Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.

Prednisolone: ​​instructions for use

Compound

active ingredient: 1 ml of solution contains prednisolone sodium phosphate in terms of prednisolone - 30 mg;

excipients: sodium hydrogen phosphate anhydrous, sodium dihydrogen phosphate dihydrate, propylene glycol, water for injection.

Description

Injection.

pharmachologic effect

It has anti-inflammatory, antiallergic, immunosuppressive, antishock and antitoxic effects.

In relatively large doses, it inhibits the activity of fibroblasts, the synthesis of collagen, reticuloendothelium and connective tissue(braking proliferative phase inflammation), delays synthesis and accelerates protein catabolism in muscle tissue, but increases its synthesis in the liver.

The antiallergic and immunosuppressive properties of the drug are due to inhibition of the development of lymphoid tissue with its involution with long-term use, a decrease in the number of circulating T- and B-lymphocytes, inhibition of mast cell degranulation, and suppression of antibody production.

The antishock effect of the drug is due to an increase in the vascular response to endo- and exogenous vasoconstrictor substances, with restoration of the sensitivity of vascular receptors to catecholamines and an increase in their hypertensive effect, as well as a delay in the excretion of sodium and water from the body.

The antitoxic effect of the drug is associated with the stimulation of protein synthesis processes in the liver and the acceleration of inactivation of endogenous toxic metabolites and xenobiotics in it, as well as with an increase in the stability of cell membranes, incl. hepatocytes. Enhances the deposition of glycogen in the liver and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose levels activates the release of insulin. Inhibits the uptake of glucose by fat cells, which leads to activation of lipolysis. However, due to increased insulin secretion, lipogenesis is stimulated, which promotes fat accumulation.

Reduces calcium absorption in the intestines, increases its leaching from bones and excretion by the kidneys. Suppresses the release of adrenocorticotropic hormone and p-lipotropin by the pituitary gland, and therefore, with long-term use, the drug can contribute to the development of functional insufficiency of the adrenal cortex.

The main factors limiting long-term therapy with prednisolone are osteoporosis and Itsenko-Cushing syndrome. Prednisolone inhibits the secretion of thyroid-stimulating and follicle-stimulating hormones.

In high doses, it can increase the excitability of brain tissue and help lower the threshold for convulsive readiness.

Stimulates excess secretion of hydrochloric acid and pepsin in the stomach, which may contribute to the development of peptic ulcers.

Pharmacokinetics

When administered intramuscularly, it is absorbed into the blood quickly, however, compared to reaching the maximum level in the blood, the pharmacological effect of the drug is significantly delayed and develops within 2-8 hours. In plasma, most of prednisolone binds to transcortin (cortisol-binding globulin), and when the process is saturated, to albumin. With a decrease in protein synthesis, a decrease in the binding capacity of albumin is observed, which can cause an increase in the free fraction of prednisolone and, as a consequence, the manifestation of its toxic effect when using normal therapeutic doses. The half-life in adults is 2-4 hours, in children it is shorter. Biotransformed by oxidation mainly in the liver, as well as in the kidneys, small intestine, bronchi. Oxidized forms are glucuronidated or sulfated and excreted by the kidneys in the form of conjugates. About 20% of prednisolone is excreted from the body unchanged by the kidneys; a small part is excreted in bile.

In liver diseases, the metabolism of prednisolone slows down and the degree of its binding to plasma proteins decreases, which leads to an increase in the half-life of the drug.

Indications for use

Intramuscular, intravenous administration: systemic diseases connective tissue: systemic lupus erythematosus, dermatomyositis, scleroderma, periarteritis nodosa, ankylosing spondylitis;

hematological diseases: acute hemolytic anemia, lymphogranulomatosis,

granulocytopenia, thrombocytopenic purpura, agranulocytosis, various shapes leukemia;

skin diseases: eczema vulgaris, exudative erythema multiforme, pemphigus vulgaris, erythroderma, exfoliative dermatitis, seborrheic dermatitis, psoriasis, alopecia, adrenogenital syndrome;

emergency conditions: severe forms nonspecific ulcerative colitis and Crohn's disease, shock (burn, traumatic, surgical, anaphylactic, toxic, transfusion), status asthmaticus, acute adrenal insufficiency, hepatic coma, severe allergic and anaphylactic reactions, hypoglycemic reactions;

Intra-articular administration: chronic polyarthritis, osteoarthritis of large joints, rheumatoid arthritis, post-traumatic arthritis, arthrosis;

Contraindications

Hypersensitivity to the components of the drug; peptic ulcer stomach and duodenum, osteoporosis, Itsenko-Cushing's disease, tendency to thromboembolism, renal failure, arterial hypertension, viral infections(including viral lesions eyes and skin), decompensated diabetes mellitus, vaccination period (at least 14 days before and after preventive immunization), lymphadenitis-poel-"BCG vaccinations, active form of tuberculosis, glaucoma, cataracts, productive symptoms with mental illness, psychosis, depression; systemic mycosis, herpetic diseases, syphilis, severe myopathy (except for myasthenia gravis), poliomyelitis (except for the bulbar-encephalitic form), pregnancy and lactation.

For intra-articular injections - infections at the injection site.

Pregnancy and lactation

The drug is not used during pregnancy.

If it is necessary to use the drug during lactation, it is recommended to stop breastfeeding.

Directions for use and doses

Mixing and simultaneous use of prednisolone with other drugs in the same infusion system or syringe is not allowed!

The drug is prescribed for intravenous, intramuscular or intra-articular administration.

The dose of prednisolone depends on the severity of the disease.

For the treatment of adults, the daily dose is 4-60 mg intravenously or intramuscularly.

For children, the drug is prescribed intramuscularly (deep into the gluteal muscle) strictly according to indications and under the supervision of a doctor: children aged 6-12 years - 25 mg/day, over 12 years - 25-50 mg/day. The duration of use and the number of injections of the drug are determined individually.

For Addison's disease, the daily dose for adults is 4-60 mg intravenously or intramuscularly.

In severe forms of nonspecific ulcerative colitis, 8-12 ml/day (240-360 mg Prednisolone) for 5-6 days, in severe forms of Crohn's disease - 10-13 ml/day (300-390 mg Prednisolone) for 5 -7 days.

At emergency conditions Prednisolone is administered intravenously, slowly (over approximately 3 minutes) or drip, at a dose of 30-60 mg. If intravenous infusion is difficult, the drug is administered intramuscularly, deeply. With this method of administration, the effect develops more slowly. If necessary, the drug is re-administered intravenously or intramuscularly at a dose of 30-60 mg every 20-30 minutes.

In some cases, an increase in the indicated dose is allowed, which is decided by the doctor individually in each specific case.

For adults, the dose of intra-articular prednisolone is 30 mg for large joints, 10-25 mg for medium-sized joints and 5-10 mg for small joints. The drug is administered every 3 days. The course of treatment is up to 3 weeks.

Side effect

Development of severe adverse reactions depends on the dose and duration of treatment. Adverse reactions usually develop when long-term treatment drug. Over a short period, the risk of their occurrence is unlikely.

Infections and infestations: increased sensitivity to bacterial, viral, fungal infections, their severity with masking of symptoms, opportunistic infections.

Blood system and lymphatic system: increase total number leukocytes with a decrease in the number of eosinophils, monocytes and lymphocytes. The mass of lymphoid tissue decreases. Blood clotting may increase, which leads to thrombosis and thromboembolism.

Endocrine system and metabolism: suppression of the hypothalamic-pituitary-adrenal system, growth retardation in children and adolescents, disorder menstrual cycle, impaired secretion of sex hormones (amenorrhea), postmenopausal bleeding, Cushingoid face, hirsutism, weight gain, decreased tolerance to carbohydrates, increased need for insulin and oral hypoglycemic drugs, hyperlipidemia, negative nitrogen and calcium balance, increased appetite, impaired mineral metabolism and electrolyte balance, hypokalemic alkalosis, hypokalemia, possible fluid and sodium retention in the body.

