• Used systemically and locally in a wide variety of chronic diseases, including:
  • Inflammatory,
  • Allergic,
  • Hematologic,
  • Neoplastic,
  • Autoimmune disorders.
• Suitable for alternate-day dosing in the management of chronic illness.
• Replacement therapy in adrenal insufficiency.

Contraindicated in:

• Active untreated infections (may be used in patients being treated for tuberculous meningitis)
• Known alcohol or bisulfite hypersensitivity or intolerance (some products contain these; avoid in susceptible patients).

Use Cautiously in:

• Chronic treatment (leads to adrenal suppression; use lowest possible dose for shortest period of time)
• Stress (surgery, infections — supplemental doses may be needed)
• Potential infections may mask signs (fever, inflammation)
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
• Pedi: Chronic use will result in ↓ growth; use lowest possible dose for shortest period of time
• Pedi: Neonates (oral solution and syrup contains benzoic acid, a metabolite of benzyl alcohol, which can cause potentially fatal gasping syndrome).

Adverse reactions/side effects are much more common with high-dose/long-term therapy

CV: hypertension.

Derm: acne, ↓wound healing, ecchymoses, hirsutism, petechiae.

EENT: cataracts, ↑ intraocular pressure.

Endo: adrenal suppression, cushingoid appearance (moon face, buffalo hump), hyperglycemia.

F and E: fluid retention (long-term high doses), hypokalemia, hypokalemic alkalosis.

GI: anorexia, nausea, PEPTIC ULCERATION, vomiting.

Hemat: THROMBOEMBOLISM, thrombophlebitis.

Metab: weight gain, weight loss.

MS: muscle wasting, osteoporosis, avascular necrosis of joints, muscle pain.

Neuro: depression, euphoria, headache, ↑ intracranial pressure (children only), personality changes, psychoses, restlessness.

Misc: INFECTION, KAPOSI'S SARCOMA.

Drug-Drug:

• Additive hypokalemia with thiazide and loop diuretics, amphotericin B, or piperacillin/tazobactam.
• Hypokalemia may ↑ risk of digoxin toxicity.
• May ↑ requirement for insulin or oral hypoglycemic agents.
• Phenytoin, phenobarbital, and rifampin stimulate metabolism; may ↓ effectiveness.
• Oral contraceptives may ↓ metabolism.
• ↑risk of adverse GI effects with NSAIDs (including aspirin).
• At chronic doses that suppress adrenal function, may ↓ antibody response to and ↑ risk of adverse reactions from live-virus vaccines.
• May ↑ risk of tendon rupture from fluoroquinolones.

(Generic available)

• Tablets: 5 mg;
• Orally disintegrating tablets (grape flavor): 10 mg; 15 mg; 30 mg;
• Oral solution: 5 mg/5 mL; 10 mg/5 mL; 15 mg/5 mL; 20 mg/5 mL; 25 mg/5 mL;

• PO (Adults): Most uses: 5–60 mg/day as a single dose or in divided doses. Multiple sclerosis: 200 mg/day for 7 days; then 80 mg every other day for 1 mo. Asthma exacerbations: 120–180 mg/day in divided doses 3–4 times/day for 48 hr; then 60–80 mg/day in 2 divided doses.
• PO (Children): Anti-inflammatory/Immunosuppressive: 0.1–2 mg/kg/day in 1–4 divided doses.Nephrotic syndrome: 2 mg/kg/day (60 mg/m²/day) in 1–3 divided doses daily (maximum dose: 80 mg/day) until urine is protein-free for 4–6 wk, followed by 2 mg/kg/dose (40 mg/m²/dose) every other day in the morning; gradually taper off over 4–6 wk. Asthma exacerbations: 1 mg/kg every 6 hr for 48 hr; then 1–2 mg/kg/day (maximum: 60 mg/day) divided twice daily.

Orapred ODT, Pediapred, Prelone

• In pharmacologic doses, suppresses inflammation and the normal immune response.
• Suppresses adrenal function at chronic doses of 5 mg/day.
• Has minimal mineralocorticoid activity.

• Suppression of inflammation and modification of the normal immune response.
• Replacement therapy in adrenal insufficiency.

Therapeutic Classification: corticosteroids (intermediate-acting), immune modifiers

Pharmacologic Classification: corticosteroids

Absorption: Well absorbed following oral administration.

Distribution: Widely distributed.

Metabolism/Excretion: Metabolized mostly by the liver.

Half-life: 2.1–3.5 hr (plasma), 18–36 hr (tissue); adrenal suppression lasts 1.25–1.5 days.

