Prednisone intravenous side effects. Side effects of prednisolone - consequences of taking a glucocorticosteroid

H.02.A.B.06 Prednisolone

PREDNISOLONE NYCOMED

(PREDNISOLONY NYCOMED)

Glucocorticoid hormonal drug.

Chemical rational name of the drug. Pregna-1,4-diene-3,20-dione, 11,17,21-trihydroxy-, (11c).

PREDNISOLONE NIKOMED - Solution for injection - 25 mg / ml

Release form. Solution for injections 25 mg/ml.

Description. Clear, colorless solution.

Compound. Each 1 ml ampoule contains 25 mg of prednisolone.

pharmacological properties. Prednisolone is a synthetic glucocorticoid drug. It is a highly active derivative of hydrocortisone, from which it is obtained as a result of a dehydrogenation reaction. It has anti-inflammatory, anti-allergic, anti-shock and immunosuppressive effects. Its anti-inflammatory and anti-allergic activity is 3-4 times higher than that of cortisone or hydrocortisone. It affects various types of metabolism: it has a catabolic effect, increases blood glucose levels, promotes the redistribution of adipose tissue, and can cause osteoporosis. It also has an effect on the water-electrolyte balance: it causes sodium and water retention in the body. Prednisolone inhibits the secretion of ACTH by the pituitary gland, thereby inhibiting the synthesis of glucocorticoids and androgens by the adrenal glands. After oral administration, prednisolone is absorbed in the gastrointestinal tract. Bioavailability is 70-90%. The maximum plasma concentration is reached within 1-2 hours. Plasma protein binding is 90-95%. The half-life is 2-3.5 hours. Metabolized in the liver. It is excreted in the urine, mainly as inactive metabolites.

Indications for use.

- Rheumatic diseases: acute rheumatic fever, rheumatic myocarditis and pericarditis, acute exudative phases chronic arthritis, tendinitis.

- Collagenosis: systemic lupus erythematosus (SLE), dermatomyositis, scleroderma, periarteritis nodosa.

- Allergic diseases: bronchial asthma, hay fever, Quincke's edema, urticaria, drug allergy, transfusion reaction, anaphylactic shock.

- Pulmonary diseases: chronic bronchitis (with antibacterial protection), pulmonary fibrosis, sarcoidosis.

- Tuberculosis: tuberculous meningitis, exudative pulmonary tuberculosis, exudative pleurisy (in combination with tuberculosostatic drugs).

- Heart disease: myocarditis, exudative pericarditis, post-infarction syndrome with pericarditis, decreased threshold excitation in patients with pacemakers.

- Hematological disorders: hemolytic anemia, granulocytopenia, thrombocytopenic purpura, bone marrow dysfunction, chronic lymphadenitis with autoimmune phenomena.

- Liver diseases: epidemic hepatitis, serum hepatitis, chronic active hepatitis, intrahepatic cholestasis.

- Gastrointestinal diseases: ulcerative colitis, granulomatous enteritis (Crohn's disease): in case of signs of increased inflammation, treatment should be as short as possible and should be carried out in combination with salazopurine; celiac disease.

- Diseases of the kidneys and urinary tract: nephrotic syndrome, lipoid nephrosis in children, urogenital tuberculosis (in combination with tuberculosis drugs), retroperitoneal fibrosis, urethral stricture.

- Skin diseases: common eczema, erythema multiforme exudative, pemphigus vulgaris.

- Diseases of the nervous system: bacterial meningitis (auxiliary therapy), toxic neuropathy; polyneuritis and sciatica (allergic etiology), peripheral nerve compression syndrome; multiple sclerosis.

- Palliative care: For infectious diseases (in combination with antibiotics) and for tumors.

- Replacement therapy: Addison's disease, Waterhouse-Friderichsen syndrome (meningoccal septicemia) and chronic adrenal insufficiency, after adrenalectomy, with adrenogenital syndrome and with insufficiency of the anterior pituitary gland. Use strictly according to the doctor's prescription to avoid complications!

Contraindications.

- Peptic ulcer of the stomach and duodenum;

- Severe osteoporosis;

- Severe myopathy (with the exception of myasthenia gravis);

- Viral diseases (chicken pox, herpes simplex eyes);

- Poliomyelitis (with the exception of the bulbar-encephalitic form);

- Lymphadenitis after BCG vaccination;

- Systemic mycosis;

- Glaucoma;

- Intra-articular injections: infections in the injection area;

— Within 14 days before and after preventive immunization.