Mental disorders: irritability, euphobia, depression, suicidal tendencies, insomnia, labile mood, increased concentration, psychological dependence, mania, hallucinations, exacerbation of schizophrenia; dementia, psychosis, anxiety, sleep disturbance, epileptic seizures, cognitive dysfunction (including amnesia and impaired consciousness), increased intracranial pressure which is accompanied by nausea and disc swelling optic nerve in children.

Nervous system: increased intracranial pressure, epileptic seizures, peripheral neuropathies, paresthesia, dizziness, headache, autonomic disorders.

Visual organs: increased intraocular pressure, glaucoma, swelling of the optic nerve, cataracts, thinning of the cornea and sclera, exacerbation of eye viral and fungal infections, exophthalmos.

Cardiovascular system: myocardial rupture due to myocardial infarction, arterial hypo- or hypertension, bradycardia, combined ventricular arrhythmia, asystole (due to rapid drug administration), atherosclerosis, thrombosis, vasculitis, heart failure, peripheral edema.

Immune system: allergic reactions that cause fatal anaphylactic shock, angioedema, allergic dermatitis, change in reaction to skin tests, relapse of tuberculosis, immunosuppression.

Gastrointestinal tract: nausea, bloating, bad taste in the mouth, dyspepsia, peptic ulcers with perforation and bleeding, esophageal ulcer, esophageal candidiasis, pancreatitis, perforation gallbladder, stomach bleeding, local ileitis and ulcerative colitis.

During the use of the drug, an increase in ALT, AST and alkaline phosphatase may be observed, which is usually not important and is reversible after discontinuation of the drug.

Skin: slower regeneration, skin atrophy, formation of hematomas and atrophic stripes of the skin (striae), telangiectasia, acne, acne, hirsutism, microhemorrhages, ecchymosis, purpura, hypo- or hyperpigmentation, post-steroid panniculitis, which is characterized by the appearance of erythematosis, hot subcutaneous thickenings for 2 weeks after discontinuation of the drug, Galoshi's sarcoma.

Musculoskeletal system: proximal myopathy, osteoporosis, tendon rupture, muscle weakness, atrophy, myopathy, fractures of the spine and long bones, aseptic osteonecrosis.

Urinary system: increased risk of urolith formation and the content of leukocytes and red blood cells in the urine without obvious kidney damage.

General: malaise, persistent hiccups when using the drug in high doses, adrenal insufficiency, which leads to arterial hypotension, hypoglycemia and deaths in stressful situations such as surgery, trauma or infection, unless the prednisolone dose is increased.

With abrupt withdrawal of the drug, withdrawal syndrome is possible, the severity of symptoms depends on the degree of adrenal atrophy, headache, nausea, pain in the adrenal glands are observed. abdominal cavity, dizziness, anorexia, weakness, mood changes, lethargy, increased body temperature, myalgia, arthralgia, rhinitis, conjunctivitis, pain syndrome skin, weight loss. In more severe cases - severe mental disorders and increased intracranial pressure, steroid pseudorheumatism in patients with rheumatism, death.

Reactions at the injection site: pain, burning, pigmentation changes (depigmentation, leucoderma), skin atrophy, sterile abscesses, rarely - lipoatrophy.

Overdose

In case of overdose, nausea, vomiting, bradycardia, arrhythmia, increased symptoms of heart failure, cardiac arrest are possible; hypokalemia, increased blood pressure, muscle cramps, hyperglycemia, thromboembolism, acute psychosis, dizziness, headache, possible development of symptoms of hypercortisolism: weight gain, development of edema, arterial hypertension, glucosuria, hypokalemia. In children with a first dose, there is a decrease in the hypothalamic-pituitary-adrenal system, Itsenko-Cushing syndrome, decreased excretion of growth hormone, and increased intracranial pressure.

There is no specific antidote.

Treatment: discontinuation of the drug, symptomatic therapy, and, if necessary, correction of electrolyte balance.

Interaction with other drugs

Anticoagulants: when used simultaneously with glucocorticoids, the effect of anticoagulants may be increased or decreased. Parenteral administration of prednisolone causes the thrombolytic effect of vitamin K antagonists (fluindione, acenocoumarol).

Salicylates and other non-steroidal anti-inflammatory drugs: Concomitant use of salicylates, indomethacin and other non-steroidal anti-inflammatory drugs may increase the likelihood of gastric ulcers. Prednisolone reduces the level of salicylates in the blood serum, increasing their renal clearance. Caution is necessary when reducing the dose of prednisolone during long-term concomitant use.

Hypoglycemic drugs: Prednisolone partially inhibits the hypoglycemic effect of oral hypoglycemic agents and insulin.

Hepatic enzyme inducers, for example, barbiturates, phenytoin, pyramidone, carbamazepine and rifampicin increase the systemic clearance of prednisolone, thereby reducing the effect of prednisolone by almost 2 times.

CYP3A4 inhibitors, such as erythromycin, clarithromycin, ketoconazole, diltiazem, aprepitant, itraconazole and oleandomycin, increase the elimination and plasma levels of prednisolone, which increases the therapeutic and side effects of prednisolone.

Estrogen may potentiate the effect of prednisolone by slowing its metabolism. It is not recommended to adjust the dose of prednisolone for women using oral contraceptives, which contribute not only to an increase in the half-life, but also to the development of the atypical immunosuppressive effect of prednisolone.

Fluoroquinolones: Concomitant use may cause tendon damage. Amphotericin, diuretics and laxatives: Prednisolone may increase potassium excretion in patients receiving these drugs concomitantly. Immunosuppressants: Prednisolone has active immunosuppressive properties, which may cause an increase in therapeutic effects or the risk of developing various adverse reactions when used simultaneously with other immunosuppressants. Only some of them can be explained by pharmacokinetic interactions. Glucocorticoids increase the antiemetic effectiveness of antiemetic drugs that are used in parallel during therapy with anticancer drugs that cause vomiting.

Corticosteroids may increase plasma concentrations of tacrolimus when used concomitantly; when they are discontinued, plasma concentrations of tacrolimus decrease.

Immunization: Glucocorticoids may reduce the effectiveness of immunization and increase the risk of neurological complications. The use of therapeutic (immunosuppressive) doses of glucocorticoids with live virus vaccines may increase the risk of developing viral diseases. Emergency vaccines may be used during drug therapy.

Anticholinesterase agents: In patients with myasthenia gravis, the use of glucocorticoids and anticholinesterase agents may cause muscle weakness, especially in patients with myasthenia gravis.

Others: Two serious cases of acute myopathy have been reported in elderly patients who took doxocarium chloride and high-dose prednisolone. With long-term therapy, glucocorticoids may reduce the effect of somatotropin.

Cases of acute myopathy have been described with the use of corticosteroids in patients who are simultaneously receiving treatment with neuromuscular transmission blockers (for example, pancuronium).

Cases of seizures have been reported with the simultaneous use of prednisolone and cyclosporine. Because coadministration of these drugs causes mutual inhibition of metabolism, it is likely that seizures and other side effects associated with the use of each of these drugs as monotherapy may occur more frequently when administered concomitantly. Concomitant use may cause an increase in plasma concentrations of other drugs.

Antihistamines reduce the effect of prednisolone.

When prednisolone is used simultaneously with antihypertensive drugs, the effectiveness of the latter may be reduced.

Features of application

For infectious diseases and latent forms of tuberculosis, the drug should be prescribed only in combination with antibiotics and anti-tuberculosis drugs. If it is necessary to use prednisolone while taking oral hypoglycemic drugs or anticoagulants, it is necessary to adjust the dosage regimen of the latter. In patients with thrombocytopenic purpura, the drug is used only intravenously.

After cessation of treatment, withdrawal syndrome, adrenal insufficiency, and exacerbation of the disease for which prednisolone was prescribed may occur. If, after finishing treatment with prednisolone, functional adrenal insufficiency is observed, use of the drug should be resumed immediately, and the dose reduction should be carried out very slowly and with caution (for example, the daily dose should be reduced by 2-3 mg over 7-10 days). Because of the risk of developing hypercortisolism, a new course of treatment with cortisone, after a previous long-term treatment with prednisone over several months, should always be started with low initial doses (except in acute life-threatening conditions).

Electrolyte balance should be monitored especially carefully during combined use prednisolone with diuretics. With long-term treatment with prednisolone to prevent hypokalemia, it is necessary to prescribe potassium supplements and an appropriate diet due to a possible increase in intraocular pressure and the risk of developing subcapsular cataracts.

During treatment, especially long-term treatment, observation by an ophthalmologist is necessary. If there is a history of psoriasis, prednisolone in high doses is used with extreme caution.

If there is a history of psychosis or seizures, prednisolone should be used only in minimal effective doses.

Prednisolone is prescribed to children with particular caution.

It is prescribed with particular caution for immunodeficiency conditions (including AIDS or HIV infection). Also prescribed with caution after a recent myocardial infarction (in patients with acute, subacute myocardial infarction, expansion of the focus of necrosis, slowdown in the formation of scar tissue, and rupture of the heart muscle are possible).

With particular caution, prescribe hepatic failure, conditions that cause the occurrence of hypoalbuminemia, obesity of III - IV degree.

Women during menopause need to undergo research regarding possible occurrence osteoporosis.

When treated with glucocorticoids over a long period of time, it is recommended to regularly monitor blood pressure, determine the level of glucose in the urine and blood, and perform a stool test. occult blood, tests of blood clotting indicators, X-ray control spine. Before starting treatment with glucocorticoids, a thorough examination should be performed. gastrointestinal tract to exclude gastric and duodenal ulcers.

The ability to influence the reaction speed when driving a vehicle or a robot with other mechanisms.

Patients being treated with prednisone should avoid potentially dangerous species activities that require increased attention and speed of mental and motor reactions.

Prednisolone a synthetic analogue of the hormones cortisone and hydrocortisone secreted by the adrenal cortex. Prednisolone is 4-5 times more active than cortisone and 3-4 times more active than hydrocortisone when administered orally. Unlike cortisone and hydrocortisone, prednisolone does not cause noticeable sodium and water retention and only slightly increases potassium excretion.
The drug has a pronounced anti-inflammatory, anti-allergic, anti-exudative, anti-shock, anti-toxic effect.
The anti-inflammatory effect of prednisolone is achieved mainly with the participation of cytosolic glucocorticosteroid receptors. The hormone-receptor complex, penetrating into the nucleus of the skin target cells (keratinocytes, fibroblasts, lymphocytes), enhances the expression of genes encoding the synthesis of lipocortins, which inhibit phospholipase A2 and reduce the synthesis of arachidonic acid metabolic products, cyclic endoperoxides, prostaglandins and thromboxane. The antiproliferative effect of prednisolone is associated with inhibition of the synthesis of nucleic acids (primarily DNA) in the cells of the basal layer of the epidermis and fibroblasts of the dermis. The antiallergic effect of the drug is due to a decrease in the number of basophils, direct inhibition of the synthesis and secretion of biologically active substances.
Pharmacokinetics.
When taken orally, it is well absorbed from the gastrointestinal tract. The maximum concentration in blood plasma is reached 90 minutes after administration. In plasma, 90% of prednisolone is in bound form (with transcortin and albumin). Biotransformed by oxidation mainly in the liver; oxidized forms are glucuronidated or sulfated. It is excreted in urine and feces in the form of metabolites, partly unchanged. Penetrates the placental barrier and is found in small quantities in breast milk.

Indications for use:
Indications for use of the drug Prednisolone are: collagenoses ( common name diseases characterized by diffuse damage to connective tissue and blood vessels), rheumatism, infectious nonspecific polyarthritis (inflammation of several joints), bronchial asthma, acute lymphoblastic and myeloblastic leukemia ( malignant tumor blood arising from hematopoietic cells bone marrow), Infectious mononucleosis(an acute infectious disease that occurs with a high rise in temperature, enlargement of the palatine lymph nodes, liver), neurodermatitis (a skin disease caused by dysfunction of the central nervous disease), eczema (a neuroallergic skin disease characterized by weeping, itchy inflammation) and other skin diseases, various allergic diseases, Addison's disease (decreased adrenal function), acute adrenal insufficiency, hemolytic anemia (decreased hemoglobin in the blood due to increased breakdown of red blood cells), glomerulonephritis (kidney disease), acute pancreatitis(inflammation of the pancreas); shock and collapse (sharp drop in blood pressure) with surgical interventions; to suppress the rejection reaction during homotransplantation (transplantation from one person to another) of organs and tissues.
Allergic, chronic and atypical conjunctivitis (inflammation outer shell eyes) and blepharitis (inflammation of the edges of the eyelids); inflammation of the cornea with intact mucosa; acute and chronic inflammation of the anterior segment choroid, sclera (opaque part of the fibrous membrane eyeball) and episclera (the outer loose layer of the sclera in which blood vessels); sympathetic inflammation of the eyeball (inflammation of the anterior part of the choroid due to penetrating injury to the other eye); after injuries and operations with prolonged irritation of the eyeballs.

Mode of application:
Dose of the drug Prednisolone installed individually. IN acute conditions and 20-30 mg per day (4-6 tablets) is usually used as an introductory dose. The maintenance dose is 5-10 mg per day (1-2 tablets). For some diseases (nephrosis - a kidney disease characterized by damage to the renal tubules with the development of edema and the appearance of protein in the urine), some rheumatic diseases) are prescribed in higher doses. Treatment is stopped slowly, gradually reducing the dose. If there are indications of psychosis in the anamnesis (medical history), high doses are prescribed under the strict supervision of a physician. The dose for children is usually 1-2 mg per kg of body weight per day in 4-6 divided doses. When prescribing prednisolone, the daily secretory rhythm of glucocorticoids (the rhythm of the secretion of hormones of the adrenal cortex) should be taken into account: large doses are prescribed in the morning, medium doses in the afternoon, small doses in the evening.
For shock, 30-90 mg of prednisolone is administered intravenously slowly or by drip.
For other indications, prednisolone is prescribed at a dose of 30-45 mg intravenously slowly. If intravenous infusion is difficult, the drug can be injected deep into the muscle. According to indications, prednisolone is administered repeatedly at a dose of 30-60 mg, intravenously or intramuscularly. After relief (removal) of the acute condition, prednisolone is prescribed orally in tablets, gradually reducing the dose.
In children, prednisolone is used at the following rate: at the age of 2-12 months - 2-3 mg/kg; 1-14 years - 1-2 mg/kg intravenously slowly (over 3 minutes). If necessary, the drug can be re-administered after 20-30 minutes.
The drug in the form of an injection suspension and solution for injection is intended for intra-articular, intramuscular and infiltration (impregnation of tissues) administration with strict adherence to asepsis (sterility). For intra-articular injection, it is recommended to administer 10 mg to small joints, 25 mg or 50 mg to large joints. The injection can be repeated several times. After several injections, the severity should be assessed therapeutic effect. If the intensity is insufficient, decide on increasing the dose. After removing the needle from the joint, the patient must move the joint several times, bending and unbending it, for better distribution of the hormone. When infiltrated into small affected parts of the body - 25 mg, into larger ones - 50 mg.
The eye suspension is instilled into the conjunctival sac (the cavity between the back surface of the eyelids and the front surface of the eyeball) 1-2 drops 3 times a day. The course of treatment is no more than 14 days.
It is recommended to regularly monitor blood pressure, conduct urine and stool tests, measure blood sugar levels, administer anabolic hormonal drugs, and antibiotics. You should especially carefully monitor the electrolyte (ionic) balance when using prednisolone with diuretics in combination. During long-term treatment with prednisolone, potassium supplements and an appropriate diet must be prescribed to prevent hypokalemia (low potassium levels in the blood). To reduce the risk of catabolism (tissue breakdown) and osteoporosis (eating disorders bone tissue, accompanied by an increase in its fragility), methandrostenolone is used.

Side effects:
With prolonged use Prednisolone possible obesity, hirsutism (excessive hair growth in women, manifested by the growth of a beard, mustache, etc.), acne, menstrual irregularities, osteoporosis, Itsenko-Cushing symptom complex (obesity, accompanied by decreased sexual function, increased bone fragility due to increased release of adrenocorticotropic pituitary hormone), ulceration of the digestive tract, perforation of an unrecognized ulcer (the appearance of a through defect in the wall of the stomach or intestine at the site of the ulcer), hemorrhagic pancreatitis (inflammation of the pancreas that occurs with hemorrhage into its body), hyperglycemia (increased blood sugar levels), decreased resistance to infections, increased blood clotting, mental disorders. When stopping treatment, especially long-term treatment, withdrawal syndrome (sharp deterioration in the patient's condition after stopping the drug), adrenal insufficiency, and exacerbation of the disease for which prednisolone was prescribed may occur.

Contraindications:
Contraindications to the use of the drug Prednisolone are: severe forms hypertension(persistent rise in blood pressure), diabetes mellitus and Itsenko-Cushing's disease; pregnancy, circulatory failure Stage III, acute endocarditis (inflammation of the internal cavities of the heart), psychosis, nephritis (inflammation of the kidneys), osteoporosis, peptic ulcer of the stomach and duodenum, recent operations, syphilis, active form of tuberculosis, old age.
Prednisolone is prescribed for diabetes mellitus with caution and only when absolutely indicated or for the treatment of insulin resistance (lack of response and insulin administration) associated with high titres of anti-insulin antibodies. For infectious diseases and tuberculosis, the drug should be used only in combination with antibiotics or drugs for the treatment of tuberculosis.

Pregnancy:
Controlled clinical researches safety of the drug Prednisolone were not carried out during pregnancy.
Experimental studies found that GCS caused an increase in the incidence of cleft palate, miscarriages, placental insufficiency and fetal growth retardation.
IN clinical practice the teratogenic effect has not been confirmed, however, there is evidence indicating an increased risk of placental insufficiency, malnutrition at birth and fetal death in women who received GCS during pregnancy.
Prescribing GCS during pregnancy and women of childbearing age is permissible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus. Women of childbearing potential should be informed of the potential risks of GC therapy to the fetus.
Prednisolone is excreted in breast milk and can cause undesirable effects in a breastfed baby (growth retardation or inhibition of the production of endogenous adrenal hormones). If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Interaction with othersmedicines:
If Prednisolone is prescribed against the background of antidiabetic or anticoagulant drugs, their dose should be adjusted.
Caution should be exercised when prednisolone and barbiturates are used together in patients suffering from Addison's disease.
During pregnancy, especially in the first trimester, prednisolone should be prescribed with extreme caution.

Overdose:
Reports of acute toxic effects or death from glucocorticoid overdose are rare. In cases of overdose Prednisolone there are no specific antidotes. Symptomatic therapy is carried out.

Storage conditions:
List B. In a place protected from light.
Dispensing conditions: by prescription.

Release form:
PillsPrednisolone, containing 0.001; 0.005; 0.02 or 0.05 g of prednisolone in a package of 100 pcs. Ampoules of 25 and 30 mg in 1 ml in a package of 3 pieces. Ampoules with 1 ml of injection suspension containing prednisolone 25 or 50 mg, in packages of 5, 10, 50, 100 and 1000 pieces. 0.5% ointment in tubes of 10 g. 0.5% ophthalmic suspension in packages of 10 ml.

Compound:
1 tablet Prednisolone contains 0.005 g of prednisolone; excipients: milk sugar, potato starch, calcium stearate.

You should consult your doctor before using PREDNISOONE. These instructions for use are for informational purposes only. To get more complete information Please refer to the manufacturer's instructions.

PREDNISOONE: Clinical and pharmacological group

04.001 (GCS for oral use)

PREDNISOONE: Release form, composition and packaging

Tablets white or almost white, round, chamfered, practically odorless, with an engraving “P” on one side.

Excipients: lactose monohydrate, silicon dioxide, stearic acid, magnesium stearate, talc, povidone, corn starch, potato starch.

100 pieces. - polypropylene bottles (1) - cardboard packs.

PREDNISOONE: Pharmacological action

Synthetic glucocorticosteroid (GCS), dehydrogenated analogue of hydrocortisone. It has anti-inflammatory, immunosuppressive and antiallergic effects.

Easily penetrating into target cells, it interacts with GCS receptors in the cytoplasm. Free receptors are usually associated with the so-called. heat shock protein (HSP90). After joining the GCS receptors, the structure of HSP90 changes and it leaves the receptor. The latter moves to the cell nucleus. The multilateral effect of steroids is due to the presence of the so-called. glucocorticoid response elements (CRE) in the promoter regions of several genes, some of which are “turned off” as a result of the attachment of receptors to their CRE, while others are in an active state. A key role in this complex process is played by the ubiquitous so-called. intracellular transcription factor Nf-kB. Various inflammatory mediators activate Nf-kB to trigger cytokine production. GCS induce transcription of the IkB protein, which captures activated Nf-kB and forms an inactive cytoplasmic complex with it. In addition, steroids activate lipocortins, which are representatives of another family of proteins, and enhance the transcription of β2 receptor genes. The essence of the action of lipocortins is to inhibit the chain of reactions leading to the formation of prostaglandins, leukotrienes and platelet activating factor. These mediators usually increase vascular permeability, leading to tissue edema, migration of leukocytes and formation of fibrin deposits.

Prednisolone has an effect on all stages inflammatory process, among which particularly important is the inhibition of phospholipase A2 and the blockade of arachidonic acid formation by stimulating the synthesis of an inhibitor polypeptide, the so-called. lipocortin-1 with subsequent suppression of the biosynthesis of inflammatory mediators, the so-called. pleiotropic cytokines of the reaction of the acute phase of inflammation: interleukin-1, TNF-α, as well as interleukins-4 and 5. In addition, it blocks the transcription of genes for such inflammatory enzymes as NO synthetase and cyclooxygenase. Suppresses the functions of neutrophils and macrophages, incl. release of chemical mediators and their effects on capillaries. Prednisolone stabilizes cell and organelle membranes (especially liposomal ones) and increases their resistance to various damaging factors. By blocking inflammatory reactions in connective tissue, it prevents the formation of scar tissue.

Suppresses the inflammatory process regardless of its etiology, in case of excessive or “useless” inflammatory reaction has a beneficial effect, but is dangerous during infections due to the suppression of the protective inflammatory process.

The immunosuppressive effect is achieved through its action on numerous targets, among which suppression of cytokine secretion is particularly important. Prednisolone suppresses the proliferation of lymphocytes, incl. leukemia lymphocytes, the expression of MHC II on macrophages and adhesion molecules of endothelial cells, causes eosinopenia and prevents eosinophil degranulation and neutrophil adhesion, prevents the release of cytokines by cells (mainly interleukin-2 and γ-interferon) and the secretion and release of prostaglandin E, and also blocks in fibroblasts collagen synthesis. Large doses of glucocorticosteroids suppress the production of antibodies.

Prevents the development of allergic reactions. Reduces the number of circulating eosinophils, basophils and the release of immediate allergy mediators. The interaction of allergens with antibodies remains unchanged, but the damaging effects of inflammation are absent.

The drug affects different kinds metabolism in the human body.

Carbohydrate metabolism: prednisolone activates gluconeogenesis (increased absorption of carbohydrates from the gastrointestinal tract, increased activity of glucose-6-phosphatase and phosphoenol-pyruvate kinase with an increase in the flow of glucose from the liver into the blood), while peripheral glucose utilization (transport of glucose through cell membrane) may decrease, leading to hyperglycemia and sometimes glycosuria. Latent diabetes manifests itself, this effect can be used as a test to identify the prediabetic stage of the disease.

