinergics (including antihistamines and tricyclic antidepressants) and nitrates contributes to an increase in intraocular pressure.

The simultaneous appointment of prednisolone with isoniazid and mexiletin increases the metabolism of isoniazid, mexiletin (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 osteoporosis.

The simultaneous appointment of prednisolone with indomethacin - displacing prednisolone from its association with albumins, increases the risk of its side effects.

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

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

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

The appearance of hirsutism and acne contributes to the simultaneous use of other steroid hormonal drugs (androgens, estrogens, anabolics, oral contraceptives).

The simultaneous appointment 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.

The simultaneous appointment of prednisolone with mitotane and other inhibitors of the adrenal cortex may necessitate an increase in the dose of prednisolone.

When used simultaneously with live antiviral vaccines and against the background of other types of immunization, it increases the risk of virus activation and the development of infections.

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

The simultaneous appointment of antacids reduces the absorption of prednisolone.

With simultaneous use with antithyroid drugs, it decreases, and with thyroid hormones, the clearance of prednisolone increases.

With simultaneous use 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 prolonged therapy) the content of folic acid.

Hypokalemia caused by glucocorticosteroids can increase the severity and duration of muscle blockade against the background of muscle relaxants.

In high doses, it reduces the effect of somatropin.

Analogues of the drug Prednisolone

Structural analogues for the active substance:

Decortin H20;
Decortin H5;
Decortin H50;
Medopred;
Prednisol;
Prednisolone 5 mg Jenafarm;
prednisolone bufus;
Prednisolone hemisuccinate;
Prednisolone Nycomed;
Prednisolone-Ferein;
Prednisolone sodium phosphate;
Solu-Decortin H25;
Salt-Decortin H250;
Solu-Decortin H50.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see 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. Violates the ability of macrophages to phagocytosis, as well as to the formation of interleukin-1. Contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to the release of histamine. Suppresses the activity of fibroblasts and the formation of collagen.
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; inhibits the formation of antibodies.
Prednisolone inhibits the release of pituitary ACTH and b-lipotropin, but does not reduce the level of circulating b-endorphin. Inhibits the secretion of TSH and FSH.
When applied directly to the 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 stimulates the secretion of insulin.
Prednisolone inhibits the uptake of glucose by fat cells, which leads to the activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which contributes to the accumulation of fat.
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: it promotes the excretion of potassium and calcium ions, the retention of sodium and water ions in the body. Osteoporosis and Itsenko-Cushing's syndrome are the main factors limiting long-term therapy with corticosteroids. As a result of the catabolic action, 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.
With systemic use, the therapeutic activity of prednisolone is due to anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.
With external and local application, the therapeutic activity of prednisolone is due to anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action.
Compared with hydrocortisone, the anti-inflammatory activity of prednisolone is 4 times greater, and the 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 prednisolone binds to transcortin (cortisol-binding globulin). It is metabolized mainly in the liver.
The half-life is about 200 minutes. Excreted by the kidneys unchanged - 20%.

Indications

For oral and / m: rheumatism; rheumatoid arthritis; dermatomyositis; nodular periarteritis; scleroderma; ankylosing spondylitis; 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 forms of leukemia, lymphogranulomatosis, thrombocytopenic purpura, hemolytic anemia; chorea; pemphigus, eczema, itching, exfoliative dermatitis, psoriasis, pruritus, 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; acute and chronic inflammation of the anterior segment of the 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 of individual joints, arthrosis.
For infiltration introduction into tissues: epicondylitis, tendovaginitis, bursitis, humeroscapular periarthritis, keloids, sciatica, Dupuytren's contracture, rheumatic and similar lesions of the joints and various tissues.

Dosing 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. The daily dose should be reduced gradually. For children, the initial dose is 1-2 mg / kg / day in 4-6 doses, the maintenance dose is 300-600 mcg / kg / day.
With the / m administration, the dose, frequency and duration of use are determined individually. With intra-articular injection into large joints, a dose of 25-50 mg is used, for joints of medium size - 10-25 mg, for small joints - 5-10 mg. For infiltration administration into tissues, depending on the severity of the disease and the size of the affected area, doses from 5 to 50 mg are used.
Locally used in ophthalmology 3 times / 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's 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 of gastric juice, ulcerogenic effect on the gastrointestinal tract.
From the side of metabolism: increased excretion of potassium, sodium retention in the body with the formation of edema, negative nitrogen balance.
From the side of the cardiovascular system: arterial hypertension.
From the blood coagulation system: increased blood clotting.
From the musculoskeletal system: osteoporosis, aseptic necrosis of bones.
On the part of the organ of vision: steroid cataract, provoking latent glaucoma.
From the side of the central nervous system: mental disorders.
Effects due to immunosuppressive action: reduced resistance to infections, delayed wound healing.
When applied externally: steroid acne, purpura, telangiectasias may appear, 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 of the 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 in mental illness. Hypersensitivity to prednisolone.
Infiltration introduction into the lesions of the skin and tissues with chickenpox, specific infections, mycoses, with a local reaction to vaccination.
In ophthalmology - viral and bacterial eye diseases, primary glaucoma, corneal diseases 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), they are used only for health reasons. If necessary, use during lactation should carefully weigh the expected benefits of treatment for the mother and the risk to the child.

special instructions

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

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

drug interaction

With the simultaneous use of prednisolone with anticoagulants, it is possible to increase the anticoagulant effect of the latter; with salicylates - the likelihood of bleeding increases; with diuretics - aggravation of electrolyte disturbances is possible; with antidiabetic drugs - the rate of decrease in blood sugar decreases; with cardiac glycosides - the risk of developing glycoside intoxication increases; with rifampicin - a weakening of the therapeutic effect of rifampicin.

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

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