- The period of pregnancy and lactation. During pregnancy (especially in the first trimester) can be used only for health reasons. During treatment with prednisone, breast-feeding should be discontinued.

Method of application and dose. PREDNISOLONE NIKOMED for injections 25 mg/ml is intended for intramuscular, intravenous and intraarticular injections (ready solution).

Adults. At the beginning of the course of treatment, depending on the age, constitution of the patient and the course of the disease, the daily dose is 25-50 mg intravenously or intramuscularly. In severe cases, a significant increase in the indicated dose is allowed.

Children. Children under 6 years of age should be treated with PREDNISOLONE NIKOMED 5 mg tablets. The average dose for children aged 6-12 years is 25 mg per day intravenously or intramuscularly, and children over 12 years of age should be given 25-50 mg per day intravenously or intramuscularly. Treatment with glucocorticoids should not be abruptly discontinued. In cases where there is no need for parenteral administration of PREDNISOLONE NIKOMED, ​​it is recommended to continue and complete the treatment with the appointment of PREDNISOLONE NIKOMED 5 mg tablets. The dose must be reduced gradually.

Special instructions. During treatment (especially long-term), it is necessary to observe an ophthalmologist, control blood pressure and water and electrolyte balance, as well as pictures of peripheral blood and glycemia. In order to reduce side effects, you can prescribe anabolic steroids, antibiotics, antacids, as well as increase the intake of potassium in the body (diet, potassium preparations). In the case of treatment with glucocorticoids for a long time, it is recommended to regularly monitor the level of glycemia, blood clotting, X-ray control of the spine and ophthalmological control. Before starting treatment with glucocorticoids, thorough examination gastrointestinal tract to exclude gastric ulcer or duodenal ulcer. In diabetes mellitus, tuberculosis, acute and chronic bacterial and amoebic infections, hypertension, thromboembolism, heart and kidney failure, treatment with glucocorticoids should be prescribed with great caution, in case of possible concomitant treatment underlying disease (antidiabetic drugs, tuberculostatics, chemotherapy drugs and antibiotics, anticoagulants, etc.). In the case of a history of psychosis, prednisolone therapy is carried out only for health reasons. Children should be given with great caution. In very rare cases, after the end of treatment with prednisolone, adrenal insufficiency is observed. In this case, you should immediately resume taking prednisolone and reduce the dose very slowly and with caution (for example, the daily dose should be reduced by 2-3 mg within 7-10 days). As a result of the risk of hypercortisolism, a new course of cortisone treatment after previous long-term treatment prednisolone for several months, always start with low initial doses (except in acute life-threatening conditions).

There is an interaction when using prednisolone in combination with the following compounds: Cardiac glycosides: the effect of glycosides is enhanced. Saluretics: increases the excretion of potassium. Antidiabetic drugs for oral administration: weakening the hypoglycemic effect. Derivatives of coumarin: decrease in anticoagulant action. Rifampicin: Decreased corticoid activity. Salicylates: danger increases gastrointestinal bleeding. If a glucocorticoid is administered within 8 weeks before or within 2 weeks after vaccination, the effect of immunization will be reduced or completely neutralized.

Side effect. In the case of using prednisolone, side effects common to glucocorticoids are observed:

- exacerbation (as well as formation) of ulcers of the gastrointestinal tract,

- increased risk of infection, rapid development, exacerbation of fungal infections, the development of viral or other infections (for example, tuberculosis),

- deterioration or exacerbation of old infectious processes (for example, tuberculosis),

- slowing down the process wound healing,

- mental disorders (such as depression),

– osteoporosis,

- myopathy,

- Cushing's syndrome

- steroid diabetes

- hypertension,

- increased risk of thromboembolism,

- cataract

- glaucoma.

Special instructions for patients. PREDNISOLONE NYCOMED is a powerful drug and you should strictly follow your doctor's instructions. First of all, you should tell your doctor if you are pregnant or planning to become pregnant - if you have not already told your doctor about it. You must also inform your doctor if you have or have had tuberculosis in the past or other chronic infections(e.g. gingivitis, frontal sinusitis, cholecystitis), recent vaccination, gastric or duodenal ulcer, diabetes mellitus. You should also contact your doctor if you develop a fever or stomach problems, nervous disorders or any other symptoms that occur during treatment. If you have changed doctors (for example, in the event of surgery, while traveling, etc.), you must inform the other doctor that you are taking PREDNISOLONE NYCOMED. Possible strengthening of the described side effects. Treatment is symptomatic.

