Prednisone side effects and how to avoid them

Prednisone side effects include insomnia, weight gain, hair loss, and constipation

Common prednisone side effects | Serious side effects | Insomnia | Weight gain | Hair loss | Constipation | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects

Prednisone is a generic prescription drug prescribed for many medical conditions including allergic reactions, inflammatory arthritis, cancer, autoimmune diseases, irritable bowel syndrome (IBS), lung disorders, endocrine disorders, blood disorders, connective tissue disorders, and organ transplants. 

As a corticosteroid, prednisone primarily affects the immune system to reduce inflammation. Unfortunately, it also has a rich variety of side effects. At a low dose for a short time, prednisone can provide tremendous benefits without serious problems. High-dose or long-term treatment may be needed for certain conditions, but is also associated with more side effects. Not all prednisone side effects are avoidable, but they may be minimized or managed.

Common side effects of prednisone

Prednisone has a long list of common side effects affecting just about every system in the body. Most people—about 2 in every 3—will experience some side effects when taking prednisone. Common side effects include:

• Stomach pain
• Nausea and vomiting
• Face puffiness
• Facial redness
• Unwanted hair growth
• Acne
• Weight gain
• Changes in appetite
• Mood swings
• Agitation
• Rash
• Hives
• Thinning or discoloration of the skin
• Fluid retention and swelling
• Sweating
• Sodium retention
• Potassium loss
• Elevated blood pressure
• Elevated pressure in the eyes
• Increased blood glucose
• Headache
• Slow wound healing
• Menstrual changes

Serious side effects of prednisone

Serious side effects are more likely when taken in high doses or for a long time. These include:

• Steroid psychosis
• Muscle damage
• Infection
• Diabetes
• High blood pressure
• Seizures
• Congestive heart failure
• Peptic ulcer or gastrointestinal perforation
• Swelling of the pancreas
• Bone tissue death
• Tendon rupture
• Bulging eyes
• Increased pressure in the brain
• Severe or life-threatening allergic reactions
• Withdrawal or adrenal gland insufficiency

When taken over the long term, serious side effects might also involve:

• Bone loss (osteoporosis)
• Glaucoma
• Cataracts
• Serious infections
• Growth suppression in children
• Cushing syndrome

Insomnia

While the incidence is not known, sleep problems are a common complaint in people taking prednisone. It may not always affect total sleep time, but people taking prednisone may wake up during the night more than usual and feel less rested in addition to having problems falling asleep. People can try to take prednisone early in the day and practice good sleep hygiene. If sleep quality becomes a problem, ask for medical advice from a healthcare professional.

Weight gain

When taken continuously for a long enough time, corticosteroids are associated with weight gain. In one study, 70% of people taking corticosteroids for 60 days gained some weight. Part of this is due to increased appetite and part is due to a change in the body’s metabolism. Fluid retention also adds weight, but this will go away when steroid treatment is stopped. People taking a short course of prednisone shouldn’t be concerned, but when taken for weeks or months at a time, the best solution is to talk to a nutritionist or other healthcare professional about a fitness and diet program.

Hair loss

In some people, prednisone and other corticosteroids may accelerate hair thinning, but the incidence is unknown. However, they may also cause unwanted hair growth. Talk to a healthcare provider if hair loss or unwanted growth is becoming problematic. 

Constipation

Some people experience constipation when taking prednisone. It’s unclear why systemic corticosteroids may cause constipation, but it seems to be dose-related. Constipation can be managed through fluid intake, fiber intake, and medications, so talk to a healthcare provider if constipation is a problem when taking prednisone.

Prednisone side effects in women vs. men

Women may be more vulnerable to prednisone side effects. In one study, more women experienced side effects than men (95% versus 81%), including intolerable side effects (77% versus 50%). The exact reasons aren’t known. Studies have shown that men eliminate prednisolone, the active version of prednisone, from the body faster than women, which may be a factor. Age may also be a factor because women past menopause clear prednisolone from the body more slowly than premenopausal women. No matter the reason, always get medical advice when the problems seem to outweigh the benefits of a drug.

How soon do prednisone side effects start?

When a prednisone tablet is taken, it is rapidly and almost fully absorbed into the body, and will reach peak concentration in one or two hours. Some side effects such as headache, insomnia, abdominal pain, and mood problems can come on within that short period. Others such as fluid retention, skin problems, and increased appetite will take a few days or weeks to become a problem. Some side effects are experienced more commonly by people taking prednisone for longer periods of time, including weight gain, facial puffiness, and thinning hair. Many of the most serious side effects occur with long-term use or high doses.

How long do prednisone side effects last?

The body clears prednisolone, the active version of prednisone, pretty slowly. The half-life ranges anywhere from 18 to 36 hours, so it may take a few days for side effects like headache, mood swings, or irritability to start getting better. Some side effects, such as weight gain, swelling, hair loss, or skin problems may take a few weeks or months to return to normal. 

What are the long-term side effects of prednisone?

Even after prednisone has been stopped, some side effects may have long-term consequences, such as bone loss, muscle damage, glaucoma, cataracts, and heart failure.

