Prednisolone is an artificially produced active substance, which belongs to the group of glucocorticoids. This group is often summarized under the well-known name “cortisone“. In its effects and side effects, prednisolone is similar to the hormone cortisol or hydrocortisone, which is produced in the adrenal cortex of the human body. It can be used in very many different dosage forms.
Prednisolone as tablets, ointments and co.
For internal and thus systemic use, the active ingredient is available in tablet form or as infusion or injection solutions. If prednisolone is to be used only locally, suppositories, ointments, creams, or tinctures can be used. These forms may contain prednisolone itself or other active ingredient forms such as prednisone, the precursor of prednisolone, or the water-soluble form prednisolone acetate.
How does prednisolone work?
Like the endogenous hormone cortisone, prednisolone has an immunosuppressive effect, meaning it inhibits the immune system. This makes it anti-inflammatory and anti-allergic. Prednisolone prevents inflammatory cells from migrating into damaged tissue and causing an excessive inflammatory reaction there. Therein lies the therapeutic benefit of this active ingredient. In addition, prednisolone affects carbohydrate metabolism and lipid metabolism, which is why too high a dosage of prednisolone or too long a course of prednisolone therapy can cause unpleasant side effects.
Indications for use of this cortisone
Sometimes treatment with cortisone can be important or even vital. We provide an overview of indications for which therapy with prednisolone may be considered here.
- Many allergies such as severe hay fever, allergic skin inflammation, allergic eye inflammation or even severe allergic shock are treated with cortisone to prevent the extremely exaggerated reaction of the immune system.
- Lung diseases such as bronchial asthma or chronic obstructive bronchitis (smoker’s cough) can be so severe that the patient would not be able to breathe without anti-inflammatory treatment. Similarly, patients with other lung diseases (e.g., pseudocroup) may be dependent on prednisolone therapy.
- In the so-called Addison’s disease, the adrenal cortex of the human body can not produce enough cortisol, there is a deficiency. Then the missing glucocorticoid must be replaced by artificial cortisone such as prednisolone.
- A disorder of the pituitary gland causes insufficient stimulation of the adrenal cortex. A lack of glucocorticoids in the body is also the result here. Equally a common reason for prednisolone therapy are chronic inflammation of joints (polyarthritis) or diseases from the rheumatic form.
Prednisolone helps with autoimmune diseases.
Most autoimmune diseases such as lupus erythematosus or collagenoses are treated with cortisone. They also include Crohn’s disease or ulcerative colitis, inflammatory bowel diseases, and some inflammatory kidney diseases. Neurological diseases such as multiple sclerosis can also be treated with prednisolone. Some forms of headache or a hearing loss are also relieved in this way. After organ transplants, prednisolone is used for rejection prophylaxis. If acute rejection is already in progress, the active substance can also be used. Nausea and vomiting are common side effects of chemotherapy. Prednisolone can relieve these side effects of some cancer treatments.
Prednisolone: dosage
The dosage of prednisolone prescribed by a doctor always depends on the disease, its severity, and other individual factors. Patients with a history of many other diseases need a different dosage than patients who are largely healthy. Especially in children, the active ingredient must be precisely adapted to need, size, weight and age. Prednisolone should therefore always be taken in consultation with the attending physician and exactly according to his instructions. The body’s own cortisol has a circadian rhythm, i.e. it is released more in the morning hours. Therefore, the highest dosage of prednisolone should be taken in the morning to resemble the natural hormonal behavior. Prednisolone tablets should be taken with plenty of liquid, preferably during or immediately after a meal.If severe side effects or allergic reactions to the active ingredient occur, a doctor should always be consulted.
Discontinuation of prednisolone
Abrupt discontinuation of prednisolone may increase side effects and upset the patient’s hormone balance. A better approach is to slowly discontinue medications containing this active ingredient. This is referred to as “tapering off.” Prednisolone should therefore be slowly reduced in dose until it can eventually be stopped completely.
Directions for use
- Any treatment with prednisolone should be monitored regularly by a physician.
- In case of allergies to prednisolone preparations, this active substance must not be taken.
- There are situations in which the body depends on a well-functioning immune defense to be protected against infections. Therefore, in acute viral infections (such as cold sores, chickenpox), eight weeks before or after vaccinations or lymph node swelling after a tuberculosis vaccination should not take medication with cortisone.
- During pregnancy and lactation, prednisolone should be taken only if deemed absolutely necessary by a physician.
- Because prednisolone interferes with the body’s sugar metabolism, it should not be taken in the presence of a chronic metabolic disease such as diabetes mellitus. Patients with osteoporosis or hypertension, which is difficult to adjust, should also be carefully weighed for necessity.
- Patients with hypertension that is difficult to adjust should avoid therapy with prednisolone. If it is nevertheless necessary, regular medical checks are essential.
- Ophthalmological checks should also be perceived to quickly detect side effects in the eyes.
- Because prednisolone therapy may have effects on mood and concentration, patients may be impaired and should not actively participate in traffic or operate machinery.
- When taking prednisolone may interact with other medications such as painkillers, blood pressure medications, certain antibiotics, diabetes medications or the “pill”.
Despite many warnings and possible side effects, however, it should not be forgotten that cortisone is a hormone necessary for survival. Treatment with prednisolone can very well alleviate many chronic and acute diseases.