Protein metabolism: anabolism decreases (decrease in the amount of globulins, increase in albumin synthesis in the liver and kidneys, increase in the albumin/globulin ratio) with the same or even increased intensity of catabolic processes, which leads to a negative nitrogen balance with muscle tissue atrophy. Osteoporosis is possible due to a decrease in the protein matrix of bone tissue, growth retardation in children, skin atrophy, which with increased capillary fragility leads to increased skin vulnerability and the formation of stretch marks. Healing of wounds and peptic ulcers is slowed down and occurs with the formation of fibrous tissue.

Fat metabolism: the synthesis of higher fatty acids and triglycerides increases with the deposition of fat in the shoulder girdle, on the face and abdomen and its mobilization from the subcutaneous fatty tissue of the extremities, followed by hypercholesterolemia.

Water-electrolyte metabolism (mineralocorticoid effects): sodium retention in the renal tubules increases, potassium excretion in the urine increases. Prednisolone reduces hypercalcemia with excessive absorption of calcium from the gastrointestinal tract (sarcoidosis, vitamin D intoxication), increases urinary calcium excretion with possible stone formation.

Suppresses feedback hypothalamic-pituitary-adrenocorticoid system with long-term use (followed by slow recovery), which, with abrupt cessation of treatment, leads to the development of adrenocorticoid insufficiency in the patient: it suppresses the synthesis and secretion of ACTH by the pituitary gland, thereby inhibiting the synthesis of endogenous glucocorticoid (and androgenic) hormones by the adrenal glands.

PREDNISOONE: Pharmacokinetics

When taken orally, it is well absorbed from the gastrointestinal tract. Cmax in blood plasma is achieved within 1-2 hours. Bioavailability is 82±13%. The binding to blood proteins reaches 90-95%, with most of prednisolone bound to transcortin (cortisol-binding globulin) and albumin.

Metabolism occurs mainly in the liver and partially in the kidneys, small intestine, and bronchi. Oxidized forms are glucuronidated or sulfated. 20% is excreted by the kidneys unchanged, the rest in the form of free and conjugated metabolites. T1/2 is 2-3 hours (2.2±0.5).

Prednisolone crosses the placental barrier and is excreted in small amounts in breast milk.

PREDNISOONE: Dosage

Take orally, without chewing and with a small amount of liquid. The dose is selected individually. When prescribing, the circadian rhythm of GCS secretion should be taken into account: most of the dose (2/3) or the entire dose should be taken in the morning, around 8 a.m., and 1/3 in the evening. Treatment is stopped slowly, gradually reducing the dose.

Adults: in acute conditions and as a replacement therapy The initial daily dose is 20-30 mg, the maintenance daily dose is 5-10 mg. If necessary, the initial daily dose can be 15-100 mg, maintenance - 5-15 mg/day.

Children: the initial daily dose is 1-2 mg/kg body weight and is divided into 4-6 doses, the maintenance daily dose is 300-600 mcg/kg.

PREDNISOLONE: Overdose

Symptoms: increased side effects.

PREDNISOONE: Drug interactions

Children with bronchial asthma are contraindicated in the use of Prednisolone simultaneously with sympathomimetic aerosols.

With the simultaneous administration of Prednisolone and indirect anticoagulants, the anticoagulant effect of the latter may be weakened, or less often, enhanced. Dose adjustment is necessary.

The combination of Prednisolone with anticoagulants and thrombolytics increases the risk of developing ulcerative bleeding from the gastrointestinal tract.

The simultaneous use of Prednisolone with salicylates increases the likelihood of gastrointestinal bleeding.

Simultaneous use with acetylsalicylic acid is accompanied by accelerated excretion and a decrease in its concentration in the blood, and when Prednisolone is discontinued, an increase in the content of salicylates in the blood with the likelihood of side effects.

The combination of Prednisolone with diuretics, especially thiazide derivatives and carbonic anhydrase inhibitors, amphotericin B, can aggravate disturbances in electrolyte metabolism, incl. increase potassium excretion (when prescribed with amphotericin B, the risk of heart failure may also increase).

The combination of Prednisolone with sodium-containing drugs leads to edema and increased blood pressure.

Concomitant use of Prednisolone with antihypertensive drugs, antidiabetic drugs and insulin reduces their effectiveness, with cardiac glycosides - increases the risk of developing glycoside intoxication with the development of ventricular extrasystole as a result of hypokalemia.

Hormonal contraceptives enhance the effect of Prednisolone.

The simultaneous use of Prednisolone and ethanol or NSAIDs increases the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract (a dose reduction of the drug may be required).

The appearance of hirsutism, acne and edema is facilitated by the simultaneous use of Prednisolone with other steroids. hormonal drugs(androgens, estrogens, oral contraceptives and anabolic steroids).

Simultaneous use with hormonal contraceptives accompanied by an increase in the effect of Prednisolone due to a decrease in the clearance of the latter.

The risk of developing cataracts increases with simultaneous use of Prednisolone with antipsychotics, carbutamide and azathioprine.

Simultaneous use with inducers of microsomal liver enzymes (phenytoin and barbiturates, ephedrine, rifampicin, theophylline) leads to a decrease in the concentration and weakening of the effect of Prednisolone.

Simultaneous use of Prednisolone with M-anticholinergics, incl. antihistamines, tricyclic antidepressants and nitrates increases intraocular pressure.

Taking Prednisolone with paziquatel leads to a decrease in the concentration of the latter.

Concomitant use with paracetamol increases the hepatotoxic effect as a result of induction of liver enzymes and the formation of a toxic metabolite of paracetamol.

Simultaneous intake with vitamin D reduces the effect of the latter on the absorption of calcium in the intestine.

When taken simultaneously with growth hormone the effectiveness of the latter decreases.

Metabolism increases and the concentrations of isoniazid and mexelitine in the blood decrease when taken simultaneously with Prednisolone, especially in slow acetylators.

Carbonic anhydrase inhibitors and loop diuretics, when co-administered with Prednisolone, may contribute to the development of osteoporosis.

Indomethacin displaces prednisolone from its binding to albumin and promotes the development of osteoporosis.

Ergocalciferol and parathyroid hormone prevent the development of prednisolone osteopathy.

ACTH enhances the effect of Prednisolone.

Cyclosporine and ketoconazole, slowing down the metabolism of Prednisolone, in some cases increase its toxicity.

When taken simultaneously with other inhibitors of adrenal function, an increase in the dose of Prednisolone may be required.

Simultaneous use with live antiviral vaccines and other types of immunization promotes the activation of viruses with the development infectious diseases.

Antacids reduce the absorption of Prednisolone.

Antithyroid drugs reduce, and thyroid hormones increase, the clearance of Prednisolone.

PREDNISOONE: Pregnancy and lactation

Has an adverse effect on pregnancy in animals.

During pregnancy (especially in the first trimester), prednisolone is used only vital signs. In cases where the use of GCS is irreplaceable, women with a normal pregnancy can receive treatment similar to that prescribed to non-pregnant women. Long-term prednisolone therapy during pregnancy may be associated with a small risk of developing a gothic palate and delay intrauterine development fetus Taking the drug in the third trimester of pregnancy can lead to atrophy of the fetal adrenal cortex, which leads to the need for replacement therapy in the newborn.

During breastfeeding glucocorticosteroids are taken with caution, since in small quantities they penetrate into breast milk. In order to identify signs of possible adrenal suppression, the condition of children whose mothers take pharmacological doses of steroids should be carefully monitored.

PREDNISOONE: Side effects

The incidence and severity of side effects depend on the duration of treatment, the dose of the drug and taking into account the daily rhythm of GCS synthesis.

From the outside digestive system: increased acidity gastric juice, nausea, vomiting, hiccups, flatulence, indigestion, decreased or increased appetite, steroid ulcers in the gastrointestinal tract, erosive esophagitis, perforation of the stomach or intestinal wall, bleeding from ulcers, pancreatitis, hepatomegaly, in rare cases - increased activity of liver transaminases and alkaline phosphatase .

From the outside of cardio-vascular system: arterial hypertension, bradycardia, cardiac arrest, arrhythmia, ECG changes, characteristic of hypokalemia, worsening or development of heart failure (in patients predisposed to it), myocardial dystrophy, in acute and subacute myocardial infarction, spread of necrosis, slowing down the formation of scar tissue and a tendency to myocardial rupture.

From the blood coagulation system: increased blood clotting, thrombus formation, thromboembolism.

Metabolic: negative nitrogen balance (catabolic effect), bulimia, weight gain.

From the side of water and electrolyte balance: increased excretion of potassium, hypokalemic syndrome (hypokalemia, myalgia, muscle spasm, unusual weakness), sodium and water retention in the body with the formation of peripheral edema, hypernatremia, increased calcium excretion, hypocalcemia.

From the musculoskeletal system: decrease muscle mass(atrophy), muscle weakness, steroid myopathy, osteoporosis, very rarely - vertebral compression fractures, pathological fractures tubular bones, aseptic necrosis humeral head and femur, rupture of muscle tendons, slower growth and ossification processes in children (premature closure of epiphyseal growth zones).

Dermatological reactions: ecchymosis, skin thinning, hyper- or hypopigmentation, facial skin flushing, allergic dermatitis, steroid acne, petechiae, increased sweating.

From the central nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, nervousness, anxiety, insomnia, convulsions, epilepsy, cranial hypertension, dizziness, headache, cerebellar pseudotumor.

From the outside endocrine system: dysmenorrhea, amenorrhea, delayed sexual development in children, hyperlipoproteinemia, hirsutism, Itsenko-Cushing syndrome, adrenal insufficiency up to atrophy of the adrenal cortex, especially affecting during stress: trauma, surgical operation, concomitant diseases, decreased glucose tolerance, manifestation of latent diabetes mellitus, hyperglycemia up to steroid diabetes, withdrawal syndrome, increased activity of the renin-angiotensin-aldosterone system.

From the organ of vision: development of secondary bacterial, viral and fungal eye diseases, posterior subcapsular steroid cataract, manifestation of latent glaucoma with possible damage optic nerve, trophic changes in the cornea, exophthalmos.

From the outside immune system: increased fatigue, decreased resistance to infections, exacerbation of infections (which is facilitated by the simultaneous use of immunosuppressants and vaccines), delayed wound healing, generalized or local allergic skin rash, itching, steroid vasculitis, anaphylactic shock.

PREDNISOONE: Storage conditions and periods

Storage conditions

List B.

Store at a temperature of 15 to 30 °C, protected from light and out of reach of children.

Best before date:

Do not use after the expiration date stated on the package.

PREDNISOONE: Indications

• rheumatic fever,
• rheumatic carditis,
• chorea;
• systemic connective tissue diseases (systemic lupus erythematosus,
• scleroderma,
• periarteritis nodosa,
• dermatomyositis);
• multiple sclerosis;
• acute and chronic inflammatory diseases joints (rheumatoid arthritis,
• juvenile arthritis,
• ankylosing spondylitis,
• gouty and psoriatic arthritis,
• polyarthritis,
• glenohumeral periarthritis,
• osteoarthritis (incl.
• post-traumatic),
• Still's syndrome in adults,
• bursitis,
• nonspecific tenosynovitis,
• synovitis,
• epicondylitis);
• bronchial asthma,
• status asthmaticus;
• interstitial lung diseases (acute alveolitis,
• pulmonary fibrosis,
• sarcoidosis II-III stage);
• lung cancer (in combination with cytostatics);
• berylliosis,
• aspiration pneumonia (in combination with specific therapy),
• eosinophilic Loeffler's pneumonia;
• tuberculosis (pulmonary tuberculosis,
• tuberculous meningitis) - in combination with specific therapy;
• primary and secondary failure adrenal glands (incl.
• conditions after removal of the adrenal glands);
• congenital adrenal hyperplasia;
• adrenogenital syndrome;
• subacute thyroiditis;
• acute and chronic allergic diseases (drug and food allergies,
• serum sickness,
• hay fever,
• atopic dermatitis,
• contact dermatitis involving a large surface of the body,
• hives,
• allergic rhinitis,
• Quincke's edema,
• Stevens-Johnson syndrome,
• toxicoderma);
• hepatitis;
• hypoglycemic conditions;
• autoimmune diseases (incl.
• acute glomerulonephritis);
• nephrotic syndrome;
• inflammatory diseases of the gastrointestinal tract (nonspecific ulcerative colitis,
• Crohn's disease,
• local enteritis);
• diseases of the blood and hematopoietic organs (agranulocytosis,
• panmyelopathy,
• multiple myeloma,
• acute lympho- and myeloid leukemia,
• lymphogranulomatosis,
• thrombocytopenic purpura,
• secondary thrombocytopenia in adults,
• autoimmune hemolytic anemia,
• erythroblastopenia,
• congenital erythroid hypoplastic anemia);
• autoimmune and other skin diseases (eczema,
• seborrheic dermatitis,
• psoriasis,
• Lyell's syndrome,
• bullous dermatitis herpetiformis,
• pemphigus,
• exfoliative dermatitis);
• postoperative cerebral edema,
• post-radiation,
• post-traumatic,
• for brain tumors (use after parenteral glucocorticosteroids);
• eye diseases,
• incl.
• allergic and autoimmune (sympathetic ophthalmia,
• allergic forms of conjunctivitis,
• allergic corneal ulcers,
• nonpurulent keratitis,
• iridocyclitis,
• iritis,
• severe sluggish anterior and posterior uveitis,
• choroiditis,
• optic neuritis);
• prevention of transplant rejection reactions;
• hypercalcemia due to cancer;
• for the prevention and relief of nausea,
• vomiting during cytostatic therapy.

PREDNISOONE: Contraindications

In case of short-term use of the drug for health reasons, the only contraindication is hypersensitivity to the components of the drug.

Before starting treatment, the patient should be carefully examined to identify possible contraindications. In the future, during treatment, especially long-term treatment, it is necessary to periodically repeat the examination with a study of the state of the cardiovascular system and water-electrolyte metabolism, x-ray examination lungs, examination of the stomach and duodenum, urinary system, as well as a picture of peripheral blood and sugar levels in the blood and urine, and the organ of vision.

Treatment of children with glucocorticosteroids during the growth period is possible only according to absolute indications and with careful supervision of the attending physician.

Children receiving Prednisolone therapy and who have been in contact with people with measles or chicken pox, specific immunoglobulins are prescribed prophylactically.

During treatment with Prednisolone, you should refrain from immunization.

If there is a history of psychosis, high doses of Prednisolone should be prescribed under strict medical supervision.

For diabetes mellitus, Prednisolone is prescribed only for absolute indications. In order to reduce side effects can be assigned anabolic steroid, increase the intake of potassium in the body (diet, potassium supplements).

In severe infectious diseases, the use of Prednisolone is permissible only against the background of specific therapy.

In the case of intercurrent infections, septic conditions and tuberculosis, simultaneous chemotherapy or antibiotic therapy is necessary.

The drug has a more pronounced effect in the case of hypothyroidism and liver cirrhosis.

In Addison's disease, the simultaneous use of Prednisolone and barbiturates should be avoided, since this combination can provoke acute adrenal insufficiency (Addisonian crisis).

If treatment with Prednisolone is abruptly stopped, especially after using high doses of the drug, withdrawal syndrome or exacerbation of the underlying disease for which Prednisolone was used may develop. To avoid the development of withdrawal syndrome (decreased appetite, nausea, lethargy, generalized musculoskeletal pain, general weakness), the drug is discontinued over several days, gradually reducing the dose.