Prednisone contraindications

Some medical conditions make taking prednisone too risky. Allergies to the drug top the list, but other people who can’t take prednisone include those with certain types of infections such as body-wide fungal infections or cerebral malaria.

Pregnancy

Risks and benefits of prednisone should be discussed with the pregnant person. When possible, long-term treatment and treatment during early pregnancy should be avoided. Corticosteroids like prednisone can harm a fetus by causing adrenal gland problems or cleft palate. 

Breastfeeding

Women who are breastfeeding are given prednisone, but often at the lowest possible dose. Although prednisone is present in the breast milk of mothers on prednisone treatment, the amounts are small, and no adverse effects on nursing babies have yet been reported. 

Children

The FDA has determined that prednisone is safe and effective in treating some medical conditions in infants, children, and teens.

Prednisone warnings

Cautions

Prednisone has a variety of effects that can worsen some medical conditions. In particular, prednisone suppresses the immune system, so it’s avoided or used with caution in people with active or latent infections. Try to avoid exposure to infections and certain vaccines while taking prednisone.

Other problems that require caution include:

• Heart problems and irregular heartbeats
• Diabetes
• High blood pressure
• Peptic ulcer disease
• Intestinal problems such as ulcerative colitis that have a risk of perforation
• A history of seizures
• Neurological disorders including myasthenia gravis
• Emotional instability
• Psychosis
• Osteoporosis
• Glaucoma
• Kidney problems
• Eye inflammation and infection

In addition, people with reduced thyroid function or cirrhosis of the liver may be more likely to experience prednisone side effects. Prednisone may be less effective when given to people with overactive thyroid.

Abuse and dependence

Prednisone is not used as a recreational drug. It does not cause physical dependence, but it does suppress adrenal gland function, an important source of hormones including cortisol. Its sudden discontinuation can cause withdrawal symptoms. The adrenal gland may not fully function for weeks or months after treatment has ended. Healthcare professionals typically stop prednisone by using a gradually decreasing dose over several weeks to prevent withdrawal symptoms.

Overdose

There is no maximum dosage for prednisone, but do not take more than instructed. Prednisone can cause problems in high doses or when taken for a long time. If the prescribed dose is exceeded, call a poison helpline for advice.

Prednisone interactions

Because it affects so many systems in the body, prednisone can have a variety of drug interactions. These combinations can affect the safety or effectiveness of prednisone, the other drugs, or both. In particular, live vaccines such as chickenpox vaccine can never be used when a person is taking prednisone or other corticosteroids. Because prednisone suppresses the immune system, it increases the risk of infection by these vaccines. 

Because prednisone suppresses the immune system, other drugs that may be a problem include:

• Other corticosteroids
• Immune suppressing drugs
• Allergy skin tests
• Some vaccines

Some drugs don’t work as well when combined with prednisone. In essence, prednisone worsens the conditions these drugs treat. These include:

• Diabetes medications
• Blood pressure medications
• Estrogens
• Antipsychotics

Some drugs increase the risk of side effects and may need extra monitoring for problems including:

• Other corticosteroids
• Nonsteroidal anti-inflammatory drugs (NSAIDs): increased risk of gastrointestinal problems
• Migraine medications and stimulants: increased risk of high blood pressure
• Loop and thiazide diuretics: increased risk of low potassium 
• Testosterone: increased risk of fluid retention
• Quinolone antibiotics: increased risk of tendon rupture

How to avoid prednisone side effects

Side effects are common when taking corticosteroids like prednisone. A few tips can help keep them at a minimum. 

1. Take prednisone as directed

Take prednisone tablets as prescribed. The dose can vary widely, from just a few milligrams to more than 1000 for some very serious conditions. Most doses are between 5 and 60 mg per day. Understand the proper dose and follow the dosing schedule rigorously. Use an alarm or app to help remember doses. 

2. Tell the prescriber about all medical conditions

As with all medications, the best way to avoid side effects is to make sure the prescribing healthcare provider knows about all past and present medical conditions, especially:

• Infections, particularly fungal infections, tuberculosis, or herpes infection of the eye
• Heart problems
• High blood pressure
• Diabetes
• Electrolyte problems
• Digestive system problems, especially stomach ulcers, diverticulitis, inflammatory bowel disease (IBD), or past colon surgery
• Multiple sclerosis or myasthenia gravis
• Osteoporosis
• Mental illness or psychosis
• Thyroid problems
• Liver problems
• Kidney problems
• Seizures
• Pregnancy or pregnancy plans
• Breastfeeding or any plans to breastfeed

3.

Tell the prescriber about all medications

Another way to avoid side effects is to keep a list of all prescription drugs, over-the-counter medications, and supplements being taken and let the prescriber read it over. In particular, make sure the prescribing healthcare provider is informed about any recent live vaccines or plans for vaccines.

4. Take prednisone tablets with food

Taking prednisone with a meal or snack will help prevent or minimize stomach pain and other gastrointestinal side effects. 

