Prednisolone
An oral glucocorticoid used for asthma and COPD flares, allergy, arthritis, bowel disease, transplant rejection and many immune disorders.
Drug card
- Class
- Glucocorticoid
- How it works
- Activating glucocorticoid receptors, which switch off inflammatory genes
- Used for
- Asthma attacks
- COPD flare-ups
- Rheumatoid arthritis and other rheumatic diseases
- Crohn's disease and ulcerative colitis flares
- Known for
- Adrenal suppression; stopping suddenly is dangerous
- Cushingoid features: moon face, central fat
- Infections, with their signs masked
- Its name
- pred- means a prednisolone-type corticosteroid
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does prednisolone work?
A synthetic steroid with mainly glucocorticoid and slight mineralocorticoid activity. After binding its receptor it enters the nucleus and alters gene expression, cutting inflammatory cytokines and circulating lymphocytes and eosinophils. Its slight salt-retaining action can still cause sodium retention, potassium loss and higher blood pressure.
Like other glucocorticoids: They enter cells and bind the glucocorticoid receptor; the activated complex moves to the nucleus, binds glucocorticoid response elements and changes which genes are read. Inflammatory cytokines and NF-kB signaling are damped, lymphocytes and eosinophils fall, and gluconeogenesis and protein breakdown rise. With long use they suppress ACTH release and so the adrenal glands' own output.
Uses
What is prednisolone used for?
- Asthma attacks
- COPD flare-ups
- Rheumatoid arthritis and other rheumatic diseases
- Crohn's disease and ulcerative colitis flares
- Severe allergic conditions
- Preventing transplant rejection
Side effects
Side effects of prednisolone
- Adrenal suppression; stopping suddenly is dangerousKnown forSerious
- Cushingoid features: moon face, central fatKnown for
- Infections, with their signs maskedKnown forSerious
- High blood sugar
- Osteoporosis and fracturesSerious
- Mood swings, depression and psychosis
- Trouble sleeping
- Increased appetite and weight gain
- Indigestion
- Peptic ulcer, which can bleed or perforateSerious
- Low potassium (hypokalemia)
- Cataracts
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- After more than 3 weeks or high doses, reduce the dose gradually; stopping suddenly can cause adrenal insufficiency.
- Avoid live vaccines on immunosuppressive doses; exposure to chickenpox, measles or shingles needs prompt assessment.
- Pregnancy: first-trimester use can harm the fetus, so benefit and risk are weighed.
- CYP3A4 inducers (rifampin, phenytoin, carbamazepine) speed its clearance; ketoconazole and macrolides slow it.
Good to know: Usually taken once in the morning, which limits sleeplessness; long or high-dose courses need a steroid card and a slow taper.
Remember it
A way to remember it
STEROIDS
- S
- Suppression of the adrenal glands
- T
- Thin bones (osteoporosis)
- E
- Eyes: cataracts and glaucoma
- R
- Raised blood sugar and blood pressure
- O
- Obesity of the trunk and a moon face (Cushingoid features)
- I
- Infections, with signs masked
- D
- Depression and other mood changes
- S
- Stomach (peptic) ulcers
Written for biofideX
Its name
pred- means prednisolone-type corticosteroid
Covers prednisone, prednisolone and methylprednisolone, and may sit inside a name (loteprednol). WHO also files the dexamethasone-type -methasone names under this stem.
- Every drug name stem
Its class
Glucocorticoids
Other glucocorticoids with a card:
Easily mixed up with inhaled corticosteroids and non-steroidal anti-inflammatory drugs.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Prednisolone sodium phosphate orally disintegrating tablets: label (DailyMed)
- Prednisolone (NCI Thesaurus)
- Prednisolone (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Thyroid, steroids and bones
Prednisolone is one of 9 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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