home Audience 6 Prednisolone intravenous side effects. Side effects and use of the drug prednisolone. Pharmacological action of the drug

Prednisolone intravenous side effects. Side effects and use of the drug prednisolone. Pharmacological action of the drug

Prednisolone belongs to a group of synthetic hormonal drugs that are used to eliminate inflammatory processes. The pharmacological drug quickly reduces the severity of symptoms and significantly accelerates the recovery of patients. But with long-term use of high doses of glucocorticosteroid, the side effects of Prednisolone appear - increased blood pressure, destruction of bone tissue, and weight gain. To avoid the development of such negative consequences, you should follow all medical recommendations, which include proper nutrition while taking and stopping the drug.

Characteristics of the drug

The adrenal cortex produces the hormone hydrocortisone, which regulates the functioning of many human life systems. Prednisolone is an artificial analogue of this glucocorticosteroid, which is several times more powerful than it. Such high therapeutic effectiveness also has a negative side, which is expressed in the occurrence of serious consequences for the patient’s body.

Manufacturers produce the drug in various dosage forms, each of which is intended for the treatment of a specific disease. On pharmacy shelves Prednisolone is presented in the form:

eye drops 0.5%;
solutions for 30 mg/ml and 15 mg/ml, used for intravenous, intramuscular and intra-articular administration;
tablets containing 1 and 5 mg of active substance;
0.5% ointment for external use.

Warning: Lack of medical supervision when taking Prednisolone will cause the development of protein deficiency in the systemic circulation. This will lead to the production of excess amounts of progesterone and the manifestation of its toxic properties.

Endocrinologists, ophthalmologists, allergists and neurologists prescribe glucocorticosteroids only in cases where the use of other drugs has not brought the required results. During treatment, patients regularly provide biological samples for laboratory testing. If the use of Prednisolone provokes negative changes in the functioning of the cardiovascular or endocrine system, then the drug is stopped or the daily and single dosages used are adjusted by the attending physician.

Pharmacological action of the drug

Regardless of the method of administration of Prednisolone, immediately after the penetration of the active substance of the drug into the human body, a powerful anti-inflammatory effect appears. Several biochemical mechanisms are involved in its development:

The drug inhibits the action of an enzyme that acts as a catalyst for special chemical reactions. Their final products are prostaglandins, synthesized from arachidonic acid and related to mediators of the inflammatory process. Blocking phospholipase A2 with Prednisolone manifests itself in the relief of pain, swelling and hyperemia;
After a foreign protein enters the human body, the immune system is activated. To eliminate the allergic agent, special white blood cells are produced, as well as macrophages. But in patients with systemic diseases, the immune system gives a distorted response, reacting negatively to the body's own proteins. The action of Prednisolone is to inhibit the accumulation of cellular structures that ensure the occurrence of an inflammatory process in tissues;
The response of the immune system to the introduction of an allergic reaction agent is the production of immunoglobulins by lymphocytes and plasma cells. Specific receptors bind antibodies, which leads to the development of inflammation to remove foreign proteins from the body. The use of Prednisolone prevents the development of events in such a negative scenario for patients with systemic pathologies;
The therapeutic properties of glucocorticosteroids include immunosuppression, or a decrease in the functional activity of the immune system. This artificial condition, provoked by taking Prednisolone, is necessary for the successful treatment of patients with systemic diseases - rheumatoid arthritis, severe forms of eczema and psoriasis.

With prolonged use of any dosage form of the drug, water and sodium ions begin to be intensively absorbed in the kidney tubules. Protein catabolism gradually increases, and destructive and degenerative changes occur in bone tissue. The negative consequences of treatment with Prednisolone include an increase in glucose levels in the bloodstream, which is closely related to the redistribution of fat in the subcutaneous tissue. All this causes a decrease in the production of adrenocorticotropic hormone by the pituitary gland and, as a consequence, a decrease in the functional activity of the adrenal glands.

Warning: For patients to fully recover after using Prednisolone, it often takes several months, during which doctors prescribe additional medications and a gentle diet.

During the administration and withdrawal of Prednisolone, constant laboratory monitoring of changes in blood composition is carried out

When is it necessary to take a glucocorticosteroid?

Despite the numerous side effects of Prednisolone, for most patients with systemic diseases it is the first choice drug. The negative consequence of taking it is the suppression of the immune system, in this case leading to long-term remission of the pathology. Prednisolone has high therapeutic efficacy in the treatment of the following diseases:

anaphylactic shock, angioedema, serum sickness;
rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis;
acute gouty arthritis, dermatomyositis, systemic vasculitis, mesoarteritis, periarteritis nodosa;
pemphigus, mycotic skin lesions, seborrheic and exfoliative dermatitis, bullous dermatitis herpetiformis;
hemolysis, idiopathic thrombocytopenic purpura, congenital aplastic anemia.

Prednisolone is included by doctors in therapeutic regimens for malignant neoplasms, chronic hepatitis of various etiologies, leukemia, and tuberculous meningitis. The drug is also used to prevent the immune system from rejecting transplants.

Since the hormonal drug is prescribed only for the treatment of serious pathologies that are difficult to treat with other medications, there are few contraindications to its use:

individual sensitivity to the main substance and auxiliary ingredients;
infections caused by pathogenic fungi.

Prednisolone is prescribed only for life-threatening conditions to patients with ulcerative lesions of the gastrointestinal tract, certain endocrine pathologies, as well as pregnant women and women who are breastfeeding.

Side effects of the drug

During the research, a relationship was established between taking certain doses of Prednisolone and the number of side effects that occur. The drug taken in a small dose over a long period of time caused fewer negative effects compared to the use of large doses over a short period. Patients were diagnosed with the following side effects of Prednisolone:

A course of medication often causes increased fatigue, weakness, drowsiness or insomnia. A decrease in the functional activity of the immune system leads to frequent relapses of chronic pathologies, viral and bacterial infectious diseases.