5. Avoid NSAIDs and alcohol

Another good way to avoid digestive system problems, particularly ulcers, is to avoid alcohol and NSAIDs like aspirin or ibuprofen. 

6. Eat a healthy diet and exercise

To avoid weight gain from steroid treatment, eat a healthy diet and increase exercise levels. A nutritionist or dietitian can help and they will likely advise a diet high in lean protein. When taking prednisone long-term, weight-bearing exercise can help prevent or minimize bone density loss.

7. Cut back on salt

Fluid retention can be minimized by adopting a low-salt diet. By keeping excess fluid from building up, other side effects such as swelling and weight gain can also be minimized.

8. Add potassium to the diet

To prevent potassium depletion, eat foods high in potassium or add potassium supplements to the day’s routine.

9. Take calcium and vitamin D supplements

To avoid bone loss while taking prednisone over a long time, take calcium and vitamin D supplements. Again, a nutritionist or dietitian can help, as well as having a regular exercise routine.

10. Try not to get sick

Even low-dose prednisone weakens the immune system, so it’s easier to get infected by something. While taking prednisone, try to stay away from people with infections. Wash your hands regularly. Wearing a mask is always a good idea. Make sure to get medical help at any sign of an infection.

11. Do not stop taking prednisone

Corticosteroids like prednisone can cause some unpleasant and even serious withdrawal problems, so follow the tapering dose schedule given by the prescriber. If prednisone is causing problems, talk to a healthcare professional before stopping the drug abruptly. 

How to treat side effects of prednisone

When side effects do become a problem, there are ways to either help minimize the problem or prevent further problems.

Infections

Infections can become serious when taking prednisone. Immediately inform a healthcare professional at any sign of infection.

Mood changes

Make sure to tell family and friends about possible mood changes and irritability before taking prednisone. Seek medical attention if you begin to feel depressed, have too much energy, can’t sleep, or have disturbing thoughts.

Insomnia

If sleeping is a problem, the prescriber may suggest taking the dose of prednisone earlier in the day. Practice good sleep hygiene by going to bed at the same time each night, turning out the light, and removing any distractions before or after going to bed.

Gastrointestinal problems

If stomach pain is a problem, take prednisone with food, preferably food that isn’t spicy or acidic. Antacids can also help. Avoid alcohol and other medications that can bother the stomach. Get medical help if you vomit blood or blood clots, if stools become black and tarry, or if abdominal pain does not go away. 

Low potassium

Talk to a healthcare professional at any sign of low potassium including muscle weakness, cramps, heart flutters, constipation, or increased urinary frequency. 

Withdrawal

Prednisone affects the hormone system that keeps the adrenal gland functioning at full capacity. This can become a problem when prednisone is stopped after taking it for more than a few days. Prednisone doses are often lowered slowly. Talk to the prescribing healthcare provider if the following symptoms occur: weakness, fatigue, diarrhea, light-headedness, skin color changes, and cravings for salt. If blood pressure drops too low, immediate medical attention may be needed.

Sources

• “Characteristics of adverse effects when using high dose short term steroid treatment,” Korean Journal of Audiology
• “Gender differences in prednisone adverse effects,” Neurology Neuroimmunology & Neuroinflammation
• Guidelines for a low sodium diet, UCSF Health
• “Population-based assessment of adverse events associated with long-term glucocorticoid use,” Arthritis & Rheumatism
• “Prednisolone pharmacokinetics and pharmacodynamics in relation to sex and race,” Journal of Clinical Pharmacology
• Prednisone, Epocrates
• Prednisone drug summary, Prescriber’s Digital Reference
• Prednisone tablet prescribing information, U. S. National Library of Medicine
• “Steroid-induced sleep disturbance and delirium: A focused review for critically ill patients,” Federal Practitioner
• “The effects of menopause and hormone replacement therapies on prednisolone and erythromycin pharmacokinetics,” Clinical Pharmacology & Therapeutics

Side effects of prednisolone tablets and liquid

The higher the dose of prednisolone that you take and the longer you take it for, the greater the chance of side effects. You’re less likely to get side effects if you take a relatively low dose of prednisolone daily.

If you have been taking prednisolone for more than a few weeks, check with your doctor before stopping it suddenly to reduce your chances of withdrawal side effects.

Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months.

Common side effects

These common side effects of prednisolone happen in more than 1 in 100 people. There are things you can do to help cope with them:

Weight gain

If you have to take prednisolone for more than a few weeks, it’s likely that you’ll put on weight. Prednisolone can make you hungrier and also can make you retain more water in your body.

Try to eat well without increasing your portion sizes. Regular exercise will also help to keep your weight stable.

Once you stop taking prednisolone, your appetite and the way your body retains water should return to normal.

Indigestion

Take prednisolone with food to reduce the chances of stomach problems. It may also help if you avoid rich or spicy food while you’re taking this medicine.

If symptoms carry on, ask your doctor if you may benefit from taking an additional medicine to protect your stomach.

Problems sleeping (insomnia)

Take prednisolone in the morning so the levels are the lowest at bedtime.