(anti-inflammatory activity)

• Educate patient on reason for prednisoloneand side effects. Instruct them to take medication as directed. Take missed doses as soon as remembered unless almost time for next dose. Do not double doses. Do not share medication with others, even if they have similar symptoms; may be harmful. Advise patient to read Patient Information before starting and with each Rx refill in case of changes.
  • Explain need for continued medical follow-up to assess effectiveness and possible side effects of medication. Periodic lab tests and eye exams may be needed.
  • Stopping the medication suddenly may result in adrenal insufficiency (anorexia, nausea, weakness, fatigue, dyspnea, hypotension, hypoglycemia). If these signs appear, notify health care professional immediately. This can be life-threatening. Medical ID should be worn in case of emergencies.
  • Inform patient that prednisolone syrup or suspension should not be refrigerated. Pediapred solution may be stored at room temperature or refrigerated.
  • Advise patient to avoid grapefruit juice during therapy.
  • Advise patient to notify health care professional of signs and symptoms of hypercorticism (acne; thicker or more hair on body and face; bruising easily; fatty pad or hump between shoulders [buffalo hump]; rounding of face [moon face]; pink or purple stretch marks on skin of abdomen, thighs, breasts, and arms; ankle swelling), adrenal suppression (tiredness, weakness, nausea and vomiting, low blood pressure), worsening of allergies (eczema, rhinitis), or infection (fever, chills, pain, feeling tired, aches, nausea and vomiting).
  • May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Instruct patient to inform health care professional promptly if severe abdominal pain or tarry stools occur.
  • Corticosteroids cause immunosuppression and may mask symptoms of infection. May worsen existing tuberculosis; fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex. Notify health care professional immediately if exposed to chicken pox or measles.
  • Caution patient to avoid vaccinations without first consulting health care professional.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications, especially St. John's wort.
  • Pedi: Advise parents that use may cause shortened stature.
  • Rep: Instruct patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Hypoadrenalism may occur in infants born to mothers receiving corticosteroids during pregnancy. Observe infant for signs of hypoadrenalism (poor feeding, irritability, weakness, vomiting).
• Long-term Therapy: Encourage patient to eat a diet high in protein, calcium, and potassium and low in sodium and carbohydrates (see Appendix M). Alcohol should be avoided during therapy.

pred-NISS-oh-lone

NDC Code^*

• 0065- Alcon Laboratories, Inc.
  • 0065-0638- OMNIPRED
    • 0065-0638-25- 10 mL in 1 BOTTLE, PLASTIC (0065-0638-25)

• 0065- Alcon Laboratories, Inc.
  • 0065-0638- OMNIPRED
    • 0065-0638-27- 5 mL in 1 BOTTLE, PLASTIC (0065-0638-27)

• 0121- Pharmaceutical Associates, Inc.
  • 0121-0759- Prednisolone Sodium Phosphate
    • 0121-0759-08- 237 mL in 1 BOTTLE (0121-0759-08)

• 0121- Pharmaceutical Associates, Inc.
  • 0121-0773- Prednisolone Sodium Phosphate
    • 0121-0773-08- 237 mL in 1 BOTTLE (0121-0773-08)

• 0121- Pharmaceutical Associates, Inc.
  • 0121-0777- Prednisolone Sodium Phosphate
    • 0121-0777-08- 237 mL in 1 BOTTLE (0121-0777-08)

• 0178- Mission Pharmacal Company
  • 0178-0582- Prednisolone Sodium Phosphate Oral Solution
    • 0178-0582-01- 30 mL in 1 BOTTLE (0178-0582-01)

• 0178- Mission Pharmacal Company
  • 0178-0582- Prednisolone Sodium Phosphate Oral Solution
    • 0178-0582-08- 237 mL in 1 BOTTLE (0178-0582-08)

• 0378- Mylan Pharmaceuticals Inc.
  • 0378-4710- Prednisolone Sodium Phosphate
    • 0378-4710-22- 48 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-4710-22)

• 0378- Mylan Pharmaceuticals Inc.
  • 0378-4715- Prednisolone Sodium Phosphate
    • 0378-4715-22- 48 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-4715-22)

• 0378- Mylan Pharmaceuticals Inc.
  • 0378-4730- Prednisolone Sodium Phosphate
    • 0378-4730-22- 48 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-4730-22)

• 0527- Lannett Company, Inc.
  • 0527-5406- PrednisoLONE
    • 0527-5406-68- 240 mL in 1 BOTTLE (0527-5406-68)

• 0527- Lannett Company, Inc.
  • 0527-5406- PrednisoLONE
    • 0527-5406-70- 480 mL in 1 BOTTLE (0527-5406-70)

• 11980- Allergan, Inc.
  • 11980-174- PRED MILD
    • 11980-174-05- 1 BOTTLE, DROPPER in 1 CARTON (11980-174-05) > 5 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-174- PRED MILD
    • 11980-174-10- 1 BOTTLE, DROPPER in 1 CARTON (11980-174-10) > 10 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-01- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-01) > 1 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-05- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-05) > 5 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-06- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-06) > 5 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-10- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-10) > 10 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-11- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-11) > 10 mL in 1 BOTTLE, DROPPER

• 11980- Allergan, Inc.
  • 11980-180- PRED FORTE
    • 11980-180-15- 1 BOTTLE, DROPPER in 1 CARTON (11980-180-15) > 15 mL in 1 BOTTLE, DROPPER

• 12634- Apotheca Inc.
  • 12634-686- Prednisolone
    • 12634-686-04- 120 mL in 1 BOTTLE (12634-686-04)

• 13925- Seton Pharmaceuticals, LLC
  • 13925-166- Prednisolone Sodium Phosphate
    • 13925-166-04- 120 mL in 1 BOTTLE (13925-166-04)

• 17856- Atlantic Biologicals Corps.
  • 17856-0759- Prednisolone Sodium Phosphate
    • 17856-0759-1- 5 mL in 1 SYRINGE, PLASTIC (17856-0759-1)

• 17856- Atlantic Biologicals Corps.
  • 17856-0759- Prednisolone Sodium Phosphate
    • 17856-0759-2- 72 CUP, UNIT-DOSE in 1 BOX (17856-0759-2) > 10 mL in 1 CUP, UNIT-DOSE

• 17856- Atlantic Biologicals Corps.
  • 17856-0759- Prednisolone Sodium Phosphate
    • 17856-0759-3- 48 SYRINGE in 1 BOX, UNIT-DOSE (17856-0759-3) > 5 mL in 1 SYRINGE

• 17856- Atlantic Biologicals Corps.
  • 17856-0759- Prednisolone Sodium Phosphate
    • 17856-0759-4- 2.5 mL in 1 SYRINGE (17856-0759-4)

• 17856- Atlantic Biologicals Corps.
  • 17856-0759- Prednisolone Sodium Phosphate
    • 17856-0759-5- 5 mL in 1 CUP (17856-0759-5)

• 23594- Cerecor, Inc.
  • 23594-505- MILLIPRED
    • 23594-505-01- 100 TABLET in 1 BOTTLE (23594-505-01)

• 23594- Cerecor, Inc.
  • 23594-505- MILLIPRED
    • 23594-505-02- 200 TABLET in 1 BOTTLE (23594-505-02)

• 23594- Cerecor, Inc.
  • 23594-505- MILLIPRED
    • 23594-505-21- 6 TABLET in 1 DOSE PACK (23594-505-21)

• 23594- Cerecor, Inc.
  • 23594-505- MILLIPRED
    • 23594-505-48- 12 TABLET in 1 DOSE PACK (23594-505-48)

• 23594- Cerecor, Inc.
  • 23594-505- MILLIPRED
    • 23594-505-50- 50 TABLET in 1 BOTTLE (23594-505-50)

• 24208- Bausch and Lomb Incorporated
  • 24208-715- PREDNISOLONE SODIUM PHOSPHATE
    • 24208-715-10- 1 BOTTLE, DROPPER in 1 CARTON (24208-715-10) > 10 mL in 1 BOTTLE, DROPPER

• 33261- Aidarex Pharmaceuticals LLC
  • 33261-475- Prednisolone
    • 33261-475-01- 240 mL in 1 BOTTLE, PLASTIC (33261-475-01)

• 42799- Edenbridge Pharmaceuticals, LLC
  • 42799-812- Prednisolone Sodium Phosphate
    • 42799-812-01- 237 mL in 1 BOTTLE, PLASTIC (42799-812-01)

• 42799- Edenbridge Pharmaceuticals, LLC
  • 42799-813- Prednisolone Sodium Phosphate
    • 42799-813-01- 237 mL in 1 BOTTLE, PLASTIC (42799-813-01)

• 44523- BioComp Pharma, Inc.
  • 44523-182- Prednisolone Sodium Phosphate Oral Solution
    • 44523-182-08- 237 mL in 1 BOTTLE (44523-182-08)

• 50090- A-S Medication Solutions
  • 50090-0559- Prednisolone Acetate
    • 50090-0559-0- 1 BOTTLE, PLASTIC in 1 CARTON (50090-0559-0) > 10 mL in 1 BOTTLE, PLASTIC

• 50090- A-S Medication Solutions
  • 50090-0561- Prednisolone Acetate
    • 50090-0561-0- 1 BOTTLE, PLASTIC in 1 CARTON (50090-0561-0) > 5 mL in 1 BOTTLE, PLASTIC

• 50090- A-S Medication Solutions
  • 50090-0655- Prednisolone
    • 50090-0655-0- 1 BOTTLE in 1 CARTON (50090-0655-0) > 240 mL in 1 BOTTLE

• 50090- A-S Medication Solutions
  • 50090-0955- Prednisolone Sodium Phosphate
    • 50090-0955-0- 237 mL in 1 BOTTLE, PLASTIC (50090-0955-0)

• 50090- A-S Medication Solutions
  • 50090-1411- Prednisolone Sodium Phosphate
    • 50090-1411-0- 120 mL in 1 BOTTLE (50090-1411-0)

• 50090- A-S Medication Solutions
  • 50090-1582- Prednisolone Sodium Phosphate
    • 50090-1582-0- 237 mL in 1 BOTTLE (50090-1582-0)

• 50383- Hi-Tech Pharmacal Co., Inc.
  • 50383-040- Prednisolone Sodium Phosphate
    • 50383-040-04- 120 mL in 1 BOTTLE (50383-040-04)

• 50383- Hi-Tech Pharmacal Co., Inc.
  • 50383-042- Prednisolone
    • 50383-042-24- 1 BOTTLE in 1 CARTON (50383-042-24) > 240 mL in 1 BOTTLE

• 50383- Hi-Tech Pharmacal Co., Inc.
  • 50383-042- Prednisolone
    • 50383-042-48- 1 BOTTLE in 1 CARTON (50383-042-48) > 480 mL in 1 BOTTLE

• 50436- Unit Dose Services
  • 50436-0759- Prednisolone Sodium Phosphate
    • 50436-0759-1- 5 mL in 1 CUP (50436-0759-1)

• 50436- Unit Dose Services
  • 50436-0759- Prednisolone Sodium Phosphate
    • 50436-0759-2- 30 mL in 1 CUP (50436-0759-2)

• 51672- Taro Pharmaceuticals U.S.A., Inc.
  • 51672-1338- Flo-Pred
    • 51672-1338-3- 1 BOTTLE in 1 CARTON (51672-1338-3) > 52 mL in 1 BOTTLE

• 51672- Taro Pharmaceuticals U.S.A., Inc.
  • 51672-1338- Flo-Pred
    • 51672-1338-5- 1 BOTTLE in 1 CARTON (51672-1338-5) > 37 mL in 1 BOTTLE

• 51672- Taro Pharmaceuticals U.S.A., Inc.
  • 51672-1338- Flo-Pred
    • 51672-1338-6- 1 BOTTLE in 1 CARTON (51672-1338-6) > 65 mL in 1 BOTTLE

• 53217- Aidarex Pharmaceuticals LLC
  • 53217-193- Prednisolone
    • 53217-193-01- 1 BOTTLE in 1 CARTON (53217-193-01) > 240 mL in 1 BOTTLE

• 59212- Concordia Pharmaceuticals Inc.
  • 59212-700- Orapred ODT
    • 59212-700-48- 8 BLISTER PACK in 1 CARTON (59212-700-48) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 59212- Concordia Pharmaceuticals Inc.
  • 59212-701- Orapred ODT
    • 59212-701-02- 1 BLISTER PACK in 1 CARTON (59212-701-02) > 2 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 59212- Concordia Pharmaceuticals Inc.
  • 59212-701- Orapred ODT
    • 59212-701-48- 8 BLISTER PACK in 1 CARTON (59212-701-48) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 59212- Concordia Pharmaceuticals Inc.
  • 59212-702- Orapred ODT
    • 59212-702-48- 8 BLISTER PACK in 1 CARTON (59212-702-48) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 60432- Morton Grove Pharmaceuticals, Inc.
  • 60432-212- Prednisolone Sodium Phosphate
    • 60432-212-08- 237 mL in 1 BOTTLE, PLASTIC (60432-212-08)

• 60758- Pacific Pharma, Inc.
  • 60758-119- PREDNISOLONE ACETATE
    • 60758-119-05- 1 BOTTLE, DROPPER in 1 CARTON (60758-119-05) > 5 mL in 1 BOTTLE, DROPPER