Recommendation: Side effects of Prednisolone can appear all at once, but more often occur gradually. You should immediately inform your doctor about this. He will compare the severity of side effects with the need to take a glucocorticosteroid, discontinue the drug or recommend continuing therapy.

The cardiovascular system

Long-term use of high doses of Prednisolone provokes the accumulation of fluid in the tissues. This condition leads to a narrowing of the diameter of blood vessels and an increase in blood pressure. Hypertension, usually systolic, gradually develops, often accompanied by persistent heart failure. These pathologies of the cardiovascular system were diagnosed in more than 10% of patients taking glucocorticosteroid drugs.

Endocrine system

The use of Prednisolone often causes addiction to glucose and an increase in its content in the blood serum. People who are genetically predisposed or prone to developing diabetes are at risk. Therefore, this endocrine pathology is a contraindication for taking glucocorticosteroids. It can be prescribed to such patients only based on vital signs. It is possible to prevent a decrease in the functional activity of the adrenal glands by gradually reducing the dose of Prednisolone and reducing the frequency of its use.

Gastrointestinal tract

The use of glucocorticosteroids in the treatment of various pathologies is contraindicated in patients with ulcerative lesions of the stomach and (or) duodenum. Long-term use of Prednisolone can provoke destructive and degenerative changes in the mucous membranes and deeper layers of the gastrointestinal tract. Also, solutions for parenteral administration and tablets cause dyspeptic disorders - nausea, vomiting, excessive gas formation. Cases of pancreatitis, ulcer perforation and intestinal bleeding have been reported.

Musculoskeletal system

In patients taking Prednisolone for a long time, the consequences were expressed in the form of myopathy. It is a chronic progressive neuromuscular disease characterized by primary muscle damage. A person experiences weakness and wasting of the proximal muscles due to impaired absorption of calcium in the intestine, a trace element necessary for the optimal functioning of the musculoskeletal system. This process is reversible - the severity of myopathy symptoms decreases after stopping Prednisolone.

Withdrawal syndrome

Abrupt withdrawal of Prednisolone can provoke serious consequences, including the development of collapse and even coma. Therefore, doctors always inform patients about the inadmissibility of skipping a glucocorticosteroid or unauthorized termination of treatment. Prescribing high daily dosages often leads to improper functioning of the adrenal cortex. When discontinuing the drug, the doctor recommends that the patient take vitamins C and E to stimulate the functioning of these paired organs of the endocrine system.

Dangerous consequences that occur after stopping Prednisolone therapy also include:

return of pathological symptoms, including pain;
headache;
sudden fluctuations in body weight;
worsening mood;
dyspeptic disorders.

In this case, the patient should resume taking the drug for several weeks, and then, under the supervision of a doctor, gradually reduce the single and daily dosages. During the withdrawal of Prednisolone, the doctor monitors the main indicators: body temperature, blood pressure. The most informative tests include laboratory tests of blood and urine.

Proper nutrition allows you to avoid the negative consequences of taking Prednisolone

Prednisolone, what does this hormonal medicine help with? The product has antiallergic, anti-inflammatory, immunosuppressive effects. The instructions for use of the drug "Prednisolone" suggest using it for allergies, dermatitis, and bronchial asthma.

Composition and release form

It is produced in the form of ointment, eye drops, tablets, solution for injection into a vein or muscle tissue. The medicine "Prednisolone", which helps for various indications, contains the active substance of the same name. Its share in solution is 30 mg per ml, in tablets - 1 or 5 mg, ointment 0.05 g.

Auxiliary components of the drug, depending on the form of release, are sodium pyrosulphide, stearic acid, propyl parahydroxybenzoate, nicotinamide and other components.

pharmachologic effect

The drug "Prednisolone", from which its effect is manifested, belongs to the corticosteroid group of drugs. This is a glucocorticosteroid agent that exhibits weak activity, which allows it to be successfully used for the treatment of many allergic, inflammatory and autoimmune pathologies.

Is Prednisolone hormonal or not? Doctors answer that the medicine is a hormonal agent for systemic or local use with an average duration of action. The active substance is an analogue of the hormone hydrocortisone, which is produced by the adrenal cortex.

The medicine stops or prevents the occurrence of allergies, suppresses the immune system, creates an anti-shock effect, and stops the inflammatory process.

Medicine "Prednisolone": what helps

Indications for the use of tablets and injection solution include the following systemic diseases:

allergic pathologies; hay fever;
rheumatic fever;
inflammatory diseases of joints and tissues (osteoarthritis, synovitis, spondyloarthritis, tenosynovitis);
multiple sclerosis;
lung cancer (in combination with cytotoxic drugs);
diffuse connective tissue abnormalities;
sarcoidosis, pneumonia, fibrosis;
minor chorea, rheumatic carditis;
tuberculosis, meningitis;
acute alveolitis, hypocortisolism;
congenital adrenal hyperplasia;
hepatitis, granulomatous thyroiditis;
inflammation of the gastrointestinal tract;
autoimmune pathologies, nephrotic syndrome;
leukemia, anemia and other diseases of the circulatory system;
cerebral edema;
skin abnormalities of autoimmune and other etiologies (psoriasis, exfoliative dermatitis, eczema, etc.);
eye diseases (keratitis, conjunctivitis, uveitis, choroiditis, keratitis, iridocyclitis, etc.) of an allergic or autoimmune nature;
hypercalcemia, caused by cancer.

What else are Prednisolone tablets and injections prescribed for? Injections are given in emergency shock conditions. After a few days of administering the solution, patients are prescribed tablets.

Internal use of the drug is indicated for severe or chronic diseases (bronchial asthma, etc.). Injections and tablets are prescribed during transplantation to prevent implant rejection and to stop vomiting that occurs while taking cytostatics.