Feeling restless

If you’re feeling restless when you’re trying to sleep, take prednisolone in the morning so the levels are the lowest at bedtime.

Sweating a lot

Try wearing loose clothing and use a strong anti-perspirant. If this does not help, talk to your doctor as you may be able to try a different medicine.

Mild mood changes

Prednisolone can affect your mood in different ways. Talk to your doctor if you are finding it hard to cope.

Speak to a doctor or pharmacist if the advice on how to cope does not help and any of these side effects bother you or last more than a few days.

Serious side effects

You are more likely to have a serious side effect if you take a higher dose of prednisolone or if you have been taking it for more than a few weeks.

Call a doctor or contact 111 straight away if you get:

• a high temperature, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva (yellowish and possibly with streaks of blood), pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
• sleepy or confused, feeling very thirsty or hungry, peeing more often, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar
• weight gain in your upper back or belly, “moon face” (a puffy, rounded face), very bad headaches and slow wound healing – these can be signs of Cushing’s syndrome
• a very upset stomach or you’re being sick (vomiting), very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
• muscle pain or weakness, muscle cramps, or changes in your heart rate – these can be signs of low potassium levels
• severe stomach pain, severe back pain, severe upset stomach or you’re being sick – these can be signs of pancreas problems
• breathlessness
• swelling in your arms or legs
• changes in your eyesight
• any bruising or bleeding that is not normal
• red or black poo

Go to 111. nhs.uk or call 111. Call 111 if you’re worried about a child under the age of 5 years.

Immediate action required: Call 999 or go to A&E if:

Mood changes

You may notice mood changes and mental health problems while taking prednisolone.

Talk to your doctor or contact 111 if you have any mood changes including:

• feeling depressed
• feeling high, or moods that go up and down
• feeling anxious, having problems sleeping, difficulty in thinking, or being confused and losing your memory
• feeling, seeing or hearing things that do not exist (hallucinations)
• having strange and frightening thoughts, changing how you act, or having feelings of being alone

The higher the dose, the more intense the mood changes can be.

Go to 111.nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E if:

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to prednisolone.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Long-term side effects

Taking prednisolone for a long time can lead to side effects such as:

• thinner bones (osteoporosis)
• poorly controlled diabetes
• eyesight problems
• high blood pressure (hypertension)

Children and teenagers

Taking prednisolone at higher doses for a long time can slow down the normal growth of children and teenagers.

Your child’s doctor will monitor their height and weight carefully for as long as they’re taking this medicine. This will help them spot any slowing down of your child’s growth and change their treatment if needed.

Even if your child’s growth slows down, it does not seem to have much effect on their eventual adult height.

Talk to your doctor if you’re worried. They’ll be able to explain the benefits and risks of giving your child prednisolone.

Other side effects

These are not all the side effects of prednisolone. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 24 February 2022

Next review due: 24 February 2025

The use of prednisone in the treatment of children with cancer

Chemotherapy
Supportive care

Other names:

Prednisone Intensol, Prednisolone, Methylprednisolone

Often used for:

Leukemia, lymphoma, side effects of cancer treatment, prevention of graft-versus-host disease (GVHD) after hematopoietic cell transplantation

Prednisone is a corticosteroid drug that is also used in chemotherapy. Therapy with this drug can be done in a clinic, hospital, or outpatient setting. As a rule, it is prescribed in combination with other drugs.

In addition, prednisone can be used to treat inflammation, allergies and asthma, skin rashes, and adrenal disorders.

As the patient matures, the dosage may change. If the family has questions about the new dosage of the drug, it is recommended to contact the pharmacist to make sure that the dose taken and the dosage in one tablet is correct.

Urine and blood tests may be required to check for elevated blood sugar levels. Blood tests may be needed to check your potassium levels in your blood.

Oral liquid form

Oral tablets

Administered intravenously (through a drip) in liquid form

• Heartburn
• Increased appetite
• Weight gain (especially in the face and abdomen)
• Fluid retention (may cause high blood pressure)
• Acne
• Active hair growth
• High blood sugar
• Low blood potassium
• Stomach irritation
• Headache
• Dizziness

• Character changes or mood swings
• Sleep disorders
• Fatigue or general weakness
• Increased sweating
• Visual disorders (including cataracts and glaucoma)
• Changes in the menstrual cycle
• Elevated white blood cells
• Increased risk of infection

The listed side effects are not observed in all patients who are prescribed prednisone. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

Some patients may experience long-term side effects or long-term effects that persist from the time of taking the drug or appear only several months or years after the end of the drug. Possible long-term effects or long-term effects of prednisone:

• Muscle loss and muscle weakness
• Slower wound healing
• Growth disorders
• Thin, fragile skin
• Osteoporosis
• Avascular necrosis
• Cataracts
• Secondary cancer (Kaposi’s sarcoma)

Be sure to discuss these and other recommendations with your doctor or pharmacist.