Release form. Solution for injection 25 mg/ml in 1 ml ampoules. Packs of 3, 5 and 25 ampoules.

Storage conditions. Store in the package in a place protected from light at room temperature not exceeding 25˚С! Keep out of the reach of children!

Best before date. 5 years. Do not use after the expiry date!

Holiday conditions. By prescription.

PREDNISOLONE NYCOMED - 5 mg - tablets

Description. Tablets are white, round, flat on both sides.

Compound. 1 tablet contains 5 mg of prednisolone.

pharmacological properties. Prednisolone is a synthetic glucocorticoid drug. It is a highly active derivative of hydrocortisone, from which it is obtained as a result of a dehydrogenation reaction. It has anti-inflammatory, anti-allergic, anti-shock and immunosuppressive effects. Its anti-inflammatory and anti-allergic activity is 3-4 times higher than that of cortisone or hydrocortisone. It affects various types of metabolism: it has a catabolic effect, increases blood glucose levels, promotes the redistribution of adipose tissue, and can cause osteoporosis. It also has an effect on the water-electrolyte balance: it causes sodium and water retention in the body. Prednisolone inhibits the secretion of ACTH by the pituitary gland, thereby inhibiting the synthesis of glucocorticoids and androgens by the adrenal glands. After oral administration, prednisolone is absorbed in the gastrointestinal tract. Bioavailability is 70-90%. The maximum plasma concentration is reached within 1-2 hours. Plasma protein binding - 90-95%. The half-life is 2-3.5 hours. Metabolized in the liver. It is excreted in the urine, mainly as inactive metabolites.

Indications for use.

- rheumatic inflammatory diseases(rheumatoid arthritis, ankylosing spondylitis),

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

— allergic diseases(hay fever, bronchial asthma, urticaria, drug allergy),

- respiratory diseases: chronic obstructive lung diseases(under the guise of antibiotics), pulmonary fibrosis, sarcoidosis,

- inflammatory bowel disease (ulcerative ileitis / colitis),

- kidney disease of autoimmune origin,

- skin diseases, for example, pemphigus vulgaris, erythroderma,

- blood diseases

— malignant tumors(in combination with chemotherapy),

- replacement therapy for primary insufficiency of the adrenal cortex and insufficiency of the anterior pituitary gland.

Use strictly according to the doctor's prescription to avoid complications!

Contraindications.

- Hypersensitivity to the components of the drug.

- Peptic ulcer of the stomach or duodenum.

- Severe osteoporosis.

- Severe myopathies.

- Viral infections.

- Lymphadenitis after the use of BCG vaccine.

- Systemic mycoses.

— Glaucoma.

- The period of pregnancy and lactation: During pregnancy, especially in the first trimester, it can be used only for health reasons. During treatment with prednisone, breast-feeding should be discontinued.

Method of application and dose. The dose of the drug is set individually.

Adults. At the start of treatment for severe acute diseases the daily dose is usually 50-75 mg of prednisolone. In chronic diseases and in less severe cases, an initial dose of 20-30 mg / day is prescribed. The maintenance dose is 5-15 mg of prednisolone per day.

Children. The initial daily dose for the treatment of acute diseases is 1-2 mg/kg of body weight. The daily maintenance dose for long-term treatment is 0.25-0.5 mg/kg of body weight. Treatment with glucocorticoids should not be abruptly discontinued. The dose must be reduced gradually. Take the tablets with a little water. With extreme caution and simultaneous treatment the underlying disease is used for diabetes mellitus, tuberculosis, hypertension, thromboembolism, cardiac activity and kidney failure. If there are indications of psychosis in the anamnesis, then glucocorticoid therapy is carried out only for health reasons. In very rare cases, after the end of treatment with prednisolone, the development of adrenal insufficiency is observed. In this case, you should immediately resume taking prednisolone and reduce the dose slowly and with caution (for example, the daily dose should be reduced by 2-3 mg within 7-10 days). Because of the risk of hypercortisolism, a new course of cortisone treatment after previous long-term treatment with prednisolone for several months should always be initiated at low initial doses (except in acute life-threatening conditions). During treatment (especially long-term), it is necessary to observe an ophthalmologist, control blood pressure and water and electrolyte balance, as well as pictures of peripheral blood and glycemia. In order to reduce side effects, you can prescribe anabolic steroids, antibiotics, antacids, as well as increase the intake of potassium in the body (diet, potassium preparations). With long-term treatment of children under 14 years of age, due to the risk of growth retardation, every 3 days it is necessary to take a break for 4 days (intermittent therapy).

drug interactions.