Prednisolone ointment: what is it prescribed for?

The medicine is used externally for the treatment of inflammatory and allergic skin diseases that do not have a microbial cause. Indications for the use of Prednisolone ointment include:

Why are eye drops prescribed?

Prednisolone is indicated for use in non-infectious inflammations of the eye affecting its anterior segment. Drops are prescribed for the development of an inflammatory process as a result of injury and surgery. The drug is used for the following eye pathologies:

Contraindications

The instructions for use prohibit the use of the drug "Prednisolone" for:

Caution during therapy is required for patients during infectious diseases, vaccinations, herpes and viral diseases.

The drug "Prednisolone": instructions for use

The dosage, form and method of administration of the medication depend on the complexity of the disease, the effectiveness of therapy and the patient’s condition.

Prednisolone tablets are taken immediately after or during meals. The daily dosage according to the instructions is 0.025–0.05 g. The medicine is taken 2-3 times. Subsequently, the dosage is reduced to 0.005 g. You need to drink 4-6 times a day.

The maximum daily amount of the drug should not exceed 0.1 g, a single dose - 0.015 g. It is possible to increase the highest dosage to 0.3–1.2 g per day in especially severe cases. Prednisolone tablets are prescribed to children under 4 years of age based on their weight. The daily dosage is distributed as follows:

Up to 4 years - 0.001 g/kg;
5–6 years - 0.02 g;
7–9 years - 0.025–0.03 g;
10–14 years - 0.025-0.04 g.

Application of the solution

Injections are given into the muscle; for this, the ampoule is diluted in 5 ml of injection water, heated to body temperature. The drug is administered in a volume of 0.03-0.06 g. For jet or drip intravenous use, the dosage is 0.015-0.03 g.

The dropper is placed in patients, having previously diluted the ampoule in saline, glucose, 5% or polyglucin (250-500 ml). Patients in shock or acute adrenal insufficiency are given intravenous injections of 0.03 g.

Instructions for use of ointment and drops

Prednisolone ointment is used topically. The medicine is applied to the affected areas in a thin layer. Large lesions should not be treated to avoid causing an overdose.

For the treatment of ophthalmic ailments, 1-2 drops of a 0.3% solution are administered into each eye. Treatment continues for up to 2 weeks. During the treatment of ENT diseases, 4-5 units are dripped into the ear cavity or nostrils. solution 4-5 times a day.

Side effects

The medicine "Prednisolone", reviews and instructions indicate this, can cause negative reactions in the body:

diabetes mellitus, erosive esophagitis;
increased or decreased appetite;
dizziness;
adrenal dysfunction;
nausea, vomiting, increased blood pressure;
hallucinations, stomach and intestinal ulcers;
changes in corneal trophism, digestive disorders;
slow wound healing, flatulence;
headache, arrhythmia;
disorientation, hiccups;
depressive psychosis; bradycardia;
hypokalemic syndrome, osteoporosis;
increased intracranial pressure, acne;
nervousness, skin rash;
weight gain, tendon rupture;
anaphylactic shock, convulsions;
increased intraocular pressure, increased sweating;
stretch marks, secondary eye infections, itching;
growth retardation or delayed sexual development in children, withdrawal syndrome.

Analogues

What can replace Prednisolone? The following drugs have a similar mechanism of action:

Price, where to buy

Prednisolone preparations (ointment, solution, injections, tablets) have a low price. In Moscow you can buy medicine for 30-250 rubles, in Kyiv for 16-30 hryvnia. In Minsk, the cost of the product reaches 0.3-6 BYN. rubles, in Kazakhstan – for 395-1200 tenge.

Opinions of patients and doctors

Reviews of the drug Prednisolone by patients and specialists differ. The effectiveness of the drug is confirmed, but there are many side effects. With prolonged use, the medicine causes withdrawal symptoms.

What is “Withdrawal Syndrome”? The condition is observed after using the drug Prednisolone and other hormonal drugs. It manifests itself in mild cases as malaise, muscle pain, and fatigue. In difficult situations, after prolonged use of the drug, a hypoadrenal crisis may occur, accompanied by convulsions and vomiting. The patient may die without administration of glucocorticosteroids.

How to “get off” Prednisolone?

The treatment regimen involves a gradual reduction in dosage. To do this, the volume of the drug is reduced weekly by 1/8. A faster way out of the syndrome is achieved by using the product every other day, while simultaneously reducing its volume by 1/5. This requires stimulation of the adrenal glands. The patient is advised to use insulin and ascorbic acid.

During the treatment of bronchial asthma, the drug Prednisolone is replaced at the final stage with inhaled steroids. In case of autoimmune pathologies, they switch to mild cytostatic medications.

Patients respond completely positively to the ointment and solution for external use. They note the absence of serious side effects, while confirming the effectiveness of the drug.

Prednisolone is an anti-inflammatory, anti-allergic, anti-toxic and anti-shock drug. And to know exactly what Prednisolone should be taken for, you should read our article. This drug is a synthetic analogue of the hormones cortisone and hydrocortisone, which are secreted by the adrenal cortex. When taken orally, it is 4-5 times more effective than cortisone and about 3 times more effective than hydrocortisone. Prednisolone slightly increases the excretion of potassium and practically does not cause sodium and water retention in the human body. When taking Prednisolone tablets orally, its maximum accumulation in plasma is observed after 1.5 hours. The drug is well absorbed from the gastrointestinal tract. Biotransformed through oxidation mostly in the liver. The medicine leaves the body in the form of metabolites in urine and feces. Prednisolone affects protein, water-electrolyte, carbohydrate and fat metabolism in the human body.

What does Prednisolone help with:

inflammation of the cornea of the eye with intact mucosa; blepharitis (inflammation of the edges of the eyelids);
allergic and chronic conjunctivitis (inflammation of the mucous membrane of the eye);
sympathetic ophthalmia (inflammation of the membrane of the eye due to injury to the other eye);
after eye surgery;
multiple sclerosis;
bronchial asthma;
hepatitis; chronic and acute allergies (atopic dermatitis, urticaria, food and drug allergies, Quincke's edema, toxicoderma, hay fever);
rheumatic fever;
rheumatic carditis;
chronic and acute diseases of the joints (polyarthritis, osteoarthritis, bursitis, synovitis, rheumatoid arthritis, psoriatic and gouty arthritis, glenohumeral periarthritis, Still's syndrome in adults);
inflammatory diseases of the gastrointestinal tract (local enteritis, nonspecific ulcerative colitis);
infectious mononucleosis (an infectious disease in which the palatine lymph nodes and liver are enlarged and there is a high body temperature);
connective tissue diseases (dermatomyositis, scleroderma, lupus erythematosus, periarteritis nodosa);
autoimmune diseases;
acute pancreatitis (nonspecific inflammation of the pancreas);
hemolytic anemia;
glomerulonephritis (kidney disease).

What else can you take Prednisolone tablets for:

shock during surgical interventions;
prevention of rejection during tissue and organ transplantation.

Mode of application:

The dose of the drug for each person is determined individually. To correctly prescribe the dose of Prednisolone, you need to take into account the daily secretory rhythm of glucocorticoids. The tablets are taken orally with a small amount of liquid. Typically, a large dose is prescribed in the morning, a medium dose in the afternoon, and a small dose in the evening. As a rule, the introductory dose of the drug is 20-30 mg over 24 hours (4-6 tablets). Gradually the transition is made to a maintenance dose, which is 5-10 mg (1-2 tablets). For certain diseases (some rheumatic diseases, nephrosis), the daily introductory dose can be 15-100 mg. To complete treatment with Prednisolone, the daily dose is gradually reduced. For children, the initial dose of the drug is prescribed at the rate of 1-2 mg/kg body weight and is distributed into 4-6 doses per day. The maintenance dose of the drug is 300-600 mcg/kg of the child’s body weight. When treating with Prednisolone, blood pressure should be checked, urine tests done, and blood sugar levels determined.

Contraindications:

individual sensitivity to the components of the drug;
post-vaccination period; diabetes;
acute endocarditis;
pregnancy;
ulcer of the duodenum and stomach;
gastritis; acute peptic ulcer;
persistent rise in blood pressure;
active form of tuberculosis;
syphilis;
nephritis (kidney inflammation);
acute psychosis;
polio;
recent myocardial infarction;
chronic heart failure.

Side effects:

The occurrence of adverse reactions depends on the duration of treatment with Prednisolone and the dose taken. The following side effects may develop:

mental disorders;
increased blood sugar levels;
menstrual irregularities;
obesity;
decreased resistance to infections;
hirsutism (excessive hair growth in women);
convulsions;
dizziness;
osteoporosis;
growth retardation in children;
depression;
insomnia;
hallucinations;
decrease in muscle mass.

We hope that this article helped you understand why Prednisolone should be taken and how to calculate its dose.

According to reviews, “Prednisolone” is the name of a drug that belongs to synthetic glucocorticoids (in other words, it is a hormonal drug). It is an analogue of "water-deprived" hydrocortisone. In medical activities, Prednisolone is used externally, orally in the form of tablets, eye drops, or for intravenous (sometimes intramuscular) administration.

Characteristics of the active substance

Prednisolone is a crystalline powder, odorless and white in color (sometimes with a slight tint of yellow). Almost insoluble in water. But it is slightly soluble in alcohol, dioxane, chloroform and methanol. Its molecular weight is 360.444 g/mol.

pharmachologic effect

According to reviews, Prednisolone has anti-inflammatory, immunosuppressive, antiallergic, glucocortioid and anti-shock effects.

The substance interacts with special receptors in the cytoplasm of the cell and forms a specific complex that penetrates into the nucleus, binding to DNA and causing the expression of mRNA. Changes the formation of proteins on ribosomes that express the effects of cells. Accelerates the synthesis of lipocortin, which inhibits phospholipase A2, inhibits the biosynthesis of endoperoxide and the liberation of archidonic acid, essential for the body, as well as prostaglandins, leukotreins (promote the progression of inflammation, allergies and other processes of a pathological nature).

Stabilizes the membrane membrane of lysosomes, inhibits the synthesis of hyaluronidase (an enzyme that breaks down hyaluronic acid in a special way), reduces the production of lymphokines produced by lymphocytes. Affects the processes of alteration and exudation during inflammation, delays the spread of the inflammatory process.

Inhibits the migration of monocytes in areas of inflammation and limits the proliferation of connective tissue cells, which has an antiproliferative effect. Inhibits the process of formation of mucopolysaccharides, thereby preventing water from combining with plasma proteins in the rheumatic focus of inflammation.

Inhibits the intensity of destruction of peptide bonds, preventing the destruction of tissue and cartilage in rheumatoid arthritis.

In what cases is Prednisolone prescribed to children? Reviews confirm that the antiallergic effect of the drug is due to a decrease in the number of basophils, a decrease in the synthesis and secretion of mediators of an immediate allergic reaction. Promotes the development of lymphopenia and involution of lymphoid tissue, thereby causing immunosuppression.

Reduces the concentration of T-lymphocytes in the blood plasma and the production of immunoglobulins. Increases the breakdown and reduces the production of components of a complex of complex proteins, inhibits Fc receptors of immunoglobulins, inhibits the functions of macrophages and leukocytes. Increases the number of receptors and normalizes their sensitivity to a variety of physiologically active substances in the body. This is confirmed by the instructions for use and reviews for Prednisolone ointment.