• Taking prednisone may mask the symptoms of a fever. The patient’s family should be monitored for signs of infection. Report signs of infection to your doctor or nurse as soon as possible.
• Your healthcare team may recommend a diet that is low in sodium and sugar and high in protein. A nutritionist will give advice on healthy eating with increased appetite.
• Patients may need to take potassium supplements or eat foods high in potassium.
• The patient should wash their face twice a day with soap and water to prevent acne.
• Sexually active patients should use contraceptive methods during therapy and for 6 months thereafter. Pregnant or breastfeeding patients should notify the attending physician about this.

Prednisone at home:

• The drug should be taken with food or milk to reduce stomach irritation.
• When taking prednisone in liquid form, measure the dosage using the measuring device provided.
• Take your dose as soon as possible if you miss it. Do not do this only if there is little time left until the next appointment. In no case do not double the dose at the next dose!
• Prednisone must be stored at room temperature.
• Do not use an expired drug.
• Follow instructions for safe handling and disposal.

Read more about prednisone

• Home oral chemotherapy
• Sex life in therapy

Learn more about prednisone

Instructions for Prednisolone 30 mg ampoules 1 ml No. 5

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Instructions

002 for medical treatment

(Prednisolone)

9 0209 Warehouse:

intoxicating speech: 1 ml to replace prednisolone sodium phosphate in reconstitution for prednisolone – 30 mg;

additional speech: sodium hydrophosphate anhydrous sodium dihydrophosphate dihydrate propylene glycol water for injection.

Pharmaceutical form. Injection retailers.

The main physical and chemical authorities: barless or barless opening;

Pharmacotherapeutic group. Corticosteroids for systemic congestion. Glucocorticoids. ATX code H02A B06.

Pharmacological authorities.

Pharmacodynamics.

Repair anti-allergic anti-alergic immunosuppressive anti-shock and anti-toxic drug.

At apparently high doses, the activity of fibroblasts in the synthesis of collagen in the reticuloendothelial and healthy tissues (galvanization of the proliferative phase of inflammation) inhibits the synthesis and accelerates the catabolism of protein in the mucosal tissues of the liver schuє yogo synthesis in the liver.

Protialergic and immunosuppressive power of the drug to galvanize the development of lymphoid tissue with involution in case of a drastic decrease in the number of circulating T- and B-lymphocytes in the lymphocytes degranulation of mast cells to the production of antibodies.

Protishokova used the drug to improve the response of vessels to endo- and exogenous vascular sounds due to changes in the sensitivity of vascular receptors to catecholamines and to reduce their hypertensive effect so zatrimkoy vivendennya s sodium and water to the body.

Antitoxic effect of the drug due to stimulation of liver protein synthesis processes and accelerated inactivation of endogenous toxic metabolites and xenobiotics and also to increased stability clitin membranes incl. hepatocytes.

Supports liver glycogen deposition and synthesis of glucose from protein metabolism products. The rise of glucose level in the blood activates the appearance of insulin. Ignore the uptake of glucose by fatty cells to lead to the activation of lipolysis. However, as a result of increased secretion of insulin, stimulation of lipogenesis is stimulated by accumulating fat.

Decreased absorption of calcium in the intestines, increasing the absorption of yoga from the bones and excretion of nirks. Ignore the development of pituitary adrenocorticotropic hormone and b-lipotropin in connection with which, in case of trivial congestion, the drug can cope with the development of functional deficiency of measles of supramental ulcers.

The main factors that surround prednisolone therapy are osteoporosis and Itsenko-Cushing’s syndrome. Prednisolone inhibits the secretion of thyroid-stimulating and follicle-stimulating hormones.

At high doses, may increase the alertness of the brain tissue and accept a lower threshold for judgmental readiness.

Stimulates supra-world secretion of hydrochloric acid and pepsin into the tubule in a ligament, which may suppress the development of peptic virase.

Pharmacokinetics.

In case of intravenous administration, it is observed in the blood quickly and evenly in proportion to the maximum level in the blood, the pharmacological effect of the drug significantly slows down and develops for 2-8 years. In blood plasma, a greater part of prednisolone binds to transcortin (cortisol-binding globulin) and, when the process is high, to albumin. With a decrease in the synthesis of the protein, a decrease in the binding capacity of albumin is likely to be caused, which can cause an increase in the free fraction of prednisolone and as a result of the manifestation of toxic effects in the presence of significant therapeutic them doses. The period of drinking in adults – 2-4 years in children – is short. Biotransformation by the pathway of oxidation is important in the liver, as well as in the small intestine and bronchi. Oxidized forms are glucuronized or sulfated and appear to be nirks in the form of conjugates. Approximately 20% of prednisolone is excreted from the body by the circulatory system in an unchanging way; a small part – you can see it from the zhovchyu.

In case of liver disease, the metabolism of prednisolone improves and the degree of its association with blood plasma proteins decreases, which leads to an increase in the period of drug administration.

Clinical characteristics.

Intra-lingual intravenous administration: systemic disease of healthy tissues: systemic dermatomyositis scleroderma vuzlikovy periarteritis Bekhterev’s ailment;

hematological disease: gostra hemolytic anemia lymphogranulomatosis granulocytopenia thrombocytopenic purpura agranulocytosis various forms of leukemia;

major ailments: sever eczema multiforme exudative erythema puffiness sever erythroderma exfoliative dermatitis seborrheic dermatitis psoriasis alopecia adrenogenital syndrome;

replacement therapy: Addison’s crisis;

uncommon cases: severe forms of nonspecific viral colitis and ailments Crohn’s shock (opioid traumatic operative anaphylactic toxic transfusion) asthmatic status of measles insufficiency of epidermal ulcers hepatic coma severe allergic and anaphylactic reactions of hypoglycemia;

Internal introduction: chronic polyarthritis osteoarthritis of the great joints rheumatoid arthritis post-traumatic arthritis arthrosis.

Contraindication. Increased sensitivity to drug components; Viraz’s ailment of the duct and the twelfth colon osteoporosis of the Itsenko-Cushing’s ailment Slightness to thromboembolism Nirkov’s insufficiency bet period of vaccination (not less than 14 days before the next prophylactic immunization) lymphadenitis after vaccination BCG is an active form of tuberculosis glaucoma cataract productive symptomatology in mental illness psychosis depression; systemic mycosis herpetic infection syphilis severe myopathy (caused by myasthenia) poliomyelitis (caused by bulbar-encephalitic form) period of pregnancy and breastfeeding.

For internal nodular injections – infections in the injection site.

Interactions with other medical practices and other types of interactions.

Anticoagulants: in case of one-hour congestion with glucocorticoids, the effect of anticoagulants may improve or change. Parenteral administration of prednisolone has a thrombolytic potential for vitamin K antagonists (fluindione acenocoumarol).

Salicylates and other non-steroidal antiseptic drugs: Overnight infusion of salicylates with indomethacin and other non-steroidal antiseptic drugs may lead to the elimination of mucus membranes. Prednisolone changes the level of salicylates in blood syrovatts and increases their nirk clearance. Caution is required when changing the dose of prednisolone with a three-hour one-hour stoppage.

Hypoglycemic preparations: prednisolone often reduces the hypoglycemic effect of oral tsukrozvezhivnyh zabobiv and insulin.

Liver enzyme inducers, for example barbiturates phenytoin pyramidone carbamazepine and rifampicin increase the systemic clearance of prednisolone, thus changing the effect of prednisolone practically 2-fold.

Inhibitors of CYP3A4 for example erythromycin clarithromycin ketoconazole diltiazem aprepitant itraconazole and oleandomycin increase the elimination and rate of prednisolone in blood plasma that is potent therapeutic and biological effects of prednisolone.

Estrogen may potentiate the effect of prednisolone on enhancing metabolism. It is not recommended to adjust the dose of prednisolone for women who need to take oral contraceptives and take not only a longer period of drinking and the development of an atypical immunosuppressive effect of prednisolone.

Fluoroquinolones: overnight congestion can lead to tendon spallation.

Amphotericin diuretics and side effects: prednisolone may increase the excretion of potassium from the body in patients and take off the drug once an hour.

Immunosuppressants: prednisolone may have additive immunosuppressive power, which may cause an increase in therapeutic effects or the development of various adverse reactions in case of one-hour blockage with other immunosuppressants santami. Only a few of them can be explained by pharmacokinetic interactions. Glucocorticoids increase the anti-emetic efficacy of anti-emetic drugs in the same way as they occur in parallel with anti-tumor therapy, which causes vomiting.

Corticosteroids may increase plasma concentrations of tacrolimus with concomitant ingestion.

Immunization: glucocorticoids may alter the effectiveness of immunization and reduce the risk of neurological complications. The use of therapeutic (immunosuppressive) doses of glucocorticosteroids with live virus vaccines may increase the risk of developing viral infections.

Emergency vaccines may be blocked during drug therapy.

Anticholinergic diseases: in patients with myasthenia gravis, glucocorticoid and anticholinesterase diseases can cause malignant weakness, especially in patients with myasthenia gravis.

Heart glycosides: possible risk of developing glycoside toxicity.

Other: Two serious episodes of acute myopathy have been reported in summer patients who were taking doxacaryum chloride and prednisolone at high doses. With triple therapy, glucocorticoids can change the effect of somatotropin.

Descriptions of symptoms of acute myopathy in case of chronic corticosteroids in patients with ailments should be immediately treated with blockers of nerve and meatal transmission (for example, pancuronium).

One-hour ingestion of prednisolone and cyclosporine led to a court judgment. Oskilki one-hour introduction of these drugs with the cause of mutual galvanization of metabolism and modern scho judging and other side effects of the effects of dermal stagnation of these drugs as monotherapy with their total stosuvanni can be blamed often, the accumulation of constipation can cause an increase in the concentration of other drugs in the blood plasma.

Antihistamine drugs reduce the effect of prednisolone.

In case of one-hour congestion of prednisolone with antihypertensive drugs, the effectiveness of the remaining drugs may decrease.

