Prednisone / Prednisolone

(prednisolone sodium succinate, prednisolone acetate, prednisolone, prednisone)

Brands

Available in several brand names

Availability

  • Prednisone oral solution / syrup: 1 mg/mL in 30mL
  • Prednisone tablets: 2.5 mg, 5 mg, 10 mg and 20 mg
  • Prednisone suspension: 10 mg/mL
  • Prednisone injectable: 10 mg/mL
  • Prednisolone syrup: 15 mg/5mL in 240mL
  • Prednisolone tablets: 5 mg and 20 mg

Pharmacology

Prednisone and prednisolone are synthetic members of the glucocorticoid class of hormones. They are an intermediate acting, broad anti-inflammatory, medication. Typically stating, this means that the action of one dose lasts from a day to a day and a half.

Prednisone and prednisolone have less activity than the longer acting dexamethasone or betamethasone, but exhibit greater activity than hydrocortisone.

Though prednisone and prednisolone are used in the same manner and equally as effective, they should not be confused with each other. Prednisone is activated by the liver into prednisolone. For this reason, and because it is more easily absorbed, prednisolone is the drug of choice when hepatic disease or insufficiency is present.

Both prednisone and prednisolone are readily absorbed and distributed into muscle, liver, intestines, and kidneys. It is also distributed in breast milk and crosses the placental barrier. Glucocorticoids have been found to cause abortion and should not be used in pregnant animals.

Prednisone and Prednisolone are both metabolized in the liver, and excreted in the urine.

Indications

Used as an anti-inflammatory and immunosuppressant in the following:

  • Inner ear infections so called wry neck or head tilt
  • Adjunctive treatment in respiratory disorders such as pneumonia
  • Supportive/palliative treatment in the presence of tumors
  • In severe itching (e.g. dermatologic disorders)
  • Adjunctive treatment for autoimmune disorders
  • Adjunctive treatment in adrenal disease
  • In treating shock to improve circulation (Prednisolone sodium succinate)

*Note: in conditions where long term use of a glucocorticoid is required, it is recommended that sulcralfate be given concurrently.

Drug Interactions or Contraindications

  • Do not give in active untreated infections, or viral and fungal diseases of the eye.
  • Use with caution in CHF and where an inflammatory bowel is present.
  • Has only minor mineralcorticoid effect and should not be used alone to treat adrenal insufficiency.
  • When used with NSAIDs (e.g., aspirin, ibuprofen, meloxicam) will increase GI distress or cause bleeding, use with caution.

Adverse Reactions

EENT: cataracts, glaucoma

CV: CHF, edema

GI: Known to increase appetite but may have opposite effect in rats with resulting weight loss

GU: Increased thirst and urination due to activity in the kidney leading to conservation of salt

Skin: delayed wound healing

Local: atrophy at injection site

Other: may mask or exacerbate infections already present.

Dosage Recommendations

0.25 mg/lb to 1 mg/lb, PO, SID (once a day)  4. May be given in divided dose q12hr.

or

if oral solution of 1mg/1 mL then give 0.25mL/lb to 1 mL/lb 4. May be given in divided dose q12hr.

or

0.5 mg/kg to 2.2 mg/kg, SC, IM 1, 26, 27, 34, 35, 41. May be given in divided dose q12hr.

Example of a typical method of administration for prednisone or prednisolone

Divided dose q12hr. times three days, then once daily times three days, then once every other day as directed by veterinarian.

Examples of reduction/weaning schedules when terminating prednisone or prednisolone administration

Divided dose q12hr. times three days, then decrease to once daily times three days, then decrease to half that dose and give once a day for three days and then every other day for three doses and stop.

or

Dosing once a day times two days, then decrease to half of that dose and give once a day times two days, then decrease by half again and give once a day times two days, then decrease by half that again and give once a day times two days and then stop.

The veterinarian may choose a different dosing and reduction schedule based on the rat’s condition.

*Note:  Prednisone or Prednisolone is normally used for a few days to a couple of weeks, but where illness is deemed terminal it may be used longer to provide comfort to the rat.

Considerations

  • Recommended for short duration. If intending long term use for a chronic process it is important to try (if disease process permits) and taper dose down to an every other day schedule. Doing so helps the body to be able to maintain its own production and source of cortisone. Sudden withdrawal of drug may be fatal if given over a period of time.
    Check with veterinarian prior to stopping, or to determine how best to gradually reduce dosage.
  • Store in tightly closed container at cool room temperature. Prednisolone sodium succinate should not be reconstituted until it is to be used. Prednisolone syrup should not be refrigerated.

Cross-references

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