Reduces protein synthesis and its amount in the blood plasma, but at the same time accelerates its energy metabolism in muscle tissue. Promotes the production of fibrinogen, surfactant, erythropoietin, lipomodulin and enzyme proteins in the liver. It also promotes the redistribution of fat, the production of triglycerides and IVH. Increases the absorption of carbohydrates from the gastrointestinal tract, the activity of phosphoenolpyruvate kinase and glucose-6-phosphatase, which enhances gluconeogenesis and mobilizes glucose in the bloodstream.

Retains water and sodium, and also accelerates the excretion of potassium. Reduces the absorption of calcium in the intestines, while increasing excretion by the kidneys and leaching it from the bones.

Pharmacokinetics

“Prednisolone,” according to reviews, has an anti-shock effect, activates the production of certain cells in the bone marrow, increases the number of red blood cells and platelets in the blood, and also reduces the number of monocytes, lymphocytes, basophils and eosinophils.

When taken orally, the medicine is well and quickly absorbed from the gastrointestinal tract. 70-90% of the substance is found in plasma in bound form: with albumin and transcortin. After oral administration, the maximum concentration of the substance in the blood plasma is observed after an hour and a half.

Metabolized in the liver by oxidation. The half-life of the substance from plasma is 120-240 minutes, from tissues - in the range from 20 to 34 hours. Less than 1% of the dose of the substance passes into the milk of a nursing woman. 20% of the substance is excreted unchanged by the kidneys.

Indications for use

According to reviews, Prednisolone is administered by intravenous or intramuscular infusion for:

acute allergic reaction;
bronchial asthma and status asthmaticus;
for the prevention and treatment of thyrotoxic reactions and thyrotoxic shock;
myocardial infarction;
acute adrenal insufficiency;
liver cirrhosis;
acute hepatitis;
poisoning with cauterizing liquids.

Prednisolone is administered by intra-articular injection for:

rheumatoid arthritis;
spondyloarthritis;
post-traumatic arthritis;
osteoarthritis.

Pills

In the form of Prednisolone tablets, according to reviews, it is prescribed for:

systemic connective tissue diseases;
chronic and acute inflammatory diseases of the joints: psoriatic and gouty arthritis, osteoarthritis, polyarthritis, juvenile arthritis, glenohumeral periarthritis, Still's syndrome in adults, synovitis and epicondylitis;
rheumatic fever and acute rheumatic carditis;
bronchial asthma;

acute and chronic allergies;
allergic reactions to food and drugs, angioedema, serum sickness, urticaria, allergic rhinitis, drug exanthema, hay fever;
skin diseases;
pemphigus, psoriasis, eczema, atopic dermatitis, diffuse neurodermatitis, contact dermatitis, toxicerma, seborrheic dermatitis, exfoliative dermatitis, malignant exudative erythema (Stevens-Johnson syndrome), cerebral edema after preliminary use in the form of intravenous or intramuscular injections;
adrenal insufficiency;
kidney diseases of autoimmune origin, nephrotic syndrome;
diseases of the hematopoietic organs: agranulocytosis, panmyelopathy, autoimmune hemolytic anemia, lymphogranulomatosis, myeloma, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia;
lung diseases: acute alveolitis, pulmonary fibrosis, stage II-III sarcoidosis;
pulmonary tuberculosis, tuberculous meningitis, aspiration pneumonia;
berylliosis, Loeffler's syndrome;
lung cancer;
multiple sclerosis;
diseases of the gastrointestinal tract;
hepatitis;
prevention of transplant rejection reactions;
hypercalcemia due to cancer;
nausea and vomiting during cytostatic therapy;
allergic eye diseases;
inflammatory eye diseases.

This is confirmed by the instructions for use and reviews for Prednisolone. The price will be presented below.

Ointment

Prednisolone in ointment form is used for:

urticaria, atopic dermatitis, diffuse neurodermatitis, lichen simplex chronicus, eczema, seborrheic dermatitis, discoid lupus erythematosus, simple and allergic dermatitis, toxicerma, erythroderma, psoriasis, alopecia;
epicondelitis, tenosynovitis, bursitis, humeroscapular periarthritis, colloid scars, sciatica.

Drops

"Prednisolone" in the form of eye drops is prescribed for non-infectious inflammatory diseases of the anterior segment of the eye - iritis, uveitis, episcleritis, scleritis, conjunctivitis, parenchymal and discoid keratitis without damage to the corneal epithelium, allergic conjunctivitis, blepharoconjunctivitis, blepharitis, inflammatory processes after eye injuries and surgery , sympathetic ophthalmia.

The price and reviews of Prednisolone are of interest to many. We will talk about them below.

Contraindications for use

Contraindications for systemic use are:

This is confirmed by the instructions for use and reviews for Prednisolone.

Contraindications to intra-articular injections are:

infectious and inflammatory processes in the joint;
general infectious diseases;
“dry” joint;
pregnancy;
joint instability as an outcome of arthritis.

Contraindications for use on the skin are:

viral, bacterial and fungal skin diseases;
skin manifestations of syphilis;
lupus;
skin tumors;
acne vulgaris;
pregnancy.

Contraindications to the use of Prednisolone, according to reviews, in the form of eye drops may be:

fungal and viral eye diseases;
purulent corneal ulcer;
acute purulent conjunctivitis;
glaucoma;
trachoma.

Adverse reactions

The severity and frequency of adverse reactions depend on the duration and method of use of the drug. Basically, the following side effects may develop when using Prednisolone:

disruption of the menstrual cycle;
obesity, acne, hirsutism;
stomach ulcers and ulceration of the esophagus;
Itsenko-Cushing complex, osteoporosis;
hyperglycemia;
hemorrhagic pancreatitis;
psychical deviations;
increased blood clotting, weakened immunoglobulins.