- Cardiac glycosides: the effect of glycosides is enhanced.

- Saluretics: increases the excretion of potassium.

- Oral antidiabetic drugs: reduced hypoglycemic effect.

- Derivatives of coumarin: weakening of the anticoagulant effect.

- Rifampicin: decrease in corticoid activity.

- Salicylates: increased risk of gastrointestinal bleeding.

- If a glucocorticoid is administered 8 weeks before or within 2 weeks after vaccination, the effect of immunization will be reduced or completely neutralized.

Side effect.

- exacerbation or occurrence of peptic ulcer of the stomach and/or duodenum,

- increased risk of occurrence or reappearance of fungal, viral and bacterial infections,

- weakening of the immune system, slowing down the healing of wounds.

For longer treatment:

- Cushing's syndrome

- atrophy of the adrenal cortex,

- steroid diabetes

- sodium retention and edema development,

Prednisone - very serious side effects

Prednisolone is a synthetic glucocorticoid drug that has all the advantages and disadvantages of this group of drugs. Its side effects increase with long-term use in high doses, so Prednisolone Prednisolone is against inflammation, allergies and pain, but with complications try to appoint only in case of emergency and short courses.

Prednisolone affects all types of metabolic processes. Under its influence, proteins are destroyed and their decay products are used by the body to produce glucose.

The amount of glucose increases Glucose: a source of energy in the blood, which adversely affects diabetic patients. It enhances the breakdown and at the same time the formation of fats that are deposited in the tissues, creating excess weight and an incorrect figure configuration. Mineral metabolism is disturbed due to the fact that potassium is excreted from the body (reduced contractility myocardium) and calcium (osteoporosis is formed - thinning of the bones). Sodium and water are retained in the body - this causes edema.

PREDNISOLONE

The description of the drug PREDNISOLONE is based on the officially approved instructions for use of the drug PREDNISOLONE for specialists and approved by the manufacturer for the 2010 edition.

pharmachologic effect

Synthetic glucocorticoid drug with a pronounced anti-inflammatory effect. It is believed that 5 mg of prednisolone in terms of anti-inflammatory effect corresponds to 4 mg of methylprednisolone or triamcinolone, 0.75 mg of dexamethasone, 0.6 mg of betamethasone and 20 mg of hydrocortisone. The mineralocorticoid effect of prednisolone is about 60% of the activity of hydrocortisone.

Prednisolone inhibits the development of symptoms of inflammation, without affecting its cause. It inhibits the accumulation of macrophages, leukocytes and other cells in the area of ​​​​the inflammatory focus. It inhibits phagocytosis, the release of lysosomal enzymes, as well as the synthesis and release of chemical inflammatory mediators. It causes inhibition of the localization of macrophages, a decrease in the expansion and permeability of capillaries, a decrease in the adherence of leukocytes to the capillary endothelium. This leads to inhibition of migration of leukocytes and the formation of edema. The synthesis of lipomodulin, an inhibitor of phospholipase A 2, is enhanced. releasing arachidonic acid from the phospholipid membrane, with simultaneous inhibition of its synthesis.

It has an immunosuppressive effect, the mechanisms of which are not fully understood, but it has been established that prednisolone can inhibit cellular immunological responses, as well as specific mechanisms associated with the immunological response. Reduces the number of T-lymphocytes, monocytes and acidophilic granulocytes. It also reduces the attachment of immunoglobulins to receptors on the cell surface and inhibits the synthesis or release of interleukins by reducing the blastogenesis of T-lymphocytes and reducing the enhancement of the early immunological response. It can also inhibit the penetration of immunological complexes through the main membranes and reduce the concentration of complement components and immunoglobulins.

Prednisolone . acting on the distal tubules, it enhances sodium reabsorption, excretion of potassium and hydrogen, as well as water retention. Similarly affects the transport of cations in other excretory cells. To a lesser extent, it affects the excretion of water and electrolytes by the large intestine and sweat and salivary glands. In the case of prednisolone, this action is not the basis for determining indications.