In infectious diseases and latent forms of tuberculosis, the drug is indicated only in combination with antibiotics and anti-tuberculosis diseases. If you need to take prednisolone on the background of taking oral hypoglycemic drugs or anticoagulants, you need to adjust the dosing regimen of the rest. In patients with thrombocytopenic purpura, the drug should only be administered intravenously.

In case of indulgence, it is possible to blame the syndrome of insufficiency of epidermal deposits, as well as the disease caused by any prescription of prednisolone. Since the end of treatment with prednisolone, there is a risk of functional insufficiency of the epidermal folds, such that it is negligible to stop the drug, and the change in the dose should be carried out even more correctly and with care (for example, the additional dose should be changed to 2-3 mg for 7-10 days). Through the development of hypercorticism, a new course of treatment with cortisone after the previous trial of treatment with prednisolone for a long period of time should be started from low cob doses (for a few years, the hospital is not safe for life).

There was a particularly strong control of the electrolytic balance during the combined ingestion of prednisolone with diuretics. In case of trival treatment with prednisolone as a method of preventing hypokalemia, it is necessary to administer potassium preparations and a healthy diet in connection with possible advancement of the internal pressure and risk of development of subcapsular cataract.

On the eve of the jubilation of a particularly troubling, necessary guardian of the oculist. When applying for psoriasis in history, prednisolone at high doses should be taken with special care.

With a history of psychosis, prednisolone should be less effective at minimal effective doses.

With particular care, the drug should be considered for migraine with a history of data on parasitic infections (especially amoebeas).

Prednisolone is recognized for special care for children.

With special care to recognize in immunodeficiency states (including those with SNID or VIL-infection). It is also due to the preservation of signs after a recently transferred myocardial infarction (in patients with a hostile myocardial infarction, it is possible to widen the fossa, necrosis, increase the formation of scar tissue, and rupture of the heart mass).

For special precautions in case of hepatic insufficiency, they rethink the blame for hypoalbuminemia of obesity III – IV stage.

Women at the age of menopause need to undergo further treatment for possible diagnosis of osteoporosis.

When treated with glucocorticoids for a three-hour period, it is recommended to regularly monitor the arterial pressure to determine the level of glucose in the cross section and blood. Before the spadix treatment with glucocorticoids, it is necessary to carry out a strapping of the duct-intestinal tract to turn off the disease of the duct and the twelve-fingered intestine.

Congestion during pregnancy or breastfeeding.

Do not stop the drug during pregnancy.

If necessary, the drug should be taken in the breast during lactation.

The ability to increase the speed of the reaction when caring for vehicles or other mechanisms.

Patients who rejoice at prednisolone should avoid potentially unsafe types of activity that may increase respect and susceptibility of mental and rukhovy reactions.

Method of dosing.

It is not allowed to mix that one-hour infusion of prednisolone with other medications in one and the same infusion system or syringes!

Prescription drug for intravenous intravenous or intravenous administration. The dose of prednisolone should be taken due to the severity of the disease.

For older adults, the additional dose should be 4-60 mg intravenously or intravenously.

For children, the drug is indicated internally (deeply in the middle of the day) according to the indications and under the control of the doctor: for children at age 6-12 years – 25 mg / day at age 12 years – 25-50 mg / day. The duration of the drug intake and the number of injections of the drug is determined individually.

In case of Addison’s disease, the additional dose for adults is 4-60 mg intravenously or internally.

In severe form of non-specific virazic colitis – 8-12 ml / dose (240-360 mg Prednisolone) for 5-6 days for severe form of Crohn’s disease – 10-13 ml / dose

(300-390 mg Prednisolone) for 5-7 days

In case of emergency, prednisolone should be administered intravenously in full (approximately 3 strands) or dropwise at a dose of 30-60 mg. As an intravenous infusion, it is more difficult to administer the drug intravenously. With this method of introduction, the effect develops more. If necessary, the drug is administered repeatedly intravenously or intraperitoneally at a dose of 30-60 mg every 20-30 minutes.

In other cases, an increase in the prescribed dose is allowed, depending on the drug individually for a specific skin condition.

An increase in the dose of prednisolone for intravenous administration should be 30 mg for large globules, 10-25 mg for moderate lobes and 5-10 mg for small lobes. The drug is administered to the skin for 3 days. Likuvannya course – up to 3 days.

Children. Zastosovuvat children vіkom vіd 6 roіv vinyatkovo for recognition and under the control of the doctor.

Doses and duration of drug therapy are determined individually depending on the severity of the illness. With a trivial intake in children, it is possible to increase the growth of that, it is necessary to intersect with the minimum doses for the indications for the shortest hour. Coresty in the form of glee may overestimate the possible risk of blame for side reactions.

Overdose. In times of overdose, nausea, vomiting, bradycardia, arrhythmia, exacerbation of symptoms of heart failure of the heartbeat; hypokalemia of arterial pressure subsidence of sudoma and m’yazyv hyperglycemia thromboembolism hostrial psychosis headache head pain possible development of symptoms in hypercortisolism: increased body mass development of swelling of arterial hypertension glucosuria hypokalemia. In children with an overdose, the hypothalamic-pituitary-supra-pituitary system can suffer from the Cushing’s syndrome, a decrease in the excretion of the hormone, an increase in the movement of the intracranial vice.