This is confirmed by the instructions and reviews for Prednisolone.

Dosage and method of administration

The dosage is set depending on the method of use of the drug.

IN In the form of Prednisolone tablets, doctors recommend taking it once a day or a double dose every other day from 6 to 8 am. The total daily dose can be divided into several doses, and in the morning you should take the drug in a larger dosage. Prednisolone in tablet form should be taken during or after meals. Sudden termination of treatment can lead to negative consequences, so this should not be done. The dosage of the drug should be increased by 1.5-3 times in acute stressful conditions. If the case is severe, then the dosage is increased by 5-10 times.

In acute cases of the disease, adults are prescribed 4-6 tablets (20-30 mg) per day. The dose that maintains the therapeutic effect is 1-2 tablets (5-10 mg) per day. For some diseases, an initial dose of 5-100 mg/day may be prescribed or 5-15 mg/day as hormonal maintenance therapy.

As a rule, for children over three years of age, a dose of 1-2 mg per 1 kg of body weight per day, divided into several doses, is prescribed. The dose that maintains the therapeutic effect for children is about 0.5 mg per 1 kg of body weight. After achieving the effect, the dose should be reduced to 5 mg and then to 2.5 mg per day with a break of 3-5 days.

In the form of an ointment, the hormonal drug Prednisolone is used externally for allergic rashes and itching of the skin. The cream is applied several times a day in a thin layer. Also, Prednisolone ointment can be used in gynecology, but only in combination with antifungals and antibiotics. As a rule, the course of treatment with Prednisolone ointment ranges from 6 to 14 days. To maintain the therapeutic effect, the ointment is applied once a day.

In the form of an injection solution, the drug is administered intraarticularly, intravenously or intramuscularly under strict sterile conditions. For intra-articular administration of the drug, the recommended dose is 10 mg in small joints, and 25-50 mg in large joints. This injection can be repeated several times. If the therapeutic effect is insufficient, it is necessary to consider increasing the dose with your doctor.

For intravenous administration of the drug, the recommended dose is 25 mg for small affected parts of the body, and 50 mg for larger parts of the body.

In the form of eye drops, apply 1-2 drops three times a day into the conjunctival sac. As a rule, the course of treatment with these eye drops is no more than two weeks.

special instructions

with long-term therapy, it is necessary to prescribe potassium supplements and diet in order to avoid the development of hypokalemia;
after the end of long-term therapy, doctors should monitor the patient for another year so that adrenal insufficiency does not develop;
Do not suddenly stop using the drug, because this can lead to anorexia, weakness, nausea, exacerbation of the disease and muscle pain;
It is prohibited to administer any vaccines during Prednisolone therapy;
It is not recommended to drive complex machinery and vehicles during treatment with Prednisolone.

Price

Ampoules cost about 30 rubles, ointment - 70 rubles, tablets - about 100 rubles, drops - 100-200 rubles. It all depends on the city and the specific pharmacy.

GCS for oral use

Active substance

Prednisolone

Release form, composition and packaging

Pills white or almost white, flat-cylindrical, chamfered on both sides and engraved “P” on one side.

Excipients: colloidal silicon dioxide - 0.65 mg, potato starch - 1 mg, stearic acid - 1.2 mg, magnesium stearate - 1.5 mg, talc - 4.8 mg, - 10 mg, corn starch - 73 mg, lactose monohydrate - 102.85 mg.

100 pieces. - polypropylene bottles (1) - cardboard packs.

pharmachologic effect

GKS. Prednisolone is a synthetic glucocorticoid drug, a dehydrogenated analogue. It has anti-inflammatory, antiallergic, desensitizing, antishock, antitoxic and immunosuppressive effects.

Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus, stimulates the synthesis of matrix ribonucleic acid (mRNA); the latter induces the formation of proteins, incl. lipocortin, mediating cellular effects. Lipocortin inhibits phospholipase A2, suppresses the release of arachidonic acid and suppresses the synthesis of endoperoxides, prostaglandins, leukotrienes, which contribute to inflammation, allergies, etc.

Suppresses the release of ACTH by the pituitary gland and, secondarily, the synthesis of endogenous glucocorticoids. Inhibits the secretion of TSH and FSH.

Reduces the number of lymphocytes and eosinophils, increases the number of red blood cells (stimulates the production of erythropoietins).

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

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation 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, leading to increased flow from the liver into the blood; increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases, leading to the activation of gluconeogenesis.

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, “washes” calcium from the bones, and increases its excretion by the kidneys.

Anti-inflammatory effect associated with inhibition of the release of inflammatory mediators by eosinophils and mast cells, induction of lipocortin formation and a decrease in the number of mast cells producing hyaluronic acid; with a decrease in capillary permeability, stabilization of cell membranes and organelle membranes (especially lysosomal ones).

Antiallergic effect develops as a result of suppression of 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, suppression of the development of lymphoid and connective tissue, a decrease in the number of T- and B-lymphocytes, mast cells, a decrease sensitivity of effector cells to allergy mediators, inhibition of antibody formation, changes in the body's immune response.

In obstructive diseases of the respiratory tract, the action is based mainly on inhibition of inflammatory processes, inhibition of development or prevention of swelling of the mucous membranes, inhibition of eosinophilic infiltration of the submucosal layer of the bronchial epithelium and deposition of circulating immune complexes in the bronchial mucosa. Erosion and desquamation of the mucous membrane is inhibited. Prednisolone increases the sensitivity of β-adrenergic receptors of small and medium-sized bronchi to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by inhibiting or reducing its production.

Antishock and antitoxic effect is associated with an increase in blood pressure (due to an increase in the concentration of circulating catecholamines and restoration of the sensitivity of adrenergic receptors to them, as well as vasoconstriction), a decrease in the permeability of the vascular wall, membrane protective properties, and activation of liver enzymes involved in the metabolism of endo- and xenobiotics.

