Prednisone tablets

Prednisolone is a synthetic glucocorticosteroid drug that exerts an anti-inflammatory effect. Has anti-allergic, anti-shock, anti-inflammatory effect.

Prednisolone is a dehydrogenated analog of the hormone produced by the adrenal cortex of hydrocortisone. Its activity is four times higher than that of hydrocortisone. Prevents the development of an allergic reaction (in case the reaction has already begun, it stops), suppresses the activity of the immune system, removes inflammation, increases the sensitivity of β2-adrenoreceptors to endogenous catecholamines, has anti-shock effect.

This drug is used only as part of complex therapy to relieve severe inflammation, edema, itching, exudation and proliferation in vasculitis, rheumatism, arthritis, myocarditis, pericarditis, dermatomyositis, glomerulonephritis, multiple sclerosis, pemphigus, psoriasis, systemic lupus erythematosus, leukemia, lymphogranulomatosis, tumors, scleroderma, periarteritis, bronchial asthma, Quincke's edema, Bechterew's disease, drug allergy, shock, eczema, dermatitis, hepatitis, inflammatory pathologies of the eye and insufficiency of the adrenal cortex.

instagram viewer

Clinical and pharmacological group

GCS for oral administration.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much are pills of prednisolone in pharmacies? The average price is at the level of90 rubles.

Form of issue and composition

Tablets have a circular planoclinic shape and white color. On one side there is a chamfer for easy breaking of a tablet in half

Prednisolone in tablets: 1 or 5 mg of active substance, colloidal silicon dioxide, magnesium stearate, stearic acid, starch (potato and corn), talc, lactose monohydrate.

Tablets are packaged in bottles of dark glass in an amount of 30 pieces. A cardboard pack contains one vial of tablets and instructions to the preparation.

Pharmacological effect

Prednisolone is a synthetic analogue of cortisone and hydrocortisone. Has anti-inflammatory, antiallergic, antitoxic effects. It also has an immunosuppressive and anti-shock effect. Does not cause a delay in water and sodium in the body, increases the production of potassium and hydrogen ions.

Anti-inflammatory effect is achieved by inhibiting the accumulation of macrophages, stabilizing the cell membranes in the inflammation zone. The action of prednisolone prevents the formation of edema, affects the synthesis of mediators of inflammation, the metabolism of arachidonic acid. Prednisolone increases the level of glucose in the blood. In this regard, glycogen accumulates in the liver and there is resistance to insulin.

The action of prednisolone inhibits the production and release of adrenocorticotropic hormones, which leads to a decrease in the synthesis of glucocorticosteroid hormones by the adrenal cortex.

Indications for use

Systemic application is advisable when:

Multiple sclerosis;
asthmatic status and asthma;
granulomatous thyroiditis;
autoimmune diseases;
hepatitis;
inflammatory diseases of the digestive tract;
hypoglycemic conditions;
nephrotic syndrome;
small chorea, rheumatic fever, rheumatic heart disease;
diffuse connective tissue diseases;
lung cancer (medication is prescribed in combination with cytostatics);
interstitial diseases of the lung tissue (fibrosis, acute alveolitis, sarcoidosis, etc.);
primary and secondary hypocorticism (including after adrenalectomy);
congenital adrenal hyperplasia (UGN) or dysfunction of their cortex;
diseases of the blood-forming organs and blood (leukemia, anemia and diseases associated with the defeat of the hemostatic system);
eosinophilic and aspiration pneumonia, tuberculosis meningitis, pulmonary tuberculosis (as a supplement to specific therapy);
edema of the brain (postradiation, developing with a tumor, after surgery or trauma, in the annotation and Vidal's guide indicates that when the brain is swollen, treatment starts with parenteral forms of the drug);
autoimmune and other skin diseases (including Dühring's disease, psoriasis, eczema, pemphigus, Lyell's syndrome, exfoliative dermatitis);
eye diseases (including autoimmune and allergic, including uveitis, allergic ulcer keratitis, allergic conjunctivitis, sympathetic ophthalmia, choroiditis, iridocyclitis, non-purulent keratitis, etc.);
acute and chronic diseases, which are accompanied by inflammation in the joints and periarticular tissue (synovitis, nonspecific tendosynovitis, seronegative spondylitis, epicondylitis, osteoarthritis (including post-traumatic), etc.);
allergic diseases (including allergies of food or medication, toxicodermia, serum sickness, atopic / contact dermatitis, pollinosis, allergic rhinitis, hives, Stevens-Johnson syndrome, Quincke's edema);
developing against a background of oncological diseases of hypercalcemia.