After discontinuation of the drug, a state of relative insufficiency of the adrenal cortex persists for several months, so monitoring of the patient should be continued. Whenever stressful situations during the period of withdrawal of prednisolone, glucocorticoid drugs are prescribed temporarily and according to indications, if necessary - in combination with mineralocorticosteroids.

Due to its weak mineralocorticoid effect in adrenal insufficiency, Prednisolone is used in combination with mineralocorticoids.

For latent kidney infections and urinary tract Prednisolone provokes leukocyturia, which may have diagnostic significance.

Prednisolone increases the content of 11- and 17-hydroxyketocorticosteroid metabolites.

PREDNISOONE: Use for impaired renal function

Use with caution in severe renal failure.

PREDNISOONE: Use for liver dysfunction

Use with caution in severe liver failure.

The drug has a more pronounced effect in cases of liver cirrhosis.

Prednisolone, what does this hormonal medicine help with? The product has antiallergic, anti-inflammatory, immunosuppressive effects. The instructions for use of the drug "Prednisolone" suggest using it for allergies, dermatitis, bronchial asthma.

Composition and release form

Produced in the form of an ointment, eye drops, tablets, solution for injection into a vein or muscle tissue. The medicine "Prednisolone", which helps various indications, contains the active substance of the same name. Its share in solution is 30 mg per ml, in tablets - 1 or 5 mg, ointment 0.05 g.

Auxiliary components of the drug, depending on the form of release, are sodium pyrosulphide, stearic acid, propyl parahydroxybenzoate, nicotinamide and other components.

pharmachologic effect

The drug "Prednisolone", from which its effect is manifested, belongs to the corticosteroid group of drugs. This is a glucocorticosteroid agent that exhibits weak activity, which allows it to be successfully used for the treatment of many allergic, inflammatory and autoimmune pathologies.

Is Prednisolone hormonal or not? Doctors answer that the medicine is a hormonal agent for systemic or local use, which has average duration actions. Active substance is an analogue of the hormone hydrocortisone, which is produced by the adrenal cortex.

The medicine stops or prevents the occurrence of allergies, suppresses the immune system, creates an anti-shock effect, and stops the inflammatory process.

Medicine "Prednisolone": what helps

Indications for use of tablets and injection solution include the following systemic diseases:

• allergic pathologies; hay fever;
• rheumatic fever;
• inflammatory diseases of joints and tissues (osteoarthritis, synovitis, spondyloarthritis, tenosynovitis);
• multiple sclerosis;
• lung cancer (in combination with cytotoxic drugs);
• diffuse connective tissue abnormalities;
• sarcoidosis, pneumonia, fibrosis;
• minor chorea, rheumatic carditis;
• tuberculosis, meningitis;
• acute alveolitis, hypocortisolism;
• congenital adrenal hyperplasia;
• hepatitis, granulomatous thyroiditis;
• inflammation of the gastrointestinal tract;
• autoimmune pathologies, nephrotic syndrome;
• leukemia, anemia and other diseases of the circulatory system;
• cerebral edema;
• skin abnormalities of autoimmune and other etiologies (psoriasis, exfoliative dermatitis, eczema, etc.);
• eye diseases (keratitis, conjunctivitis, uveitis, choroiditis, keratitis, iridocyclitis, etc.) of an allergic or autoimmune nature;
• hypercalcemia, caused by cancer.

What else are Prednisolone tablets and injections prescribed for? Injections are given for emergencies states of shock. After a few days of administering the solution, patients are prescribed tablets.

Internal use of the drug is indicated for severe or chronic diseases(bronchial asthma, etc.). Injections and tablets are prescribed during transplantation to prevent implant rejection and to stop vomiting that occurs while taking cytostatics.

Prednisolone ointment: what is it prescribed for?

The medicine is used externally for the treatment of inflammatory and allergic diseases skin that do not have a microbial cause. Indications for the use of Prednisolone ointment include:

• psoriasis;
• hives;
• limited neurodermatitis;
• erythroderma;
• eczema;
• dermatitis;
• lupus erythematosus;
• toxicoderma.

Why are eye drops prescribed?

Prednisolone is indicated for use in non-infectious inflammations of the eye affecting its anterior segment. Drops are prescribed for the development of an inflammatory process as a result of injury and surgical intervention. The drug is used for the following eye pathologies:

• allergic conjunctivitis;
• blepharoconjunctivitis;
• irite;
• blepharitis;
• iridocyclitis;
• sympathetic ophthalmia;
• sclerite;
• keratitis;
• uveitis;
• episcleritis.

Contraindications

The instructions for use prohibit the use of the drug "Prednisolone" for:

• stomach and intestinal ulcers;
• To old people;
• diabetes mellitus;
• acute endocarditis;
• hypertension;
• pregnancy;
• mental abnormalities;
• jade;
• thrombophlebitis;
• osteoporosis;
• thromboembolism;
• cardiac decompensation;
• after undergoing surgery.

Caution during therapy is required for patients during infectious diseases, vaccinations, herpes and viral diseases.

The drug "Prednisolone": instructions for use

The dosage, form and method of administration of the medication depend on the complexity of the disease, the effectiveness of therapy and the patient’s condition.

Prednisolone tablets are taken immediately after or during meals. The daily dosage according to the instructions is 0.025–0.05 g. The medicine is taken 2-3 times. Subsequently, the dosage is reduced to 0.005 g. You need to drink 4-6 times a day.

The maximum daily amount of the drug should not exceed 0.1 g, a single dose - 0.015 g. It is possible to increase the highest dosage to 0.3–1.2 g per day in particularly severe cases. Prednisolone tablets are prescribed to children under 4 years of age based on their weight. The daily dosage is distributed as follows:

• Up to 4 years - 0.001 g/kg;
• 5–6 years - 0.02 g;
• 7–9 years - 0.025–0.03 g;
• 10–14 years - 0.025-0.04 g.

Application of the solution

Injections are given into the muscle; for this, the ampoule is diluted in 5 ml injection water warmed up to body temperature. The drug is administered in a volume of 0.03-0.06 g. For jet or drip intravenous use the dosage is 0.015–0.03 g.

The dropper is placed in patients, having previously diluted the ampoule in saline, glucose, 5% or polyglucin (250-500 ml). Patients in shock, with adrenal insufficiency in acute form do intravenous injections 0.03 g.

Instructions for use of ointment and drops

Prednisolone ointment is used topically. The medicine is applied to the affected areas in a thin layer. Large lesions should not be treated to avoid causing an overdose.

For the treatment of ophthalmic ailments, 1-2 drops of a 0.3% solution are administered into each eye. Treatment continues for up to 2 weeks. During the treatment of ENT diseases, 4-5 units are dripped into the ear cavity or nostrils. solution 4-5 times a day.

Side effects

The medicine "Prednisolone", reviews and instructions indicate this, can cause negative reactions in the body:

• diabetes mellitus, erosive esophagitis;
• increased or decreased appetite;
• dizziness;
• adrenal dysfunction;
• nausea, vomiting, increased blood pressure;
• hallucinations, stomach and intestinal ulcers;
• changes in corneal trophism, digestive disorders;
• slow wound healing, flatulence;
• headache, arrhythmia;
• disorientation, hiccups;
• depressive psychosis; bradycardia;
• hypokalemic syndrome, osteoporosis;
• increased intracranial pressure, acne;
• nervousness, skin rash;
• weight gain, tendon rupture;
• anaphylactic shock, convulsions;
• increased intraocular pressure, increased sweating;
• stretch marks, secondary eye infections, itching;
• growth retardation or delayed sexual development in children, withdrawal syndrome.

Analogs

What can replace Prednisolone? The following drugs have a similar mechanism of action:

1. Medopred.
2. Flosteron.
3. Betamethasone.
4. Dexamethasone.
5. Triamcinolone.
6. Hydrocortisone.
7. Deltason.
8. Dexazone.
9. Medrol.