Immunosuppressive effect is caused by inhibition of the proliferation of lymphocytes (especially T-lymphocytes), suppression of the migration of B cells and the interaction of T and B lymphocytes, inhibition of the release of cytokines (interleukin-1, interleukin-2; interferon gamma) from lymphocytes and macrophages and a decrease in the formation of antibodies.

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

Pharmacokinetics

Suction and distribution

Absorption is high, Cmax in the blood after oral administration is achieved after 1-1.5 hours. In plasma, up to 90% of prednisolone is bound to proteins: transcortin (cortisol-binding globulin) and albumin.

Metabolism and excretion

Metabolized in the liver, kidneys, small intestine, bronchi. Oxidized forms are glucuronidated or sulfated. Metabolites are inactive. T 1/2 - 2-4 hours. Excreted through the intestines and kidneys by glomerular filtration and is 80-90% reabsorbed by the tubules. 20% is excreted unchanged by the kidneys.

Indications

Endocrine disorders:

primary and secondary adrenal insufficiency (including the condition after removal of the adrenal glands);
congenital adrenal hyperplasia;
subacute thyroiditis;
hypoglycemic conditions.

Systemic connective tissue diseases:

rheumatoid arthritis;
systemic lupus erythematosus;
dermatomyositis;
scleroderma;
periarteritis nodosa.

Acute rheumatism, acute carditis, minor chorea.

Acute and chronic inflammatory diseases of the joints:

glenohumeral periarthritis;
ankylosing spondylitis (ankylosing spondylitis);
gouty and psoriatic arthritis;
osteoarthritis (including post-traumatic);
polyarthritis;
juvenile arthritis;
Still's syndrome in adults;
bursitis;
nonspecific tenosynovitis;
synovitis;
epicondylitis.

Acute and chronic allergic diseases:

allergic reactions to medications and foods;
drug exanthema;
serum sickness;
hives;
hay fever;
angioedema;
allergic rhinitis.

Bronchial asthma, status asthmaticus.

Diseases of the blood and hematopoietic system:

autoimmune hemolytic anemia;
acute lympho- and myeloid leukemia;
lymphogranulomatosis,
thrombocytopenic purpura;
agranulocytosis;
panmyelopathy;
secondary thrombocytopenia in adults;
erythroblastopenia (erythrocyte anemia);
congenital (erythroid) hypoplastic anemia.

Skin diseases:

pemphigus;
eczema;
psoriasis;
exfoliative dermatitis;
atopic dermatitis;
diffuse neurodermatitis;
contact dermatitis (affecting a large surface of the skin);
toxicoderma;
seborrheic dermatitis;
toxic epidermal necrolysis (Lyell's syndrome);
bullous dermatitis herpetiformis;
malignant exudative erythema (Stevens-Johnson syndrome).

Allergic and inflammatory eye diseases:

allergic corneal ulcers;
allergic forms of conjunctivitis;
sympathetic ophthalmia;
severe sluggish anterior and posterior uveitis;
Optic neuritis.

Gastrointestinal diseases:

ulcerative colitis, Crohn's disease;
hepatitis;
local enteritis.

Lung cancer (in combination with cytostatic drugs).

Multiple myeloma.

Lung diseases:

acute alveolitis;
pulmonary fibrosis;
sarcoidosis stage II-III.

Kidney diseases of autoimmune origin (including acute glomerulonephritis); nephrotic syndrome.

Tuberculous meningitis, pulmonary tuberculosis.

Aspiration pneumonia (in combination with specific chemotherapy).

Berylliosis, Loeffler's syndrome (not amenable to other therapy).

Multiple sclerosis.

Brain edema (including due to a brain tumor or associated with surgery, radiation therapy or head trauma) after prior parenteral use.

Prevention of graft rejection during organ transplantation.

Hypercalcemia due to cancer.

Nausea and vomiting during cytostatic therapy.

Contraindications

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

In children during the growth period, GCS should be used only for absolute indications and under the careful supervision of the attending physician.

Carefully

Immunodeficiency conditions (including AIDS or HIV infection).

Gastrointestinal diseases: gastric and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcers, newly formed intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis.

Diseases of the cardiovascular system, incl. recent myocardial infarction (in patients with acute and subacute myocardial infarction, the necrosis focus may spread, the formation of scar tissue may slow down and, as a result, the heart muscle will rupture), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.

Endocrine diseases: diabetes mellitus (including impaired carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease, obesity (III-IV degrees).

Severe chronic renal and/or liver failure, nephrourolithiasis.

Hypoalbuminemia and conditions predisposing to its occurrence.

Systemic osteoporosis, myasthenia gravis, acute psychosis, poliomyelitis (except for the form of bulbar encephalitis), open- and closed-angle glaucoma.

Dosage

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

Usually the daily dose is taken once or a double dose is taken every other day, in the morning, between 6 and 8 am.

A high daily dose can be divided into 2-4 doses, with a larger dose taken in the morning.

The tablets should be taken during or immediately after meals with a small amount of liquid.

At acute conditions and as replacement therapy adults prescribed at an initial dose of 20-30 mg/day, the maintenance dose is 5-10 mg/day. For some diseases (nephrotic syndrome, some rheumatic diseases) higher doses are prescribed. Treatment is stopped slowly, gradually reducing the dose. If there is a history of psychosis, high doses are prescribed under the strict supervision of a physician.

Doses for children: initial dose - 1-2 mg/kg/day in 4-6 doses, maintenance dose - 0.3-0. 6 mg/kg/day.

When prescribing, the daily secretory rhythm of glucocorticoids should be taken into account: most (or all) of the dose is prescribed in the morning.

