Prednisone (Deltasone, Prednisolone)

Prednisone, a dehydrated derivative of hydrocortisone, exhibits anti-inflammatory, anti-allergic, desensitizing, anti-shock, and immunosuppressive effects.

Prednisolone augments the breakdown of proteins and prompts the activation of hepatic enzymes engaged in amino acid metabolism. Moreover, the medication hinders protein synthesis while escalating the disintegration of proteins within lymphoid, connective, muscular tissues, and the skin. Prolonged utilization of this drug can potentially lead to the deterioration of these tissues.

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The medication heightens glucose availability by stimulating gluconeogenesis in the liver, accelerating protein catabolism (resulting in an augmented pool of amino acids contributing to gluconeogenesis), and diminishing glucose absorption in diverse tissues. This culminates in the buildup of liver glycogen, elevated blood glucose levels, and heightened insulin resistance.

Prednisone enhances lipolysis and mobilizes fatty acids from adipose tissue, thereby increasing plasma levels of free fatty acids. Long-term employment of Prednisolone may result in a preferential accumulation of fat in the upper body. Furthermore, the drug diminishes blood calcium concentrations, interferes with bone growth in children and adolescents, and contributes to osteoporosis across all age groups.

Prednisolone intensifies the influence of both endogenous and exogenous catecholamines.

Usage Indications

Glucocorticoids serve as treatment options for numerous conditions, including but not limited to:

• Primary and secondary adrenal insufficiency, encompassing disorders like Addison's disease and adrenogenital syndrome.
• Non-purulent thyroiditis.
• Intense allergic reactions, such as serum sickness, hypersensitivity reactions to drugs, perennial or seasonal allergic rhinitis, and angioedema.
• A range of rheumatic conditions, including rheumatoid arthritis, rheumatic myocarditis, dermatomyositis, systemic lupus erythematosus, granulomatous arteritis, polyarteritis nodosa, relapsing polychondritis, ankylosing spondylitis, and psoriatic arthritis.
• Vasculitis, severe seborrheic dermatitis, and erythema multiforme (Stevens-Johnson syndrome), alongside atopic, contact, or exfoliative dermatitis, pemphigus, ulcerative colitis, and Crohn's disease.

Administration Routes and Dosages

The prescribed dosage should be tailored to the individual, considering the specific ailment and treatment response. Regular reassessment of the dosage is vital, as disease severity may fluctuate or complications could emerge during therapy. Once the desired outcome is attained, a gradual reduction to the minimal effective dose is recommended.

Administration Method: Administer the medication orally with a small quantity of liquid, ideally after meals.

For Adults: The typical range is 5-60 mg/day, contingent upon the ailment's gravity. Administering Prednisolone in harmony with circadian rhythms is advisable, with the highest dosage being taken in the morning.

If Prednisone has been taken for over three weeks, it should be tapered down slowly to avert withdrawal syndrome. Hasty discontinuation of the drug can lead to perilous outcomes.

The reduction in dose should be gradual over weeks or even months, contingent upon dosage, treatment duration, ailment severity, and individual treatment response. If the duration of Prednisolone use has been three weeks or less, abrupt cessation is improbable to result in noteworthy HPA suppression. Nonetheless, variations in patient response to corticosteroids and withdrawal should be considered.

Hence, individuals at risk of adrenal insufficiency should cautiously reduce the dose, particularly during extended treatment periods or when high doses are administered.

When embarking on Prednisone dose reduction, the regimen must be personalized. A decrease of 2.5 mg in Prednisone every 3-7 days is well-tolerated by most individuals, until a dosage of 5-10 mg/day is achieved. For those on elevated Prednisolone dosages, a gradual reduction should extend over a span of 9-12 months.