Price, where to buy

Prednisolone preparations (ointment, solution, injections, tablets) have low price. In Moscow you can buy medicine for 30-250 rubles, in Kyiv for 16-30 hryvnia. In Minsk, the cost of the product reaches 0.3-6 BYN. rubles, in Kazakhstan – for 395-1200 tenge.

Opinions of patients and doctors

Reviews of the drug Prednisolone by patients and specialists differ. The effectiveness of the drug is confirmed, but there are many side effects. With prolonged use, the medicine causes withdrawal symptoms.

What is “Withdrawal Syndrome”? The condition is observed after use medicine"Prednisolone" and others hormonal drugs. It manifests itself in mild cases as malaise, muscle pain, and fatigue. IN difficult situations after long-term use The drug may cause a hypoadrenal crisis, accompanied by convulsions and vomiting. The patient may die without administration of glucocorticosteroids.

How to “get off” Prednisolone?

The treatment regimen involves a gradual reduction in dosage. To do this, the volume of the drug is reduced weekly by 1/8. A faster way out of the syndrome is achieved by using the product every other day, while simultaneously reducing its volume by 1/5. This requires stimulation of the adrenal glands. The patient is advised to use insulin and ascorbic acid.

During the treatment of bronchial asthma, the drug Prednisolone is replaced at the final stage with inhaled steroids. In case of autoimmune pathologies, they switch to mild cytostatic medications.

Patients respond completely positively to the ointment and solution for external use. They note the absence of serious side effects, while confirming the effectiveness of the drug.

Prednisolone for injection belongs to the group of glucocorticosteroids, the drug is intended for sufficient wide range applications and a fairly wide range of diseases. It is used both to treat asthma and to relieve anaphylactic shock or an allergy attack from an unidentified irritant. This is first aid to a person if anaphylactic shock occurs and an opportunity to save his life. The drug is also used during radiotherapy courses and is considered a good anti-inflammatory agent.

The range of uses of the medicine is very wide; it is used and prescribed by doctors for the treatment of asthmatic diseases and allergic reactions.

About the drug

The drug three main pharmacological actions:

• Anti-inflammatory;
• Immunosuppressive;
• Antiallergic;
• Antishock;
• Antipruritic;

Prednisolone is a synthetic hormone, absolutely similar to the hormone produced by the human adrenal glands.

When the adrenal glands malfunction, the hormone becomes smaller or stops being produced altogether. Lack of the hormone in the body can lead to quite sad consequences, and the drug has very strong pharmacological actions, therefore it is really used in treatment serious illnesses or difficult situations threatening human life(anaphylactic shock, exacerbation of bronchial asthma). Use it only as part of complex therapy .

The drug is produced in India.

Release forms

There are several forms of release:

• Ointment. The cost of the ointment is only about 50 rubles. The main component is prednisolone, additional components: medical white paraffin, glycerin and stearic acid.
• Pills. The cost of the tablets is about 68 rubles. The main component is also prednisolone, additional components: milk sugar, potato starch, calcium stearate. Used to treat diseases of the musculoskeletal system.
• Prednisolone injections, which cost from 46 to 130 rubles. Main component: prednisolone sodium phosphate, additional components: water for injection, nicotinamide, sodium hydroxide.

Dosages and regimen of use

Dosage and application regimen differs depending on pharmacological form release and disease:

• Prednisolone in ampoules can be prescribed as droppers. In this case, the dosage and continuation of treatment is determined by the attending physician. Typically, droppers with the drug are prescribed for seriously ill patients, people with severe allergies or anaphylactic shock.
• For acute adrenal insufficiency, 300-400 mg per day is prescribed. (injections)
• For a severe allergic reaction, 100-200 mg per day is prescribed. Treatment time ranges from 10 to 16 days.
• For bronchial asthma, the course of treatment ranges from three to 16 days, the dosage is prescribed by the doctor. Self-medication is not recommended.
• For rheumatoid arthritis, an ointment may be prescribed in addition to the main medications.
• For skin allergic reactions, 1-2 tablets per day may be prescribed.

Injections can be administered intramuscularly and can make a solution for IVs.

Solution lasts for about a day, depending on susceptibility human body and diseases. One injection may be enough intramuscularly for several days, especially when treating allergic reactions and various diseases of the musculoskeletal system. The solution administered intramuscularly contains a fairly high dose of prednisolone, which has strong pharmacological properties. Injecting the solution is quite painful, but after a couple of hours (half an hour - two hours) relief comes.

Indications for use

Instructions for use indicate that the drug can be used to treat shock, accompanied by a decrease in blood pressure, acute adrenal failure, cerebral edema, asthma and rheumatoid arthritis. The drug is also used for allergies; severe allergic (anaphylactic) shock can also be treated with injections. The drug also treats hepatic coma.

The fact is that the adrenal glands stop producing the hormone in full, so the body needs an influx of synthesized hormone for normal functioning. The drug increases the synthesis of peptide inhibitors and reduces the level of PG, stabilizes lysosome membranes.

Note!

For the treatment and prevention of SPINE and JOINT DISEASES, many have begun to use the increasingly popular method of natural, quick and non-surgical treatment, recommended by leading Russian specialists in diseases of the musculoskeletal system. According to doctors..."

Due to this, many diseases quickly decrease with successful complex therapy and correct dosage selection.

Contraindications

In shock conditions the drug is administered without taking into account contraindications(emergency situations such as anaphylactic shock, traumatic shock, severe allergic reaction). For longer treatment, the following must be taken into account:

• Presence of a stomach ulcer;
• Osteoporosis;
• Cushing's syndrome;
• Psychoses;
• Severe arterial hypertension;

The drug should not be used for smallpox, herpes, or herpes zoster; it is not recommended for active tuberculosis.

For acute renal failure and liver problems, Before taking it, you must consult a medical specialist.

Pregnant women in the first trimester and breastfeeding women are not recommended to take the drug. Children under 18 years of age are not recommended to take the drug, but emergency situations quite likely to be used. However, when used for longer treatment, examination and consultation of several medical specialists are necessary.

Overdose and side effects

As side effects:

• Weight gain;
• Hypokalemia;
• Cushing's syndrome;
• Increased blood pressure;
• Nausea;
• Vomit;
• Diarrhea;
• Depression and hallucinations;

The occurrence of side effects is not necessary; their occurrence varies depending on the physical characteristics of the person.

In general, there are very few reported cases of side effects; the drug is well tolerated by patients even with long-term treatment. If the dosage is exceeded and an overdose occurs, nausea, vomiting, weakness, drowsiness, disturbances in the gastrointestinal tract, depression, hallucinations, a sharp increase in blood pressure, and edema are possible. To reduce an overdose, it is necessary to urgently rinse the stomach and seek medical advice. medical assistance V ambulance. There is little information about the toxicity of the drug.

Interaction with substances

Interaction of the drug with alcohol and other medicines noted for tablets and solution. Solution in combination with diuretics increases potassium excretion, and in combination with antidiabetic agents reduces glucose levels. Interaction with alcohol and alcohol-containing substances is extremely negative and can lead to uncontrollable side effects.

When combined with acetylsalicylic acid, the risk of bleeding in the stomach increases.

Storage

The medicine is stored for two years and is sold in pharmacies only with a prescription. As analogues, you can use Metipred (from 300 rubles), other analogues differ much more in composition and you should consult your doctor about them.

FAQ

Does it hurt to give an injection?? Painful sensations are present, but during the injection itself and the administration of the medicine there is practically no pain, painful sensations appear after a couple of hours, the pain in the gluteal muscle increases, but is quite tolerable. When inserting and puncturing the skin, pain is practically not felt, unlike B vitamins, magnesium and other drugs.

How long does it last?? In shock conditions, anaphylactic shock, strong manifestation The allergy injection works almost instantly, and its effect lasts for a really long time. Sometimes just one injection is enough to completely get rid of all the consequences, and sometimes it is necessary to inject a full course for relief to occur. In general, the medicine lasts for about a couple of days.

Prednisolone is very often used by emergency physicians as a fast-acting, long-acting drug.