Product names (exemplary):
- 1,2-Dehydrocortisol
- Deltahydrocortisone
- Metacortandralon
- Predni blue®
- Prednisolone acis
- Predni h tablinen®
Prednisolone is an artificially produced glucocorticoid. These in turn form the group of steroid hormones, which are produced in the adrenal cortex. Related to prednisolone in structure and mode of action is the naturally occurring cortisone or hydrocortisone produced in the body itself.
The active ingredient prednisolone is found in medicines, for example:
- Decortin H
- Ultracorten®
- Urbason®
Prednisolone acts on a variety of physical processes. The carbohydrate and fat metabolism are influenced. Prednisolone also affects the haematopoietic and lymphatic systems and has effects on the calcium and mineral corticoid balance.
Prednisolone also affects inflammation, exudation and proliferation (growth) of various tissues. With regard to carbohydrate metabolism, prednisolone promotes gluconeogenesis, the build-up of glucose (sugar) from protein (muscles) and intermediate products. As a result, muscle breakdown (muscle atrophy) and osteoporosis occur, as well as a metabolic condition similar to that of diabetes mellitus (diabetic metabolic condition).
In fat metabolism, prednisolone leads to a redistribution of fat deposits with increased fat breakdown (lipolysis). The amount of fat is reduced in the extremities and deposited in the liver and the trunk of the body (trunk obesity). In the lymphatic tissue, the total number of white blood cells (leukocytes) increases under prednisolone administration, while the number of subgroups of eosinophilic granulocytes and lymphocytes decreases.
The lymphatic tissue as such, in which the proliferation and differentiation of the body’s defense cells (T-, B-lymphocytes = immune system) takes place, is also reduced and the activity of the lymphocytes is inhibited. The result is an increased susceptibility to infections, as the defence is restricted and the immune system is suppressed by prednisolone. At the same time, this results in anti-allergic efficacy, since in the case of allergies the activation of the immune system causes the symptoms.
When prednisolone is administered, the haematopoietic system shows an increase in red blood cells (erythrocytes) as well as in the number of platelets responsible for coagulation (thrombocytes). Since antithrombin, the substances that promote clotting, are also reduced, there is an increased risk of blood clots forming in the blood vessels (thrombosis) when prednisolone is taken. The inhibition of inflammation, exudation (fluid secretion during inflammatory processes) and proliferation (cell proliferation) initiated by prednisolone has an anti-inflammatory (antiphlogistic) effect in conjunction with delayed wound healing and increased ulcer formation (ulcer = deep-seated substance defect in the skin or mucous membrane).
Furthermore, prednisolone lowers the calcium level in the blood (hypocalcemia), as calcium absorption in the intestine is inhibited and excretion via the kidneys is increased. Finally, prednisolone also has a mineral corticoid effect. This results in a decrease in sodium excretion and an increase in potassium excretion.
Prednisolone is used in the form of a substitution therapy in the sense of a physiologically dosed hormone replacement therapy, and also in the form of a non-physiologically higher dosed pharmacotherapy. This pharmacotherapy with prednisolone is used in the following areas:
- Rheumatological diseases For exampleRheumatoid arthritisRheumatoid arthritisVasculitis (vascular inflammation)
- Rheumatoid Arthritis
- Vasculitis (inflammation of blood vessels)
- Diseases of the lungs and upper airways:among othersAsthma bronchialeakute worsening of COPDHay fever
- Bronchial asthma
- Acute worsening of COPD
- Hay fever
- Changes in the skin around example allergic reactions
- Allergic reactions
- Diseases of the haematopoietic system
- Cancer therapy:among other things certain forms of leukemia
- Neurological clinical pictures: for example multiple sclerosis
- Eye diseases: for example optic neuropathy
- Gastrointestinal diseases:among others chronic inflammatory intestinal diseases
- Kidney diseases:for example certain glomerulonephritis
- Infections = among others pulmonary tuberculosis
- Rheumatoid Arthritis
- Vasculitis (inflammation of blood vessels)
- Bronchial asthma
- Acute worsening of COPD
- Hay fever
- Allergic reactions
If prednisolone is prescribed, regular medical check-ups are necessary, with particular attention to potassium intake (increased) and sodium restriction (restrained). Accompanying osteoporosis prevention is also one of the doctor’s tasks when prescribing prednisolone, which consists of vitamin D and calcium administration as well as plenty of exercise.
In acute stressful situations such as accidents, operations or births, the Prednisolon dose usually has to be temporarily increased, as the need increases due to stress. If people in the vicinity suffer from measles or chickenpox, the patient should receive prophylactic treatment, as he or she can more easily contract these infections due to the immunodeficiency caused by Prednisolon. Lastly, it should be noted that if an allergy test is performed on the skin, the reaction may be suppressed by the prednisolone effect, which may falsify the result. The Prednisolon price for a 5mg tablet is about 10 to 50 cents.
