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Prednisolone: ​​correct dose of cortisone active ingredient

The doctor's advice should be strictly followed when dosing prednisolone.

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What is Prednisolone?

Prednisolone is an active ingredient from the group of glucocorticoids. Colloquially, glucocorticoids are also known as cortisone (medical notation: cortisone). Cortisone is a hormone that is produced in the adrenal cortex. It plays a role in numerous metabolic processes in the body, influences, among other things, the mineral balance and helps the body to cope with stress in extreme situations.

How does prednisolone work?

The drugs from the group of glucocorticoids all have a similar effect: like other cortisone preparations, prednisolone has an anti-inflammatory and decongestant effect. Due to its immunosuppressive effect, it can suppress the immune system and thereby the body's own inflammatory reactions. Prednisolone is offered in different dosage forms and doses for a variety of complaints.

Dosage forms of prednisolone:

  • Tablets
  • Suppositories
  • Infusion or injection solutions (intravenous)
  • (Eye) ointment or (skin) cream

The precursor of prednisolone is called prednisone. This glucocorticoid can also be contained in drugs as an active ingredient. Prednisone is inactive and is first converted into the active form prednisolone by the liver. Medicines containing prednisolone therefore work more quickly.

What is Prednisolone used for?

There are many different diseases for which a therapy with glucocorticoids such as prednisolone can be used according to medical indication to successfully alleviate acute symptoms. These include the following:

  • Bronchial asthma (usually as a therapy in combination with the administration of drugs to dilate the bronchi)

  • Emergency medication injected or as a tablet, for example in the event of an acute asthma attack or as part of the emergency kit in the event of an anaphylactic shock

  • Pseudo croup attacks

  • Autoimmune diseases in their active phases (for example rheumatoid arthritis or acute multiple sclerosis flare-ups)

  • for the treatment of impaired function of the adrenal cortex such as Addison's disease

  • acute, inflammatory skin conditions such as eczema

  • non-infectious, inflammatory eye diseases such as severe allergic conjunctivitis (conjunctivitis)

  • chronic inflammatory gastrointestinal diseases such as Crohn's disease

  • after organ transplants to avoid rejection of the transplant organ in combination with other therapies

  • Sudden hearing loss and tinnitus

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Dosage of prednisolone: ​​follow medical advice

How exactly prednisolone has to be taken depends on the dosage form and the type of disease that is to be treated. The attending physician recommends which dosage is required for the individual case. Under no circumstances should the therapy be discontinued without medical advice. The information in this article is not intended to replace the advice of your doctor or the information in the package insert.

Impulse therapy with prednisolone: ​​higher dose for acute symptoms

Like other cortisone preparations, prednisolone is administered in the form of so-called shock therapy for acute symptoms, if the symptoms require it. In such a case, the drug is initially administered in a higher dosage in order to achieve rapid relief from the symptoms. Thereafter, the dosage is slowly reduced and either continues with a low dose or you switch to another drug.

Let prednisolone therapy taper off

Long-term therapy with prednisolone leads to the body's own production of glucocorticoids being reduced. If the drug is stopped suddenly, an acute cortisone deficiency can occur with serious consequences such as circulatory disorders (Addison's crisis). For this reason, the dosage of the active ingredient is only slowly reduced step by step in consultation with a doctor. This way of ending therapy is called "tapering off".

The Addison's crisis also threatens with chronic adrenal insufficiency, in which a suddenly increased need for cortisone - due to an emergency situation such as an accident or an operation - cannot be met. Patients on hormone replacement therapy are advised to carry an emergency card with them to indicate that they should be given additional glucocorticoids quickly. An emergency kit for self-administration of the medication can also be considered useful by the doctor.

Side effects: risk of Cushing's syndrome

Whether side effects occur with the use of prednisolone and how they turn out depends on the dosage form and dosage.

  • Shock therapies or low dosages: Short-term local application, for example as an ointment, is rarely associated with side effects. Even with precise dosing of oral preparations that have a systemic effect and are thus distributed over the entire bloodstream, there are few side effects in low dosages over a longer period of time and with short-term shock therapies. Compared to this low risk, the benefit of such therapies is usually higher due to the good effectiveness of prednisolone.

  • Long-term therapies with high doses: With very high doses of prednisolone that are given over a long period of time, the risk of side effects increases. For this reason, in such cases, careful consideration is given to whether the benefit outweighs this risk. If necessary, regular medical checks and certain dietary recommendations may be required.

Possible side effects of long-term therapy with prednisolone:

Prednisolone andCushing's Syndrome: When determining the dosage of prednisolone, the treating physicians observe the so-called Cushing threshold. This is to be understood as a certain daily dosage of the active ingredient, which should not be exceeded in the long term in order to prevent Cushing's syndrome. In this syndrome, the concentration of cortisone in the blood is increased. This goes hand in hand with a changed appearance (full moon face, trunk obesity, steroid acne, bull's neck) as well as with possible other complaints such as osteoporosis (bone loss), increased blood sugar, muscle weakness, menstrual and erectile dysfunction.

Prednisolone andOsteoporosis: Depending on the duration and dosage of treatment, taking prednisolone can have a negative effect on calcium metabolism. For this reason, there is an increased risk of osteoporosis, especially in combination with other risk factors such as menopause. In consultation with the doctor, preventive measures are recommended.

Other possible side effects:

Warnings about taking prednisolone

  • Other existing e-diseases: In the case of certain pre-existing conditions such as osteoporosis or severe diabetes mellitus, the therapeutic approach is discussed with the doctor. Particular caution also applies in the presence of acute viral infections such as chickenpox, as prednisolone suppresses the immune system.

  • Time of day: Prednisolone may be recommended between six and eight o'clock in the morning, as the body's natural cortisone production is highest at this time.

  • children: Prednisolone should only be taken by children if it is medically necessary and if possible in low doses. The pediatrician will advise you on this.

  • pregnancy and breast feeding period: Whether drugs containing prednisolone can be taken depends on various factors - including the dosage, the duration of therapy and the trimester of pregnancy. More detailed information is available from the Pharmacovigilance and Advice Center for Embryonic Toxicology at Charité Berlin.

  • Competitive sport: Like all glucocorticoids, prednisolone is one of the active ingredients that, depending on the dosage, are prohibited in competitive sports because they are considered a doping agent.

  • Roadworthiness: Depending on the drug, impairments in the roadworthiness and the ability to operate machines cannot be ruled out. Consult the package insert for the medication to find out whether this is the case.

  • Drug interaction: Medicines containing cortisone may interact with other drugs. Before starting prednisolone therapy, the doctor and pharmacist should therefore be informed about the use of other medications. Particularly in the case of pre-existing illnesses, it must be ensured that the effect of the respective medication can be increased or decreased. If vaccination with a live vaccine is to be carried out, the doctor must also be informed about the prednisolone intake, as particular caution is required here: Such vaccinations can then be carried out sufficiently before or after the prednisolone therapy.

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