There is no specific antidote.

Treatment: treatment with the drug is symptomatic therapy in case of need – correction of the electrolyte balance.

Adverse reactions. The development of severe side reactions to fall in the dose and in the case of trivality. Adverse reactions develop when the drug is tried and tested. For a short period of time, the risk of their vindication is small.

Infections and invasions: increased susceptibility to bacterial viral fungal infections and severity and masking of symptoms in opportunistic infections.

On the side of the blood system and lymphatic system: an increase in the total number of leukocytes with a decrease in the number of eosinophils, monocytes and lymphocytes. The mass of lymphoid tissue changes. It is possible to increase the blood supply to lead to thrombosis of thromboembolism.

On the side of the endocrine system and metabolism: depression of the hypothalamic-pituitary-supra-pituitary system, increase in growth in children and premenopause, disruption of the menstrual cycle, disruption of the secretion of state hormones (amenorrhea) postmenopausal chnі bleeding kushengoydne lichcha hirsutism zbіlshennya masi tіla decrease in tolerance to carbohydrates increase consumption in insulin and peroral hyperlipidemia negative balance of nitrogen and calcium increased appetite disruption of mineral metabolism and electrolyte balance hypokalemia alkalosis hypokalemia can cause a decrease in sodium and sodium in the body.

Mental disorders: drativity euphobia depression susceptibility to suicide sleeplessness labile mood increased concentration psychological stagnation mania hallucinations acute schizophrenia dementia psychosis anxiety sleep disturbance, epileptic attack, cognitive dysfunction (including amnesia and impaired vision) children.

On the side of the nervous system: subduction of the intracranial pressure, epileptic attacks, peripheral neuropathy, paresthesia, confusion of the head, autonomic disorder.

On the side of the organs of the eye: increased internal pressure glaucoma swelling of the disk of the optic nerve cataract thinning of the horn and sclera of acute ocular viral and fungal infections exophthalmos.

From the side of the cardiovascular system: myocardial development in the aftermath of myocardial infarction arterial hypotension bradycardia combined ventricular arrhythmia asystole (in the aftermath of a sudden injection of the drug) atherosclerosis rose thrombosis vasculitis heart failure peripheral swelling. In ailments with acute myocardial infarction – rosacea of ​​the cavity, necrosis of the uplifting formation of the scar.

On the side of the immune system: allergic reactions that cause anaphylactic shock with a lethal end angioedema, allergic dermatitis, changes in skin reactions, tuberculosis relapse, immunosuppression actions of hypersensitivity, including hanging out of the sky.

On the side of the mucosal-intestinal tract: dyspepsia, dyspepsia, peptic dyspepsia, perforation and bleeding of the stravohod, candidiasis of the stravohod, pancreatitis, perforation of the mucosa, mucosal bleeding sciatic ileitis and virazkovy colitis.

Ingestion of the drug may lead to the development of ALT, AST, and tubular phosphatase, but it does not matter if the drug is administered.

On the side of the upper arm: increased regeneration atrophy of the upper arm, hematomas and atrophic males, upper arms (streaks) The second post-steroidal panniculitis is characterized by the appearance of erythematosis of hot infantile sweats lasting 2 days after administration of the Kaposi’s sarcoma preparation.

On the side of the cystic-m’ulcer system: proximal myopathy, osteoporosis, rupture of the tendon of the m’ulcer, weakness, atrophy, myopathy, fractures of the spine and long bones, aseptic osteonecrosis.

On the side of the sciatic system: increased risk of uroliths and instead of leukocytes and erythrocytes in the sciatica without obvious damage to the nirok.

General: unhealthy hiccup stasis in high doses of the drug insufficiency of epidermal folds that can lead to arterial hypotension, hypoglycemia and lethal episodes in stressful situations such as surgery In case of injury or infection, the dose of prednisolone was not increased.

In case of a strong dose of the drug, the syndrome can be seen, the severity of the symptoms, lie down in the stage of atrophy of the supernatal ulcers, headache pain is caused by the stomach emptying, anorexia, weakness, change in the mood of years argy increase in temperature of the body mialgiya arthralgia rhinitis conjunctivitis more severe sverbіzh shkіri vtrata masi body. In more severe depressions – severe mental disorders and the development of intracranial pressure, steroid pseudorheumatism in patients with rheumatic fever has a lethal aftermath.

Reactions at the injection site: liver changes in pigmentation (depigmentation of leukoderma)

Applicability term. 2 rocks.

Wash up the savings. Save in original packaging for protection from light at a temperature not exceeding 25 °C. Take care of the place inaccessible to children.

Inconsistency . Prednisolone cannot be mixed and infused overnight with other drugs in the same infusion system or syringe.

When mixing prednisolone with heparin, precipitation is established.

Uncertainty with aerosols of sympathomimetic effects for the treatment of bronchial asthma in children (unsafe development of respiratory paralysis).

Packaging. 1 ml or 2 ml each in ampoules.