Indications for the use of pricks are urgent conditions, for example, acute attack of food allergy or anaphylactic shock. After several days of parenteral use, the patient is usually transferred to a tablet form.

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

Prednisolone solution and tablets are also used to prevent graft rejection and stopping nausea / vomiting in patients receiving cytotoxic drugs.

Contraindications

With short-term systemic use of Prednisolone according to vital indications, the only contraindication for his use is an increased individual sensitivity to the acting or auxiliary components.

The intake of tablets, intramuscular and intravenous administration of solutions of Prednisolone are contraindicated in the following diseases and conditions:

Diabetes;
Thyrotoxicosis;
Hypothyroidism;
Osteoporosis;
Myasthenia gravis;
Acute psychosis;
Obesity III - IV degrees;
Polio;
Glaucoma;
Illness of Itenko-Cushing;
Severe chronic renal or hepatic insufficiency;
Nephrourolythiasis (kidney stones);
Low protein in the blood;
Immunodeficiency conditions;
Post-vaccination period (8 weeks before and 2 weeks after vaccination);
Lymphadenitis after BCG vaccination;
Recently suffered myocardial infarction;
Chronic heart failure in the stage of decompensation;
Hypertonic disease;
Hyperlipidemia (high cholesterol, HDL, LDL and TG in the blood);
Infectious diseases in the active phase caused by viruses, fungi and bacteria (herpes simplex, herpes zoster, chickenpox, measles, amebiasis, strongyloidiasis, systemic mycosis, tuberculosis);
Gastrointestinal diseases (peptic ulcer of stomach and duodenum, esophagitis, gastritis, newly created intestinal anastomosis, ulcerative colitis, diverticulitis);
Pregnancy and the period of breastfeeding.

Use in pregnancy and lactation

When pregnancy can be used only if there is a threat to the life of the mother, because Prednisolone has a teratogenic effect. In experiments on rats and mice, the development of the wolf mouth was shown in calves born to mothers who received prednisolone during pregnancy.

When breastfeeding Prednisolone also should not be used, because the hormone penetrates into the milk and can affect the baby's body. Therefore, when it is necessary to use in nursing mothers, it is necessary to transfer the child to artificial mixtures.

Prednisolone for children

In children, prednisolone is used only in cases of acute necessity, when there is a threat of life or a serious illness that can not be cured by other medicines. When using tablets and solution in children under 14 years of age, use a discontinuous scheme, which consists in taking the drug for 3 days, after which a break for 4 days, etc.

Such a discontinuous scheme reduces the risk of stopping the growth and development of the child. When using the ointment, it is not possible to carry out additional measures that increase the absorption of the drug into the blood (for example, warming up, tight bandages, etc.). Otherwise, the rules of application and precautions for children are the same as for adults.

Dosage and route of administration

The instructions for use indicate that the dose of Prednisolone and the duration of treatment is set by the doctor individually, depending on the indications and severity of the disease.

The entire daily dose of the drug is recommended to take a single or double daily dose - every other day taking into account circadian rhythm of endogenous secretion of glucocorticosteroids in the interval from 6 to 8 am. A high daily dose can be divided into 2-4 doses, with a large dose taken in the morning. Tablets should be taken orally during or immediately after meals, with a small amount of liquid.
In acute conditions and as a replacement therapy, adults are prescribed in an initial dose of 20-30 mg / day, the maintenance dose is 5-10 mg / day. If necessary, the initial dose may be 15-100 mg / day, supporting - 5-15 mg / day. For children from 3 years of age and older, the initial dose is 1-2 mg / kg of body weight per day in 4-6 receptions, maintaining - 0.3-0.6 mg / kg / day.
When the therapeutic effect is obtained, the dose is gradually reduced by 5 mg, then by 2.5 mg at intervals of 3-5 days, canceling at a later stage. With prolonged use of the drug, the daily dose should be reduced gradually. Long-term therapy can not be stopped suddenly! The withdrawal of the maintenance dose is slower the longer the glucocorticosteroid therapy is used.

Under stressful influences (infection, allergic reaction, trauma, surgery, nervous stress) to avoid exacerbation The main dose of prednisolone should be temporarily increased (in 1.5-3, and in severe cases - 5-10 times).

Peculiarities of nutrition when taking prednisolone

When taking Prednisolone, it is recommended to exclude from the diet fried and spicy foods, as well as fruits and sour juices that stimulate the secretion of hydrochloric acid. In addition, it is necessary to limit the amount of high-calorie food with a high content of carbohydrates and fats (their consumption on the background of GCS-therapy helps to increase blood glucose and fast weight gain), table salt and liquid.

