PREDNISOLONE
(pred-niss'oh-lone)
Delta-Cortef, Prelone
PREDNISOLONE ACETATE
Econopred, Key-Pred, Pred Forte, Predcor
PREDNISOLONE SODIUM PHOSPHATE
AK-Pred, Hydeltrasol, Inflamase, Inflamase Forte, Inflamase Mild, Pred Mild
PREDNISOLONE TEBUTATE
Hydeltra-T.B.A., Prednisol TBA
Classifications: hormones and synthetic substitutes; adrenal corticosteroid; glucocorticoid
Prototype: Prednisone
Pregnancy Category: C

Availability

Prednisolone 5 mg tablet; 5 mg/5 mL, 15 mg/5 mL syrup, 0.12%, 0.125%, 1% ophthalmic suspension

Acetate 25 mg/mL, 50 mg/mL injection

Sodium Phosphate 5 mg/5 mL liquid; 20 mg/mL injection; 0.125%, 1% ophthalmic solution

Tebuate 20 mg/mL injection

Actions

Analog of hydrocortisone with 3–5 times greater potency. Mineralocorticoid properties are minimal, and potential for sodium and water retention as well as potassium loss is reduced.

Therapeutic Effects

Effective as an anti-inflammatory agent.

Uses

Principally as an antiinflammatory and immunosuppressant agent.

Contraindications

Safety during pregnancy (category C) or lactation is not established.

Route & Dosage

Antiinflammatory
Adult: PO 5–60 mg/d in single or divided doses IM Acetate/Phosphate: 6–60 mg/d; Tebutate: 2–60 mg qwk IV Phosphate: 4–60 mg/d Ophthalmic See Appendix A-1
Child: PO 0.14–2 mg/kg/d in single or divided doses IM Acetate/Phosphate: 0.04–0.25 mg/kg 1–2 times/d IV Phosphate: 0.04–0.25 mg/kg 1–2 times/d

Administration

Oral
Alternate-Day Therapy (ADT) for Patient on Long-Term Therapy
Intramuscular

Note: Verify that drug supplied is appropriate for the ordered route. Prednisolone acetate is for IM use.

Intravenous

PREPARE: Direct: May be given undiluted.  IV Infusion: May be added to 50–1000 mL of D5W or NS.  

ADMINISTER: Direct: Give at a rate of 10 mg or fraction thereof over 60 s.  IV Infusion: Do not exceed 10 mg/min.  

INCOMPATIBILITIES Solution/additive: Calcium gluceptate, metaraminol, methotrexate, polymyxin B.

Adverse Effects (1%)

Endocrine: Hirsutism (occasional), adverse effects on growth and development of the individual and on sperm. Special Senses: Perforation of cornea (with topical drug). Body as a Whole: Sensitivity to heat; fat embolism, hypotension and shock-like reactions. CNS: Insomnia. GI: Gastric irritation or ulceration. Skin: Ecchymotic skin lesions; vasomotor symptoms. Also see prednisone.

Interactions

Drug: barbiturates, phenytoin, rifampin increase steroid metabolism, therefore may need increased doses of prednisolone; amphotericin B, diuretics add to potassium loss; ambenonium, neostigmine, pyridostigmine may cause severe muscle weakness in patients with myasthenia gravis; vaccines, toxoids may inhibit antibody response.

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Peak: 1–2 h. Duration: 1–1.5 d. Distribution: Crosses placenta; distributed into breast milk. Metabolism: Metabolized in liver. Elimination: HPA suppression: 24–36 h; Excreted in urine. Half-Life: 3.5 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug