Modern analogues of prednisolone. Prednisolone - indications and contraindications, dosages, prices and analogues

pharmachologic effect

Synthetic glucocorticosteroid (GCS), a dehydrated analog of hydrocortisone. It has anti-inflammatory, immunosuppressive and antiallergic effects.

Having easily penetrated into the target cells, it enters into contact with GCS receptors in the cytoplasm. Free receptors are usually associated with the so-called. heat shock protein (HSP90). After attaching to GCS receptors, the structure of HSP90 changes and it leaves the receptor. The latter moves to the nucleus of the cell. The multilateral action of steroids is due to the presence of the so-called. elements of the glucocorticoid response (CRE) in the promoter zones of several genes, some of which are "turned off" as a result of the attachment of receptors to their CREs, while others are in an active state. A key role in this complex process plays the ubiquitous so-called. intracellular transcription factor Nf-kB. Various inflammatory mediators activate Nf-kB to trigger cytokine production. GCS also cause transcription of the IkB protein, which captures the activated Nf-kB and forms an inactive cytoplasmic complex with it. In addition, steroids activate lipocortins, which are representatives of another family of proteins, enhance the transcription of β 2 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 typically increase vascular permeability leading to tissue edema, leukocyte migration, and fibrin deposits.

Prednisolone has an effect on all stages inflammatory process , among which the inhibition of phospholipase A 2 and the blockade of the formation of arachidonic acid 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 cytokine response acute phase 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 the connective tissue, it prevents the formation of scar tissue.

Suppresses the inflammatory process, regardless of its etiology, with excessive or "useless" inflammatory response has a beneficial effect, but is dangerous in infections due to the suppression of the protective inflammatory process.

The immunosuppressive effect is due to the action of prednisolone on numerous targets, among which the suppression of cytokine secretion is especially important. Prednisolone inhibits the proliferation of lymphocytes, incl. leukemia lymphocytes, expression of MHC II on macrophages and adhesive molecules of endothelial cells, causes eosinopenia and prevents degranulation of eosinophils and adhesion of neutrophils, prevents the release of cytokines (mainly interleukin-2 and γ-interferon) and secretion and release of prostaglandin E, and also blocks fibroblast collagen synthesis. Large doses of glucocorticosteroids suppress antibody production.

hinders development 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 there are no damaging effects of inflammation.

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 the 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 pre-diabetic stage of the disease.

Protein metabolism: anabolism decreases (a decrease in the amount of globulins, an increase in the synthesis of albumins in the liver and kidneys, an increase in the albumin / globulin ratio) with a constant or even increased intensity of catabolic processes, which leads to a negative nitrogen balance with atrophy of muscle tissue. 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 striae. The 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 with deposition of fat in the shoulder girdle, on the face and abdomen and its mobilization from the subcutaneous fat of the extremities, followed by hypercholesterolemia.

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

Suppresses feedback hypothalamic-pituitary-adrenocorticoid system with prolonged use (with subsequent slow recovery), which, with a sharp cessation of treatment, leads to the development of a state of adrenocorticoid insufficiency in the patient: it inhibits the synthesis and secretion of ACTH by the pituitary gland, thereby inhibiting the synthesis of endogenous glucocorticoid (and androgenic) hormones by the adrenal glands.

Pharmacokinetics

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

Metabolism is carried out mainly in the liver and partly in the kidneys, small intestine, bronchi. The oxidized forms are glucuronidated or sulfated. Excreted by the kidneys 20% unchanged, the rest - in the form of free and conjugated metabolites. T 1/2 is 2-3 hours (2.2±0.5).

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

Indications

- rheumatic fever, rheumatic carditis, chorea minor;

— systemic diseases connective tissue (systemic lupus erythematosus, scleroderma, periarteritis nodosa, dermatomyositis);

- multiple sclerosis;

- acute and chronic inflammatory diseases of the joints ( rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, gouty and psoriatic arthritis, polyarthritis, humeroscapular periarthritis, osteoarthritis (including post-traumatic), Still's syndrome in adults, bursitis, nonspecific tendosynovitis, synovitis, epicondylitis);

- bronchial asthma, status asthmaticus;

- interstitial lung diseases (acute alveolitis, pulmonary fibrosis, sarcoidosis stage II-III);

- lung cancer (in combination with cytostatics);

- berylliosis, aspiration pneumonia (in combination with specific therapy), Leffler's eosinophilic pneumonia;

tuberculosis (tuberculosis of the lungs, tuberculous meningitis) - in combination with specific therapy;

- primary and secondary adrenal insufficiency (including 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, urticaria, allergic rhinitis, angioedema, Stevens-Johnson syndrome, toxicoderma);

- hepatitis;

- hypoglycemic conditions;

— autoimmune diseases(including acute glomerulonephritis);

- nephrotic syndrome;

- inflammatory diseases of the gastrointestinal tract (ulcerative colitis, Crohn's disease, local enteritis);

- diseases of the blood and blood-forming 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);

- cerebral edema postoperative, post-radiation, post-traumatic, with a brain tumor (used after parenteral glucocorticosteroids);

– eye diseases, incl. allergic and autoimmune (sympathetic ophthalmia, allergic forms conjunctivitis, allergic corneal ulcers, nonpurulent keratitis, iridocyclitis, iritis, severe sluggish anterior and posterior uveitis, choroiditis, optic nerve neuritis);

— prevention of graft rejection reactions;

- hypercalcemia against the background of oncological diseases;

- for the prevention and relief of nausea, vomiting during cytostatic therapy.

Dosing regimen

Apply inside, without chewing and washing down 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 morning hours, about 8 am, and 1/3 - in the evening. Treatment is stopped slowly, gradually reducing the dose.

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

children: the initial daily dose is 1-2 mg / kg of body weight and is distributed over 4-6 doses, the maintenance daily dose is 300-600 mcg / kg.

Side effect

The frequency of development and severity of side effects depend on the duration of treatment, the dose of the drug and accounting circadian rhythm synthesis of GCS.

From the 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 wall of the stomach or intestines, bleeding from ulcers, pancreatitis, hepatomegaly, in rare cases - increased activity of hepatic transaminases and alkaline phosphatase .

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

From the blood coagulation system: increased blood clotting, thrombosis, thromboembolism.

From the side of metabolism: negative nitrogen balance (catabolic effect), bulimia, weight gain.

From the side of water-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 excretion of calcium, hypocalcemia.

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

Dermatological reactions: ecchymosis, thinning of the skin, hyper- or hypopigmentation, flushing of the skin of the face, allergic dermatitis, steroid acne, petechiae, excessive sweating.

From the CNS: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, nervousness, anxiety, insomnia, convulsions, epilepsy, craniocerebral hypertension, dizziness, headache, pseudotumor of the cerebellum.

From the endocrine system: dysmenorrhea, amenorrhea, retardation of sexual development in children, hyperlipoproteinemia, hirsutism, Itsenko-Cushing's syndrome, adrenal insufficiency up to atrophy of the adrenal cortex, especially affecting during stress: with trauma, surgical operation, comorbidities, 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 side 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, pruritus, steroid vasculitis, anaphylactic shock.

Contraindications for use

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

The drug should be administered with caution when the following diseases and states:

— peptic ulcer stomach and duodenum;

- acute or latent peptic ulcer;

- esophagitis;

- gastritis;

- diverticulitis;

- newly created intestinal anastomosis;

- non-specific ulcerative colitis with the threat of perforation or abscess formation;

- predisposition to thromboembolism;

- acute and subacute myocardial infarction;

- severe chronic heart failure;

- arterial hypertension;

— systemic mycoses;

- bacterial and fungal infections (actively occurring or recently transferred, including contact with the patient);

- active and latent forms of tuberculosis;

- pervaccinal period (8 weeks before vaccination and within 2 weeks after it);

- lymphadenitis after BCG vaccination;

— immunodeficiency states(including infection with HIV and AIDS);

- diabetes mellitus (including reduced glucose tolerance);

- Itsenko-Cushing's disease;

- hypothyroidism;

- hyperthyroidism;

- mental disorders (for example, acute psychosis);

- poliomyelitis (with the exception of bulbar encephalitis);

- severe myasthenia gravis;

- obesity stage III-IV;

- severe chronic renal and / or liver failure;

- nephrolithiasis;

- hypoalbuminemia and conditions predisposing to its occurrence;

- glaucoma;

- systemic osteoporosis.

Use during pregnancy and lactation

It has an adverse effect on pregnancy in animals.

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

During breastfeeding, glucocorticosteroids are taken with caution, as they pass into breast milk in small amounts. In order to identify signs of possible adrenal suppression, the condition of children whose mothers are taking pharmacological doses steroids.

Use in children

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

Overdose

Symptoms: increased side effects.

drug interaction

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

With the simultaneous appointment of Prednisolone and indirect anticoagulants, the anticoagulant effect of the latter may be weakened, less often - increased. Dose adjustment required.

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

Simultaneous use of Prednisolone with salicylates increases the likelihood of gastrointestinal bleeding.

Simultaneous reception with acetylsalicylic acid accompanied by an acceleration of excretion and a decrease in its concentration in the blood, and with the abolition of Prednisolone - 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 may aggravate electrolyte disturbances, incl. increase potassium excretion (when administered 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.

The simultaneous 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 ventricular extrasystole as a result of hypokalemia.

Hormonal contraceptives enhance the action 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 (dose reduction may be required).

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

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

The risk of developing cataracts increases with the 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 contributes to an increase in intraocular pressure.

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

Simultaneous administration with paracetamol increases the hepatotoxic effect as a result of the induction of hepatic enzymes and the formation of a toxic metabolite of paracetamol.

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

When taken concomitantly with growth hormone the effectiveness of the latter is reduced.

Metabolism increases and the concentration of isoniazid and mexelitin in the blood decreases while taking them 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 prednisone from its association with albumin and promotes the development of osteoporosis.

Ergocalciferol and parathyroid hormone prevent the development of prednisolone osteopathy.

ACTH enhances the action of Prednisolone.

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

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

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

Antacids reduce the absorption of prednisolone.

Antithyroid drugs reduce and thyroid hormones increase the clearance of prednisolone.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

Storage conditions

List B.

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

Shelf life:

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

Application for violations of liver function

Use with caution in severe liver failure.

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

Application for violations of kidney function

Use with caution in severe renal failure.

Use in elderly patients

There are no data on the use of the drug in elderly patients.

special instructions

Before starting treatment, the patient should be carefully examined to identify possible contraindications. In the future, during treatment, especially long-term, 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 of the lungs, examination of the stomach and duodenum, urinary system, as well as pictures of peripheral blood and blood sugar levels and urine, the organ of vision.

Treatment of children with glucocorticosteroids during the growth period is possible only absolute readings and under close medical supervision.

Children receiving prednisolone therapy and who have been in contact with patients with measles or chicken pox, prophylactically prescribe specific immunoglobulins.

During treatment with Prednisolone, immunizations should be avoided.

With indications of a history of psychosis, high doses of Prednisolone should be prescribed under the indispensable strict medical supervision.

At diabetes Prednisolone is prescribed only for absolute indications. In order to reduce side effects you can prescribe anabolic steroids, 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 the use 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 cirrhosis of the liver.

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

With a sharp cessation of treatment with Prednisolone, especially after the use of high doses of the drug, it is possible to develop a withdrawal syndrome or an exacerbation of the underlying disease, for the treatment of which Prednisolone was used. To avoid the development of a withdrawal syndrome (loss of appetite, nausea, lethargy, generalized musculoskeletal pain, general weakness), the drug is withdrawn for 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. In the event of stressful situations during the period of prednisolone withdrawal, glucocorticoid preparations are temporarily and according to indications prescribed, if necessary, in combination with mineralocorticosteroids.

Due to the mild mineralocorticoid effect in adrenal insufficiency, prednisolone is used in combination with mineralocorticoids.

For latent kidney infections and urinary tract Prednisolone provokes leukocyturia, which may be of diagnostic value.

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

irina asks:

Hello. I am 61 years old. I have been taking prednisolone injections (twice a week) for 4 years. I have a choking cough (asthma). Please tell me what can replace prednisolone,
that it was not a hormone. Thank you in advance.

It is impossible to cancel completely hormonal immunosuppressants in severe bronchial asthma, however, reduce the dosage this drug possible when using combinations of drugs from a cytostatic drug + prednisolone or prednisolone + sodium cromoglycate. To do this, you need to consult your doctor.

Anna asks:

Hello, my name is Anya. I am 25 years old, I have a relapse ( nodular erythema), In 2007, I was diagnosed with erythema nodosum (red painful nodes under the skin), it went away on its own, then appeared in 2008. The rheumatologist then prescribed to drink artrozan and calcium chloride, indovazin ointment on the nodes. It all went away within a month. In December 2010, the nodes appeared again, the doctor at the hospital changed and he prescribed me to drink prednisone for 4 weeks, 10 mg (morning) and 5 mg (evening) mg, then only in the morning, and then 5 mg each. At the same time, start drinking Plaquenil 100 mg 2 times a day - 10 days, 100 mg 1 time per day - 3 months. In the contraindications of the drug "Prednisolone" it is noted that it is impossible for osteoporosis, but they just found osteoporosis in me, and also chronic gastritis and pancreatitis. Prompt, please, than it is possible to replace this course of treatment.

Prednisolone refers to hormonal drugs; it is not recommended to cancel or replace the drug on your own, in order to avoid undesirable effects. Consult a specialist doctor for corrective treatment. This drug can be used in conjunction with calcium-preserving drugs and with gastroprotectors.

Alex asks:

Our grandmother is 68 years old, she was diagnosed with bronchial asthma two years ago. Over the past period, she did not get better, but it is getting worse, she is registered in her hospital. During the day, she suffocates, squeezes her chest, she cannot breathe, she hardly sleeps at night, she suffocates, coughs. Berodual N is attributed to her, he relieves the attack, but not for long, in one day she makes 8 to 10 times 2 injections, they also added verapamil tablets - when they are taken, she begins to suffocate, and she immediately sprays, three days ago she became breathe spiriva 18 mcg, but the result is not yet visible. Advise which doctor is better to go for a consultation, and to which sanatorium she can be sent for treatment

In this case, the help of a pulmonologist is needed. Referral to sanatorium treatment is best recommended by the attending physician.

Sergei asks:

How to replace prednisolone, with UC?

Prednisolone refers to hormonal drugs; it is not recommended to cancel or replace the drug on your own, in order to avoid undesirable effects. Consult a specialist doctor for corrective treatment.

Nina asks:

Hello! I am 16 years old, I have chronic glomerulonephritis. For 2 years in a row (in autumn), I have an exacerbation. All this time I started my sore and went to the hospital only in clinical cases. Each time I was given prednisolone, because they said that in such a situation there is no way without him. This year I will go much earlier! Tell me in the early stages of glomerulonephritis, can prednisolone be replaced with a non-hormonal remedy? If so, which one? Thank you in advance!

In this case, it is necessary to go to the hospital and determine the condition of the kidneys, if there is no proteinuria, symptomatic treatment may be prescribed. However, in the event that proteinuria is expressed, it is impossible to do without the appointment of prednisolone, tk. only this drug can reduce proteinuria. You can also prescribe cytostatics, your attending physician will help you choose the appropriate treatment, after receiving the results of the examination: ultrasound of the kidneys, a biochemical blood test, urine for daily protein, a general blood and urine test, CEC, immunoglobulins A, M, G, ASL-O , C-reactive protein. Read more about this disease, methods of diagnosis and treatment, read in a series of articles by clicking on the link.

The analogues of the drug prednisolone are presented, in accordance with medical terminology, called "synonyms" - drugs that are interchangeable in terms of effects on the body, containing one or more identical active substances. When choosing synonyms, consider not only their cost, but also the country of origin and the reputation of the manufacturer.

Description of the drug

Inhibits the activity of phospholipase A 2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.

Reduces the number of circulating lymphocytes (T- and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed into the lymphoid tissue; inhibits the formation of antibodies.

Prednisolone inhibits the release of pituitary ACTH and β-lipotropin, but does not reduce the level of circulating β-endorphin. Inhibits the secretion of TSH and FSH.

When applied directly to the vessels, it has a vasoconstrictor effect.

Prednisolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, and increases the activity of gluconeogenesis enzymes. In the liver, prednisolone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from protein metabolism products. An increase in blood glucose stimulates the secretion of insulin.

Prednisolone inhibits the uptake of glucose by fat cells, which leads to the activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which contributes to the accumulation of fat.

It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. To a lesser extent than hydrocortisone, it affects the processes of water-electrolyte metabolism: it promotes the excretion of potassium and calcium ions, the retention of sodium and water ions in the body. Osteoporosis and Itsenko-Cushing's syndrome are the main factors limiting long-term therapy with corticosteroids. As a result of the catabolic action, growth suppression in children is possible.

In high doses, prednisolone can increase the excitability of brain tissue and help lower the seizure threshold. Stimulates excess production of hydrochloric acid and pepsin in the stomach, which leads to the development of peptic ulcers.

With systemic use, the therapeutic activity of prednisolone is due to anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.

With external and topical application The therapeutic activity of prednisolone is due to anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action.

Compared with hydrocortisone, the anti-inflammatory activity of prednisolone is 4 times greater, and the mineralocorticoid activity is 0.6 times less.

List of analogues

Note! The list contains synonyms of Prednisolone, which have a similar composition, so you can choose a replacement yourself, taking into account the form and dose of the medicine prescribed by your doctor. Give preference to manufacturers from the USA, Japan, Western Europe, as well as well-known companies from of Eastern Europe: Krka, Gedeon Richter, Actavis, Egis, Lek, Geksal, Teva, Zentiva.

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The information on the page was verified by the therapist Vasilyeva E.I.

Probably, many people have come across the drug "Prednisolone". After all, this medication is used for various pathologies. Especially people suffering from chronic and systemic pathologies are well aware of it. Also, this drug is used in veterinary medicine. AT this moment you can not buy the drug everywhere. Therefore, many are wondering: why is there no prednisone in pharmacies and where can I buy it? Despite the shortage of this medication, there are many analogues of the drug. Therefore, do not panic and start self-treatment. To find a suitable replacement for the medication, you should consult a doctor.

What is Prednisolone

The drug "Prednisolone" is hormonal drug. This medication belongs to the group of glucocorticosteroids. In the body, these substances are secreted in the adrenal cortex. These hormones are necessary for the maintenance of many processes. They primarily act as anti-inflammatory agents. They also have an immunosuppressive effect and relieve swelling of the bronchi. In addition, the drug "Prednisolone" is used as an anti-shock drug. This medication is used for many ailments. Among them are diseases such as bronchial asthma, systemic lupus erythematosus, psoriasis, rheumatoid arthritis. In addition, the drug is necessary to bring a person out of anaphylactic shock and other immediate allergic reactions.

Given that the drug is widely used in various fields medicine, a lot of people are wondering: where did prednisone go? This issue is especially disturbing for people who need this drug constantly.

Indications for the use of the drug

Hormonal anti-inflammatory drugs (glucocorticoids) have many effects on the body. They are used in almost all branches of medicine. Their use is necessary for the treatment of allergic, rheumatological, dermatological, pulmonological diseases. Glucocorticoids are also used in intensive care units and intensive care units. Allocate the following indications for the use of the drug "Prednisolone":

1. Systemic pathologies. These include: acute and chronic rheumatic fever, systemic lupus erythematosus, dermatomyositis, Bechterew's disease, periarteritis nodosa. Also, the drug is prescribed for systemic articular pathologies. An example is rheumatoid arthritis.
2. Allergic diseases. Among them: bronchial asthma, angioedema, anaphylactic shock, eczema.
3. Pathologies associated with adrenal insufficiency. The drug is indicated for Addison's disease, adrenogenital syndrome.
4. Dermatological pathologies. Among them: alopecia (baldness), pemphigus and psoriasis.
5. Diseases of the internal organs that are severe. These include: pneumonia, hepatitis, nephrosis.
6. shock states.
7. Edema of the larynx, brain.
8. Severe poisoning.
9. Hepatic coma.
10. Ophthalmic diseases: inflammation of the cornea, conjunctivitis.

Dosage form and dosage

Currently, in many forums you can find the question: where did prednisone disappear? This is of interest not only to patients, but also to doctors. After all, the shortage of this medication affects the health of the population. It should be remembered that in such cases it is possible to replace the drug "Prednisolone". Analogues of the drug should be selected only with a doctor, since it is important to take into account the dosage active substance.

The release form of the drug "Prednisolone" is different: tablets, solution, ointment and eye drops. The calculation of the dose of the drug depends on the disease and the age of the patient. Children are prescribed 1-2 mg per 1 kg of body weight. The dosage for adults is 2 to 6 tablets per day. Each of them contains 5 mg.

The tablet form of the drug is prescribed for systemic pathologies, chronic diseases of the kidneys, lungs. For dermatological problems, a 0.5% ointment is used. In case of shock, the dose is increased and the drug is administered intravenously. It should be remembered that 1 ml of the solution contains 30 mg of the drug. For eye pathologies, drops or ointment are prescribed.

Contraindications to the use of the drug "Prednisolone"

It is worth knowing that there is a series pathological conditions in which you can not use the drug "Prednisolone". Analogues of the drug in these cases also can not be used. After all, the active substance, both the drug itself and its substitutes, is identical. The only contraindication for single use is hypersensitivity to the drug. If the drug "Prednisolone" (5 mg - tablets) is needed for constant use, then it cannot be used in the following cases:

Why there is no prednisolone in pharmacies: reasons

Glucocorticosteroids are included in the treatment protocols in almost every branch of medicine. The most famous drug from this group is the drug "Prednisolone". How to replace the drug when it is not in the pharmacy? It should be remembered that the analogue of the drug must contain the same active substance. Only in this case, the effectiveness of the drug will remain. In addition, you need to pay attention to the dose, more precisely, to the content of the drug in 1 tablet (5, 20 mg) or ampoule.

Not every pharmacist can answer the question why there is no prednisolone in pharmacies. They only explain that a few large companies for the manufacture of medicines stopped producing this drug. Journalists from many cities became interested in this issue. Some of them managed to find out where the prednisolone had gone. Health officials believe that companies have withdrawn the drug from production due to higher prices for substances intended for the manufacture of the drug.

Where can I buy the drug "Prednisolone"?

Regardless of why there is no prednisolone in pharmacies, this problem should somehow be resolved. After all, many people simply cannot do without this drug. According to health officials, the drug should soon be back on the market. This will happen after the revision of prices for the drug. It is also planned to order Prednisolone from other manufacturing companies. Where to buy it is currently unknown. Some order medicines on the Internet, others ask to send the medicine from other cities (or countries).

Analogues of the drug "Prednisolone"

Deficiency of the drug "Prednisolone" does not mean that you need to stop treatment. This drug is contained in analogues of the drug. Drug substitutes have not disappeared from pharmacies, so you should consult a doctor to find the dosage. Analogues of the medicinal product include medicines: Millipred, Decortin, Medopred, Inflanefran.

The drug "Prednisolone": what to replace?

When taking tablets "Prednisolone" can be replaced with the drug "Decortin". It is available in 5, 20 and 25 mg. Therefore, before use, it is important to choose the right dose! Also analogue is the drug "PrednisTab" (5 mg).

If the medication is needed in the form of a solution, then you should purchase other medicines. Among them are the drugs Millipred, Medopred.

At ophthalmic pathologies apply 1% solution "Prednefrin".

Thanks

Prednisolone is a synthetic glucocorticoid hormone(glucocorticosteroid), similar in spectrum of therapeutic activity to those that are normally produced in the human body by the adrenal glands. Glucocorticosteroids, including Prednisolone, are administered orally in the form of tablets, systemically in the form of injections, and locally - the ointment is applied to the skin and eyes.

Prednisolone has anti-inflammatory, anti-allergic, anti-shock, anti-exudative, anti-proliferative, antipruritic and immunosuppressive effects. These effects are very powerful and pronounced, so Prednisolone is used only for severe diseases and conditions that occur with severe inflammation, muscle spasm(for example, bronchi, etc.) and profuse exudation, which are potentially life-threatening.

This drug is used only as part of complex therapy to relieve severe inflammation, swelling, itching, exudation and proliferation in vasculitis, rheumatism, arthritis, myocarditis, pericarditis, dermatomyositis, scleroderma, periarteritis, bronchial asthma, angioedema, ankylosing spondylitis, drug allergies, shock, eczema, dermatitis, hepatitis, glomerulonephritis, multiple sclerosis, pemphigus, psoriasis, systemic lupus erythematosus, leukemia, lymphogranulomatosis, tumors, inflammatory pathologies of the eye and adrenal insufficiency.

Varieties, names, forms of release and composition of Prednisolone

Currently, doctors, pharmacists and patients under the name "Prednisolone" mean the entire set of drugs containing prednisolone as the active substance. These drugs are sold under different commercial names, many of which have been registered in the CIS countries over the past 20 years, since before that there was a practice of producing drugs containing the same active substance by various pharmaceutical plants in the cities and republics of the USSR under the same the same name. That is, for example, a drug containing prednisolone was produced at a pharmaceutical plant Nizhny Novgorod, Samara, Tomsk and other cities, but was always sold in pharmacies under the same name "Prednisolone".

Today, many pharmaceutical factories, wishing to protect the drug they produce, register it under a different name, for example, Prednisol, Medopred, etc. This is done so that people, doctors and pharmacists can quickly find out which "prednisolone" is produced by one plant or another. This is convenient, because some drugs, for some subjective reasons, people may like more than others. Knowing the commercial name of such a "good" prednisolone, you can immediately purchase it, and not look for "Prednisolone" produced by a certain plant in pharmacies.

Today, medicines containing prednisolone are produced and sold under the following commercial names:

• Decortin H20, Decortin H5 and Decortin H50;
• Medopred;
• Prednisol;
• Prednisolone;
• prednisolone bufus;
• Prednisolone-Nycomed;
• Prednisolone-Ferein;
• prednisolone hemisuccinate;
• Prednisolone sodium metasulfobenzoate;
• Prednisolone sodium phosphate;
• Prednisolone ointment;
• Solyu-Decortin H25, Solyu-Decortin H50 and Solyu-Decortin H250.

Prednisolone preparations are available in five dosage forms:

• Tablets for oral administration;
• Solution for intravenous and intramuscular injections;
• Powder for solution for injection;
• Ointment for external use;
• Drops or suspension for the eyes.

Prednisolone - prescription

The prescription for Prednisolone ointment is as follows:
Rp.: Ung. Prednisoloni 0.5%
D.S. Apply to affected areas 1 to 2 times a day.

The prescription for Prednisolone eye drops is as follows:
Rp.: Sol. Prednisoloni 0.5%
D. S. Introduce into the conjunctival sac 1-2 drops 2-3 times a day.

The prescription for a solution for injection of Prednisolone is as follows:
Rp.: Sol. Prednisoloni 3% (30 mg/ml)
D.t. d. N 10 inamp.
S. Administer intravenously 1 to 2 times a day.

In all recipes after the letters "Rp." the name of the dosage form of the drug is indicated (Sol - solution, Ung - ointment, Tab - tablets) and the name of the drug is written in Latin (Prednisoloni). After the name of the drug, the concentration of the active substance is indicated, that is, the dosage. On the next line, after the letters "D. t." it is indicated how much the drug needs to be given to a person (for example, No. 50 intablet means that a person needs to release 50 tablets, etc.). After the letter "S" indicates how to use the drug. This prescription line is for the person who will use Prednisone.

Effects of Prednisolone (therapeutic action)

• Anti-inflammatory action, which consists in the rapid and effective relief of the inflammatory process of any localization and intensity;
• Antiallergic action, which consists in the rapid cessation of the development allergic reaction and its manifestations, such as spasm, swelling, skin rashes, etc.;
• Anti-shock action, which consists in stopping shock in order to prevent death;
• Anti-exudative action, which consists in suppressing the active process of exudation (exudation of inflammatory fluid from tissues);
• Antiproliferative action, which consists in suppressing the active reproduction of cells in the area of ​​damage, which prevents the formation of cicatricial thickening of the walls of organs;
• Antipruritic action, which consists in eliminating the sensation of itching provoked by allergic or inflammatory reactions;
• Immunosuppressive action, which consists in suppressing the immune system and creating artificial immunodeficiency.

Because Prednisone has a very powerful action, then it is used only in severe cases, when other drugs (for example, non-steroidal anti-inflammatory drugs, antihistamines, etc.) do not have the desired effect. If it is possible to support normal condition and to prevent the aggravation of the disease not with Prednisolone, but with other, "weaker" drugs, then this should be done in this way. The use of Prednisolone should be resorted to only in cases where other means are ineffective or a life-threatening condition has arisen (for example, Quincke's edema, anaphylactic shock, bronchospasm, etc.), which must be removed very quickly.

In addition to the listed therapeutic effects, Prednisolone is able to have the following pharmacological effects:

• Increases protein breakdown, reducing its concentration in blood plasma and tissues;
• Increases protein synthesis in the liver;
• Suppresses active growth in children by increasing the breakdown of proteins;
• Leads to the redistribution of fat, increasing its deposition on the face and upper body;
• Increases blood glucose levels;
• Retains water and sodium in the body, which contributes to the formation of edema;
• Removes potassium from the body and reduces its absorption in the intestine;
• Increases the excitability of the brain;
• Reduces the threshold of convulsive readiness, as a result of which convulsions can develop in a person more often when exposed to stimuli of relatively low strength;
• Inhibits the synthesis of own glucocorticosteroids by the adrenal glands;
• Inhibits the synthesis of thyroid-stimulating and follicle-stimulating hormone (TSH and FSH).

Indications for use

Prednisolone in any form is intended only for relief of symptoms, therefore, it should be used as part of complex therapy aimed at curing the disease or achieving stable remission. Consider the indications for the use of each dosage form.

Indications for intravenous and intramuscular administration of Prednisolone solution

• Acute allergic reactions with severe swelling, spasm and infiltration (for example, Quincke's edema, bronchospasm, swelling and inflammation after an insect or snake bite, a large, itchy and painful skin rash, etc.);
• Asthmatic status;
• Bronchial asthma (severe form);
• Prevention and treatment of thyrotoxicosis and thyrotoxic crisis;
• Shock (burn, traumatic, surgical, toxic, cardiogenic, anaphylactic, blood transfusion);
• Anaphylactoid reactions;
• Cerebral edema caused by any cause;
• Acute adrenal insufficiency;
• Acute hepatitis;
• Acute liver failure or hepatic coma;
• Poisoning by cauterizing liquids (for example, vinegar essence, alkalis, etc.).

Indications for intra-articular administration of Prednisolone solution

• Polyarthritis;
• Post-traumatic arthritis;
• Osteoarthritis of large joints (femoral, shoulder, knee, elbow, etc.);
• Arthrosis.

Indications for the use of Prednisolone tablets and intramuscular injection of the solution

• Systemic connective tissue diseases (eg, systemic lupus erythematosus, dermatomyositis, rheumatoid arthritis, etc.);
• Acute and chronic inflammatory pathologies joints (arthritis, including psoriatic and gouty arthritis, polyarthritis, juvenile arthritis, osteoarthritis, humeroscapular periarthritis, ankylosing spondylitis, bursitis, synovitis, epicondylitis, tendosynovitis, Still's syndrome in adults);
• rheumatic fever;
• Acute rheumatic heart disease;
• Severe degrees of bronchial asthma;
• Asthmatic status;
• Acute and chronic allergic diseases (allergy to drugs and foods, serum sickness, urticaria, rhinitis, angioedema, exanthema, hay fever);
• Inflammatory skin diseases (pemphigus, psoriasis, eczema, atopic, contact, exfoliative and herpetiform dermatitis, pruritus, neurodermatitis, toxidermia, seborrheic dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome);
• swelling of the brain;
• Allergic ulceration of the cornea of ​​the eye;
• allergic conjunctivitis;
• Inflammatory eye diseases (sympathetic ophthalmia, sluggish uveitis, optic neuritis);
• Adrenal insufficiency, including after removal of the organ;
• Congenital adrenal hyperplasia;
• Autoimmune kidney diseases (acute glomerulonephritis, nephrotic syndrome, etc.);
• Subacute thyroiditis;
• Diseases of the blood system (autoimmune hemolytic anemia, panmyelopathy, agranulocytosis, leukemia, lymphogranulomatosis, thrombocytopenic purpura, thrombocytopenia in adults, erythroblastopenia, congenital hypoplastic anemia);
• Lung diseases (acute alveolitis, fibrosis, sarcoidosis II-III degree);
• Tuberculous meningitis;
• Pulmonary tuberculosis;
• Aspiration pneumonia (caused by inhalation of foreign bodies, sputum, water, tissue breakdown products, etc.);
• Beryllium;
• Loeffler's syndrome;
• Lung cancer;
• Chorea;
• Hepatitis;
• Pathology digestive tract(ulcerative colitis, Crohn's disease, enteritis);
• Prevention of rejection of organs and tissues after transplantation;
• Increased blood calcium levels in oncological diseases;
• Nausea and vomiting while taking cytostatics;
• multiple myeloma;
• Addison-Birmer disease;
• Androgenital syndrome.

Indications for the use of Prednisolone ointment

• Hives;
• Atopic, seborrheic, simple and allergic dermatitis;
• Simple chronic lichen;
• Eczema;
• discoid lupus erythematosus;
• Toxidermia;
• erythroderma;
• Psoriasis;
• epicondylitis;
• tendovaginitis;
• Bursitis;
• Shoulder-shoulder periarthritis;
• Keloid scars;
• Dupuytren's contracture.

Indications for the use of eye drops Prednisolone

• Non-infectious inflammatory diseases of various parts of the eye (iritis, iridocyclitis, uveitis, episcleritis, scleritis, conjunctivitis, keratitis, blepharoconjunctivitis, blepharitis);
• allergic conjunctivitis;
• Inflammatory process in the eye caused by injuries and surgical interventions;
• Sympathetic ophthalmia.

Instructions for use

Consider the rules for using various dosage forms of Prednisolone separately.

Tablets Prednisolone - instructions for use

At the start of therapy for acute and severe conditions should be taken at 50 - 75 mg (10 - 15 tablets) per day, and chronic diseases - 20 - 30 mg per day (4 - 6 tablets). After normalization of the condition, the dosage of Prednisolone is reduced to 5-15 mg per day and the tablets continue to be taken. The duration of treatment is determined by the doctor, and depends on general condition person and the effectiveness of therapy.

For children, the dosage is calculated individually by body weight, based on the ratio of 1-2 mg per 1 kg of weight to start treatment, and 0.25-0.5 mg / kg for a maintenance dose.

Prednisolone ampoules - instructions for use

The optimal way to administer a solution of Prednisolone is intravenous injection. This means that for various diseases and conditions, the method of choice for administering the solution is intravenous. Intramuscular administration of Prednisolone should be carried out only if it is impossible to perform an intravenous injection. Intra-articular administration of Prednisolone is indicated exclusively for diseases and conditions in which tissues inside the joint are affected.

When swelling, inflammation and exudation into the joint subside, Prednisolone injections can be replaced with tablets, which should be taken until a stable remission develops.

Since normally in the human body the adrenal glands release glucocorticoid hormones into the blood between 6-00 and 8-00 in the morning, injections should be made at the same time. I.e, optimum time for injection solution is the interval between 6-00 and 8-00 am. It is recommended to administer the entire dosage of the hormone at a time in the morning. If for some reason it is impossible to administer the entire daily dose of Prednisolone at a time, then most of it (at least 2/3) should be administered in the morning, and the remaining amount in the afternoon (12-00).

In case of shock, 50-150 mg of Prednisolone is administered at a time (2-5 ml of a 3% (30 mg / ml) solution). Re-introduce the same amount of solution every 3-4 hours during the first day. After that, the doctor determines whether there is a need to continue injections of Prednisolone or whether they can be stopped. In acute insufficiency of the adrenal glands and liver, as well as in case of allergic reactions, 100-200 mg of Prednisolone is administered every 8 hours. In case of asthmatic status, 500-1200 mg of Prednisolone is administered once, on the second day the dosage is reduced to 300 mg, on the third day - up to 150 mg and on the fourth day - up to 100 mg. On the 5th - 6th day, Prednisolone can be canceled if the status asthmaticus has not recurred.

For children, the daily dosage is calculated individually, depending on age and body weight:

• Children 2 - 12 months - 2 - 3 mg per 1 kg of weight;
• Children 1 - 14 years old - 1 - 2 mg per 1 kg.

The dosage of Prednisolone for intra-articular administration is determined by the size of the joint:

• In large joints - 25 - 50 mg;
• In the joints of medium size - 10 - 25 mg;
• Small joints - 5 - 10 mg.

How to properly inject Prednisolone

Intramuscular injection is made according to general rules. That is, the solution is injected into the outer-lateral upper part of the thigh, the upper third of the shoulder, or into the stomach if the person is slender. Before injection, the injection area is wiped with an antiseptic, after which the solution is drawn into the syringe, and the needle is inserted deep into the tissues perpendicular to the skin. By pressing on the piston, the solution is released into the muscle, the needle is removed, and the skin is again wiped with an antiseptic.

Dosages of prednisolone for various diseases

• Acute adrenal insufficiency - a single dose of 100 - 200 mg, daily - 300 - 400 mg;
• Severe allergic reactions - 100 - 200 mg per day for 3 - 16 days;
• Bronchial asthma - 25 - 35 mg per day for 3 - 16 days (with severe course disease and no improvement within 2 days, the dosage can be increased to 50-70 mg per day);
• Asthmatic status - 500 - 1200 mg per day;
• Thyrotoxic crisis - 200 - 300 mg per day (if necessary, increase the dosage to 1000 mg) for 2 - 6 days;
• Shock - 50 - 150 mg every 4 hours for 1 - 2 days;
• Acute renal or hepatic failure - 25 - 75 mg per day;
• Rheumatoid arthritis and systemic lupus erythematosus - 75 - 125 mg per day for 7 - 10 days;
• Acute hepatitis - 75 - 100 mg per day for 7 - 10 days;
• Poisoning with caustic fluids, burns of the gastrointestinal tract and respiratory system - 75-400 mg per day for 3-18 days.

Start of reception

Cancellation of the drug

Ointment Prednisolone - instructions for use

Rules for the use of eye drops Prednisolone

Application during pregnancy

When breastfeeding, Prednisolone should also not be used, since the hormone penetrates into milk and can affect the baby's body. Therefore, if it is necessary to use Prednisolone in nursing mothers, the child should be transferred to artificial mixtures.

special instructions

If a person has suffered from psychosis in the past, then high dosages of Prednisolone should be taken only under medical supervision.

During the entire course of therapy with Prednisolone, one should undergo an examination by an ophthalmologist once a week and donate blood to determine the concentration of potassium, sodium, calcium, chlorine and glucose in plasma, as well as a complete blood count. The level of pressure should be monitored daily, and in children, the dynamics of growth and development should be additionally monitored.

When using drops, intraocular pressure and the condition of the cornea should be monitored. And Prednisolone ointment is recommended to be used simultaneously with antifungal and antibacterial agents for the prevention of infectious diseases of the skin.

Cancel Prednisolone, which was taken for more than 5 days, should always be gradual.

Against the background of therapy with Prednisolone, a person's resistance to infections decreases, therefore, if signs of the disease appear, you should consult a doctor and take the necessary antibiotics, antiviral and antifungal drugs.

Anabolic steroids, antacids and potassium preparations can be taken to reduce the severity of the side effects of Prednisolone.

Interaction with other drugs

• Cardiac glycosides, diuretics (non-potassium-sparing) - increases the excretion of potassium;
• Antidiabetic drugs - reducing the effect of lowering glucose levels;
• Coumarin - a decrease in the anticoagulant effect;
• Rifampicin - a decrease in the activity of Prednisolone;
• Acetylsalicylic acid - increases the risk of bleeding from the digestive tract.

Overdose

Prednisone for children

Dosage of ointment and eye drops Prednisolone for children is the same as for adults. And the dosage of tablets and solution is calculated individually depending on body weight and age. The initial dosage of tablets, which the child takes for 1-2 days to relieve an acute condition, is calculated by the ratio of 1-2 mg per 1 kg of body weight. This dosage is divided into 4 - 6 doses per day. After acute condition normalizes, the child is transferred to a maintenance dosage of Prednisolone, which is calculated by the ratio of 0.3 - 0.6 mg per 1 kg of body weight per day.

The daily dosage of the solution is calculated individually depending on the age and body weight:

• Children 2 - 12 months - 2 - 3 mg per 1 kg of weight;
• Children 1 - 14 years old - 1 - 2 mg per 1 kg;
• Over 14 years old - adult dosages.

After Prednisolone (edema, overweight)

With sufficient perseverance in visiting sports hall and regular training, many people note that even during the course of using Prednisolone, they do not gain weight. The only thing that cannot be controlled is the deposition of fat on the face with the formation of a moon-shaped shape. However, it is really almost impossible to stop the deposition of fat on the face, so you have to put up with it. Some time after stopping the use of Prednisolone, the fat from the face will go away on its own.

As for edema, they are possible only during therapy with Prednisolone. After completing the course of treatment, swelling of a person should not be disturbed if there is no disease that can provoke them. However, the deposition of fat on the face during the course of the use of Prednisolone leads to an increase in the amount subcutaneous tissue in the area of ​​the cheeks, orbits and other parts, which fills with blood during sleep, as a result of which its mass and volume slightly increase. And it is this increased volume of the soft tissues of the face that people take for edema.

During the day, blood flows from the adipose tissue of the face under the influence of gravity, and this "edema" disappears by lunch or dinner. Many people are concerned about this "swelling", because they think that this is a symptom of some kind of trouble in the body. However, this is not true, and such behavior of the subcutaneous fatty tissue on the face is the price for life-saving treatment. With regular training and proper nutrition, a general weight loss will occur within a few months, and the amount of fatty tissue will decrease in all parts of the body, including the face. And only after that "edema" will begin to pass.

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