Prednisone

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Lodotra; Bulgaria: Dehydrocortison; Cyprus: Prednisone; Czech Republic: Prednison, Rectodelt; Denmark: Prednison; Finland: Prednison; France: Cortancyl, Prednisone; Germany: Cutason, Decortin, Lodotra, Nocasio, Prednison, Predni Tablinen, Rectodelt; Greece: Chocort, Prednisone, Updelta; Hungary: Rectodelt; Italy: Deltacortene; Luxembourg: Prednicort; Netherlands: Lodotra, Prednison; Poland: Encorton, Lodotra, Nocasio; Portugal: Lodotra, Meticorten; Romania: Prednison; Slovakia: Prednison, Rectodelt; Spain: Dacortín, Fiacín, Prednisona; Sweden: Deltison, Lodotra.

North America

Canada: Prednisone, Winpred; USA: Prednisone.

Latin America

Argentina: Meticortén, Metilpres, Prednipirine; Brazil: Artinizona, Becortem, Corticorten, Flamacorten, Meticorten, Prednax, Prednis, Prednison, Prednisona, Predson, Predval; Mexico: Artrinol-On, Ednaprón, Losinón, Meticortén, Norapred, Prednidib, Prednisona.

Drug combinations

Prednisone and Docetaxel

Prednisone, Dequalinium, and Tetracycline

Chemistry

Prednisone: C~21~H~26~O~5~.H~2~O. Mw: 376.44. (1) Pregna-1,4-diene-3,11,20-trione monohydrate, 17,21-dihydroxy-; (2) 17,21-Dihydroxypregna-1,4-diene-3,11,20-trione monohydrate. CAS-53-03-2.

Pharmacologic Category

Hormones and Synthetic Substitutes; Adrenals. Systemic Corticosteroid. (ATC-Code: A07EA03; H02AB07).

Mechanism of action

Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. Suppresses immune system by reducing activity and volume of lymphatic system. Suppresses adrenal function at high doses. Antitumor effects may be related to inhibition of glucose transport, phosphorylation, or induction of cell death in immature lymphocytes.

Therapeutic use

Treatment of wide variety of diseases and conditions. Used principally for glucocorticoid effects as anti-inflammatory and immunosuppressant agent and for its effects on blood and lymphatic systems in palliative treatment of various diseases.

Pregnancy and lactiation implications

Adverse events observed with corticosteroids in animal reproduction studies. Some studies have shown association between 1^st^ trimester prednisone use and oral clefts. Adverse events in fetus/neonate noted following large doses of systemic corticosteroids during pregnancy. Prednisone and its metabolite prednisolone found in low concentrations in breast milk.

Unlabeled use

Adjunctive therapy for Pneumocystis jiroveci (formerly carinni) pneumonia. Autoimmune hepatitis. Adjunctive therapy for pain management in immunocompetent patients with herpes zoster. Tuberculosis (severe, paradoxical reactions).

Contraindications

Hypersensitivity to any component of the formulation. Systemic fungal infections. Administration of live or live attenuated vaccines with immunosuppressive doses of prednisone.

Warnings and precautions

May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal axis, particularly in younger children or in patients receiving high doses for prolonged periods, which may lead to adrenal crisis. Withdrawal and discontinuation of corticosteroid should be done slowly and carefully. Prolonged use of corticosteroids may increase incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox should be avoided. Corticosteroids should not be used to treat ocular herpes simplex or cerebral malaria. Prolonged treatment with corticosteroids associated with development of Kaposi’s sarcoma (case reports). Acute myopathy reported with high-dose corticosteroids, usually in neuromuscular transmission disorders (may involve ocular and/or respiratory muscles). Prolonged use may cause posterior subcapsular cataracts, glaucoma (with possible nerve damage) and may increase risk for ocular infections. Corticosteroid use may cause psychiatric disturbances, including depression, euphoria, insomnia, mood swings, and personality changes. Pre-existing psychiatric conditions may be exacerbated by corticosteroid use. Use with caution in heart failure (long-term use associated with fluid retention and hypertension), diabetes mellitus (may alter glucose production/regulation leading to hyperglycemia), GI diseases (diverticulitis, peptic ulcer, ulcerative colitis; due to perforation risk), hepatic impairment, including cirrhosis (effects may be enhanced), and in myasthenia gravis (exacerbation of symptoms occurred). Use with caution following acute MI (corticosteroids associated with myocardial rupture). Use with caution in current or risk for osteoporosis (high doses and/or long-term use of corticosteroids associated with increased bone loss and osteoporotic fractures). Use with caution in history of seizure disorder (seizures reported with adrenal crisis). Metabolic clearance of corticosteroids increases in hyperthyroidism and decreases in hypothyroidism. May affect growth velocity.

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