When preparing food, you must use foods that contain potassium, calcium and protein salts (dietary grades meat, dairy products, fruits, hard cheeses, baked potatoes, prunes, apricots, nuts, zucchini, etc.).

Abolition of the drug

Treatment should be completed gradually. Dose reduction is carried out, weekly reducing the dose used by ⅛ or taking the last dose every other day and decreasing it by ⅕ (this method is more rapid).

With a fast method per day without Prednisolone, the patient is shown to stimulate the adrenal glands with UHF or DKV on their projection, taking ascorbic acid (500 mg / day), the introduction of insulin in increasing doses (starting - 4 units, then for each reception it is increased by 2 units, the highest dose - 16 units).

Insulin should be stabbed 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 cytotoxic drugs.

Side effects

With the short-term use of tablets, prednisolone side effects are extremely rare. With a longer use of the drug, it is possible to develop negative reactions from various organs and systems:

Metabolism is a negative nitrogen balance in the body, which is caused by increased destruction of proteins, an increase in body weight.
Skin and subcutaneous tissue - thinning (atrophy) of the skin, striae on it, deterioration of wound healing, erythema (redness skin), increased sweating (hyperhidrosis), the appearance of acne, pinpoint hemorrhages on the skin (petechiae).
Nervous system - increase in intracranial pressure, which is accompanied by a syndrome of the stagnant disk of the visual nerve (more often develops in children), sleep disorders, convulsions, severe dizziness, headache, fainting.
Water-electrolyte balance - the retention of water and salts in the body, accompanied by an increase in blood pressure, as well as the development of circulatory insufficiency.
Eyes - cataract, an increase in intraocular pressure, which subsequently develops glaucoma, exophthalmos.
Higher nervous activity - the symptomatology of psychosis may appear, especially in the first 2 weeks after taking pills, is more likely to develop in women and in people with red systemic lupus.
Musculoskeletal system - muscle weakness, increased fragility of bones (osteoporosis), which is cause subsequent pathological fractures, including compression fracture of some vertebrae.
Allergic reactions - rarely on the background of taking tablets, it is possible to develop anaphylactic shock with multiple organ failure and a progressive decrease in blood pressure.
Endocrine system - a violation of the functional activity of the adrenal cortex (adrenal insufficiency), suppression of the growth process in children, increased blood sugar (hyperglycemia), violation of the menstrual cycle in women, the manifestation of latent (latent) diabetes mellitus, hirsutism (increased ovoloration of the skin, which is especially noticeable in women).
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 system tract, performing a protective function, perforation of the ulcer or bleeding from it, recurrent 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 gassing in the intestine (flatulence).
Indicators of laboratory studies - a decrease in the number of leukocytes (leukopenia), platelets (thrombopenia), an increase in the level of calcium in blood, urine, an increase in the level of triglycerides, total cholesterol, as well as low and very low density lipoproteins.

In the case of side effects, the doctor decides whether to cancel tablets on an individual basis, depending on their type, nature and severity.

Overdose

It occurs with prolonged use of Prednisolone in high doses. It can be expressed by increased arterial pressure, peripheral edema. In addition, there may be an increase in side effects.

Also, with prolonged use may appear syndrome Itenko-Cushing. Women may experience a menstrual cycle and infertility. In men, impotence is possible. Children may grow slower.

special instructions

Before you start using the drug, read the special instructions:

The effect of the drug is enhanced in patients with hypothyroidism and liver cirrhosis.
An x-ray control of the osteoarticular system (images of the spine, hands) is shown.
During treatment, vaccination should not be given due to a decrease in its effectiveness (immune response).
Before the beginning of treatment (if it is impossible due to the urgency of the condition - during the treatment), the patient should be examined for possible contraindications. Clinical examination should include a study of the cardiovascular system, a chest X-ray, a study of the stomach and the duodenum, the urinary system, the organs of vision; the control of the formula of blood, the content of glucose and electrolytes in the blood plasma.
During treatment (especially long) it is necessary to observe the oculist, control blood pressure, condition water-electrolyte balance, as well as patterns of peripheral blood and blood glucose concentrations.
In order to reduce side effects, antacids can be used, and the intake of potassium ions (K +) into the body (diet, potassium preparations) can be increased. Food should be rich in proteins, vitamins, with a restriction of fat, carbohydrates and table salt.
The drug may enhance existing emotional instability or psychotic disorders. When referring to a psychosis in an anamnesis, prednisolone in high doses is administered under the strict supervision of a physician.
In stressful situations during maintenance treatment (eg, surgery, trauma or infectious disease) should adjust the dose of the drug due to increased demand for glucocorticosteroids. It should be carefully monitored for patients within a year after the end of long-term therapy with Prednisolone in connection with the possible development of a relative insufficiency of the adrenal cortex in stressful situations.
Applying prednisolone in intercurrent infections, septic states and tuberculosis, it is necessary to simultaneously carry out antibiotic treatment of bactericidal action.
Children during prolonged treatment need careful monitoring of the dynamics of growth and development. Children who during the period of treatment were in contact with sick measles or chickenpox, prophylactically use specific immunoglobulins.
Due to a weak mineralocorticosteroid effect for replacement therapy with adrenal insufficiency, prednisolone is used in combination with mineralocorticosteroids.
Patients with diabetes should monitor blood glucose and, if necessary, correct therapy.
In patients with latent infectious diseases of the kidneys and urinary tract can cause leukocyturia, which can have diagnostic value.
Increases the metabolites of 11- and 17-oxyketocorticosteroids.

In case of sudden cancellation, especially in case of previous application of high doses, the development of the "withdrawal" syndrome (anorexia, nausea, generalized musculo-skeletal pain, general weakness), as well as an exacerbation of the disease, which was prescribed prednisolone.

Drug Interactions

In connection with high pharmacological activity, prednisolone, like other GCS, can weaken or enhance the action of many drugs / drugs. If you need to use a solution, tablets or eye drops of Prednisolone in combination with other drugs, the attending physician should consider and take into account their possible interaction.

In connection with the possible pharmaceutical incompatibility of the solution of Prednisolone with other drugs, injected intravenously, it is recommended to enter it separately: bolus, or through another dropper. Mixing of solutions of prednisolone and heparin occurs with the formation of a precipitate.

Reviews

We picked up some reviews of people who used the drug Prednisolone:

Olga. My daughter had atypical jaundice, to which then hepatitis was added. Atypical jaundice is when direct and indirect bilirubin is almost 50/50. This not normal. Treatment for such a disease is prescribed corticosteroids, and this includes Prednisolone. Drank tablets on schedule, which the doctor painted, gradually reducing the dose. A month later, biochemical analysis showed that bilirubin is normal.
Lika. My granddaughter had an allergy with creepy swelling. She was put in a hospital and prescribed among other drugs Prednisolone. During the application, her appetite increased, but her immunity decreased. To stop his reception is impossible, you need to gradually reduce the dose. Gradually negative consequences have passed. But most importantly, this drug helped the granddaughter cope with allergies.
Leonid. For me, there was this medicine for a very long time, but then somehow forgot about it. Found analogs suitable. And actually yesterday I had an asthma attack. Very strong.. Nobody expected this. We were then at the dacha and did not take any special medicines, because knowing my body, in the autumn of attacks less often than ever. It was very nice that my aunt had prednisolone. He saved me then.

In general, reviews on Prednisolone on the one hand are positive, as the drug effectively and quickly removed an acute condition, potentially life-threatening, associated with allergic reactions, Quinck's edema, acute renal insufficiency, etc. On the other hand, in all reviews there is an indication that the drug is very serious, has a wide range of side effects that can occur after one injection, and after 10 injections, depending on the individual characteristics of the body. Therefore, in the responses, people respond positively, but recommend using it only in critical situations, when you need a quick effect or other drugs do not help.

Analogues

Structural analogs for the active substance:

Decortin H20;
Decortin H5;
Decortin H50;
Medomobred;
Prednisol;
Prednisolone 5 mg of Jenafarm;
Prednisolone buff;
Prednisolone hemisuccinate;
Prednisolone Nycomed;
Prednisolone-Ferein;
Prednisolone sodium phosphate;
Sol-Decortin H25;
Solu-Decortin H250;
Sol-Decortin H50.

Before using analogues, consult your doctor.

Prednisolone or Dexamethasone?

Dexamethasone has 7 times more potent action than Prednisolone, therefore it is prescribed only by short courses in emergency conditions. In addition, all the side effects of Dexamethasone are also more pronounced than in Prednisolone. Therefore, if you need a single injection of glucocorticoids according to vital indications, then you should prefer Dexamethasone.

If you need to take hormonal drugs course, then for this purpose is better suited Prednisolone.

Storage conditions and shelf life

Store in a place protected from light and out of reach of children, at a temperature of: tablets - up to 25 ° C, ointment, solution for injection - up to 15 ° C, do not freeze the solution; eye drops - 15-25 ° C, open the bottle for 4 weeks.

The shelf life depends on the manufacturer (see the packaging).