• 60758- Pacific Pharma, Inc.
  • 60758-119- PREDNISOLONE ACETATE
    • 60758-119-10- 1 BOTTLE, DROPPER in 1 CARTON (60758-119-10) > 10 mL in 1 BOTTLE, DROPPER

• 60758- Pacific Pharma, Inc.
  • 60758-119- PREDNISOLONE ACETATE
    • 60758-119-15- 1 BOTTLE, DROPPER in 1 CARTON (60758-119-15) > 15 mL in 1 BOTTLE, DROPPER

• 61314- Sandoz Inc
  • 61314-637- Prednisolone Acetate
    • 61314-637-05- 1 BOTTLE, PLASTIC in 1 CARTON (61314-637-05) > 5 mL in 1 BOTTLE, PLASTIC

• 61314- Sandoz Inc
  • 61314-637- Prednisolone Acetate
    • 61314-637-10- 1 BOTTLE, PLASTIC in 1 CARTON (61314-637-10) > 10 mL in 1 BOTTLE, PLASTIC

• 61314- Sandoz Inc
  • 61314-637- Prednisolone Acetate
    • 61314-637-15- 1 BOTTLE, PLASTIC in 1 CARTON (61314-637-15) > 15 mL in 1 BOTTLE, PLASTIC

• 63187- Proficient Rx LP
  • 63187-215- Prednisolone Sodium Phosphate
    • 63187-215-64- 240 mL in 1 BOTTLE (63187-215-64)

• 63187- Proficient Rx LP
  • 63187-466- Prednisolone
    • 63187-466-64- 1 BOTTLE in 1 CARTON (63187-466-64) > 240 mL in 1 BOTTLE

• 63629- Bryant Ranch Prepack
  • 63629-1862- Prednisolone
    • 63629-1862-1- 60 mL in 1 BOTTLE (63629-1862-1)

• 65162- Amneal Pharmaceuticals of New York, LLC
  • 65162-667- Prednisolone Sodium Phosphate
    • 65162-667-76- 89 mL in 1 BOTTLE (65162-667-76)

• 65162- Amneal Pharmaceuticals of New York, LLC
  • 65162-667- Prednisolone Sodium Phosphate
    • 65162-667-88- 237 mL in 1 BOTTLE (65162-667-88)

• 65162- Amneal Pharmaceuticals of New York, LLC
  • 65162-667- Prednisolone Sodium Phosphate
    • 65162-667-90- 473 mL in 1 BOTTLE (65162-667-90)

• 66993- Prasco Laboratories
  • 66993-844- Prednisolone Sodium Phosphate ODT
    • 66993-844-62- 8 BLISTER PACK in 1 CARTON (66993-844-62) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 66993- Prasco Laboratories
  • 66993-845- Prednisolone Sodium Phosphate ODT
    • 66993-845-62- 8 BLISTER PACK in 1 CARTON (66993-845-62) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 66993- Prasco Laboratories
  • 66993-846- Prednisolone Sodium Phosphate
    • 66993-846-62- 8 BLISTER PACK in 1 CARTON (66993-846-62) > 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK

• 68071- NuCare Pharmaceuticals,Inc.
  • 68071-1722- PREDNISOLONE ACETATE
    • 68071-1722-5- 5 mL in 1 BOX (68071-1722-5)

• 68788- Preferred Pharmaceuticals, Inc
  • 68788-9096- Prednisolone
    • 68788-9096-2- 240 mL in 1 BOTTLE (68788-9096-2)

• 68788- Preferred Pharmaceuticals, Inc
  • 68788-9096- Prednisolone
    • 68788-9096-4- 1 BOTTLE in 1 CARTON (68788-9096-4) > 480 mL in 1 BOTTLE

• 68791- Royal Pharmaceuticals
  • 68791-104- PEDIAPRED
    • 68791-104-04- 120 mL in 1 BOTTLE (68791-104-04)

• 69101- Burke Therapeutics
  • 69101-410- Prednisolone Sodium Phosphate
    • 69101-410-01- 237 mL in 1 BOTTLE (69101-410-01)

• 70166- Lohxa
  • 70166-549- Prednisolone Sodium Phosphate
    • 70166-549-05- 50 CUP, UNIT-DOSE in 1 BOX (70166-549-05) > 5 mL in 1 CUP, UNIT-DOSE

• 70518- REMEDYREPACK INC.
  • 70518-2084- Prednisolone
    • 70518-2084-0- 60 mL in 1 BOTTLE (70518-2084-0)

• 72189- DIRECT RX
  • 72189-055- PREDNISOLONE ACETATE
    • 72189-055-05- 1 mL in 1 BOTTLE (72189-055-05)