Side effects

The incidence and severity of side effects depend on the duration of use, the size of the dose used and the ability to comply with the circadian rhythm of prednisolone administration.

From the endocrine system: suppression of adrenal function, decreased glucose tolerance, “steroidal” diabetes mellitus or manifestation of latent diabetes mellitus, Itsenko-Cushing syndrome (moon-shaped face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae), growth retardation and delayed sexual development in children.

From the digestive system: oral candidiasis, nausea, vomiting, pancreatitis, “steroid” gastric and duodenal ulcers, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases, increased activity of liver transaminases and alkaline phosphatase.

From the cardiovascular system: increased blood pressure, arrhythmias, bradycardia; development (in predisposed patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle.

From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.

From the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral eye infections, trophic changes in the cornea, exophthalmos.

From the side of metabolism: hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating.

Adverse reactions due to mineralocorticoid activity: fluid and sodium retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, weakness and fatigue).

From the musculoskeletal system: slower growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, “steroid” myopathy, decreased muscle mass (atrophy).

From the skin and mucous membranes: delayed wound healing, petechiae, ecchymoses, skin thinning, hyper- or hypopigmentation, acne, stretch marks, tendency to develop pyoderma and candidiasis.

From the urinary system: frequent night urination, urolithiasis due to increased excretion of calcium and phosphate.

From the immune system: generalized (skin rash, skin itching, anaphylactic shock) and local allergic reactions.

Others: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia.

Overdose

In case of overdose and adverse reactions occur, it is necessary to reduce the dose of prednisolone. There is no specific antidote, treatment is symptomatic. Monitoring of electrolyte levels in the blood is necessary.

Drug interactions

Phenobarbital, phenytoin, rifampicin, ephedrine, aminoglutethimide, aminophenazone (inducers of microsomal liver enzymes) reduce the therapeutic effect of glucocorticoid hormones.

Dose may need to be increased insulin and oral hypoglycemic drugs due to weakening of the hypoglycemic effect.

It is possible to both enhance and weaken the anticoagulant effect when taking indirect anticoagulants(dose adjustment required).

Anticoagulants and thrombolytics- the risk of bleeding from ulcers in the gastrointestinal tract increases.

Simultaneous administration androgens and anabolic steroid drugs with prednisolone promotes the development of peripheral edema and hirsutism, the appearance of acne.

Mitotane and other inhibitors of adrenal function may necessitate an increase in the dose of prednisolone.

live antiviral vaccines and against the background of other types of immunization, increases the risk of viral activation and the development of infections.

Immunosuppressants increase the risk of developing infections and lymphoma or other lymphoproliferative disorders associated with the Epstein-Barr virus.

Antipsychotics (neuroleptics) and azathioprine increase the risk of developing cataracts when prescribing prednisolone.

Simultaneous administration antacids reduces the absorption of prednisolone.

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

special instructions

Before starting 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, organ of vision. Before and during steroid therapy, it is necessary to monitor a general blood count, the concentration of glucose in the blood and urine, and electrolytes in the plasma.

During treatment with GCS, especially in high doses, vaccination is not recommended due to a decrease in its effectiveness.

Medium and high doses of GCS can cause an increase in blood pressure.

For tuberculosis, the drug can only be prescribed in conjunction with anti-tuberculosis drugs.

For intercurrent infections and septic conditions, simultaneous antibiotic therapy is necessary.

During long-term treatment with GCS, potassium should be prescribed to avoid hypokalemia.

In Addison's disease, the drug should not be taken simultaneously with barbiturates due to the risk of developing acute adrenal insufficiency (Addisonian crisis).

GCS may cause growth retardation in children and adolescents. Prescribing the drug every other day usually avoids or minimizes the likelihood of such a side effect.

In elderly patients, the frequency of adverse reactions increases.

With sudden withdrawal, especially in the case of high doses, GCS “withdrawal” syndrome occurs: decreased appetite, nausea, lethargy, generalized musculoskeletal pain, asthenia.

The likelihood of adrenal insufficiency as a result of taking the drug and associated complications can be reduced by gradually withdrawing the drug. After discontinuation of the drug, adrenal insufficiency can last for months, so in case of any stressful situation, hormonal therapy should be resumed during this period.

In hypothyroidism and liver cirrhosis, the effect of GCS may be enhanced.

Patients should be warned in advance that they and their loved ones should avoid contact with patients with chickenpox, measles, and herpes. In cases where systemic treatment with GCS is carried out or treatment with GCS was carried out in the next 3 months, and the patient was not vaccinated, specific immunoglobulins should be prescribed.

Treatment of GCS requires medical supervision for diabetes mellitus (including a family history), osteoporosis (the risk is higher during postmenopause), arterial hypertension, chronic psychotic reactions (GCS can cause mental disorders and increase emotional instability), a history of tuberculosis, glaucoma, steroid myopathy, gastric and duodenal ulcers, epilepsy, herpes simplex of the eye (danger of corneal perforation).

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

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

Impact on the ability to drive vehicles and machinery

A similar effect of the drug is unknown.

Pregnancy and lactation

During pregnancy, the use of prednisolone is possible if the expected benefit to the mother outweighs the potential risk to the fetus.
In the first trimester of pregnancy, prednisolone is used only for health reasons.

With long-term therapy during pregnancy, the possibility of impaired fetal growth cannot be ruled out. If used in the third trimester of pregnancy, there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn.

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

Use in childhood

Treatment of children with GCS during the growth period is possible only according to absolute indications and with careful supervision of the attending physician.

Children with bronchial asthma are contraindicated in the use of prednisolone simultaneously with sympathomimetic aerosols.

Children receiving Prednisolone therapy and who have been in contact with patients with measles or chickenpox are prescribed specific immunoglobulins prophylactically.

For impaired renal function

Use with caution in severe renal failure.