Inhibits the secretion of ACTH by the pituitary gland, which leads to a decrease in the production of corticosteroids and androgens by the adrenal cortex. The development of insufficiency of the adrenal cortex and the recovery time of its function depends primarily on the duration of treatment and, to a lesser extent, on the dose, time and frequency of taking the drug, as well as on T 1/2 of the active substance. With oral administration of the equivalent of 20-30 mg of prednisolone, adrenal insufficiency can develop within 5-7 days, at lower doses - after about 30 days. In case of discontinuation of the drug after a short (up to 5 days) use in high doses, the restoration of adrenal function can occur in about a week. After prolonged use at high doses, adrenal function may recover within about a year, and in some patients never.

Prednisolone enhances protein catabolism and induces enzymes involved in amino acid metabolism. It inhibits the synthesis and enhances the degradation of proteins in the lymphatic, connective, muscle and skin tissues. With prolonged use, it can reach atrophy of these tissues.

Prednisolone increases glucose availability by inducing hepatic gluconeogenesis enzymes, stimulating protein catabolism (which increases amino acids for gluconeogenesis), and decreasing glucose utilization in peripheral tissues. This leads to an increased accumulation of glycogen in the liver, an increase in the concentration of glucose in the blood and an increase in insulin resistance.

It enhances lipolysis and mobilizes fatty acids from adipose tissue, which increases the concentration of fatty acids in the blood serum. With prolonged treatment, a violation of the redistribution of fats is possible.

It inhibits the formation of bone tissue and enhances its resorption. Reduces the concentration of calcium in the blood serum, which leads to secondary hyperfunction of the parathyroid glands and simultaneous stimulation of osteoclasts and inhibition of osteoblasts. This can lead to inhibition of bone growth in children and young people and the development of osteoporosis in patients of all ages.

Enhances the action of endo- and exogenous catecholamines.

Pharmacological action persists for 30-36 hours.

Pharmacokinetics

Suction

The bioavailability of prednisolone after oral administration ranges from 70 to 90%. Cmax of the drug in serum is reached within 1-2 hours. Food slows down the absorption of prednisolone in the initial phase, but does not affect the overall bioavailability of the drug.

Distribution

At concentrations below 200 ng / ml prednisolone binds to blood serum proteins by 90-95%, while at a concentration of more than 1 mg / ml - by about 70%. It binds mainly to globulins, to a lesser extent - to albumins. The binding of glucocorticoids to globulins is characterized by high affinity, but low binding capacity, and vice versa with albumins. V d of the free fraction of the drug is about 1.5 l / kg.

Penetrates through the placental barrier. Less than 1% of the dose of prednisolone is excreted in breast milk.

Metabolism and excretion

Prednisolone metabolized mainly in the liver, to a lesser extent in the kidneys.

T 1 / 2 of prednisolone from serum is 2.1-3.5 hours, from tissues - 18-36 hours. It is excreted from the body with urine in the form of inactive metabolites, in a small amount - as unchanged prednisolone .

Indications for the use of the drug PREDNISOLONE

— endocrine diseases: primary insufficiency of the adrenal cortex (Addison's disease) and secondary insufficiency of the adrenal cortex (recommended drugs are hydrocortisone and cortisone, synthetic analogues can be used with mineralocorticoids); adrenogenital syndrome (congenital, adrenal hyperplasia) - treatment is prescribed to reduce virilization due to an enzyme deficiency caused by excessive production of androgen in the adrenal glands; administration of sodium is recommended, some patients may also need the administration of mineralocorticoids; acute insufficiency of the adrenal cortex; preoperative period for severe diseases and injuries in patients with adrenal insufficiency; thyroiditis (not purulent);

- severe allergic diseases resistant to other methods of treatment: contact dermatitis, atopic dermatitis, serum sickness, hypersensitivity reactions to drugs, allergic rhinitis (including seasonal), anaphylactic reactions (glucocorticosteroids should be used as an additional treatment, in cases where other methods are ineffective for 1 hour, with reactions requiring restoration of breathing or cardiac activity, or when there is an increased risk of relapse; treatment should be started with an IV or IM injection of a fast-acting GCS), angioedema(GCS is used as additional drug, treatment should be started with an intravenous or intramuscular injection of a fast-acting corticosteroid), acute non-infectious laryngeal edema (recommended drug is epinephrine, if corticosteroids are needed, treatment should be started with an intramuscular or intravenous injection of a fast-acting drug);

- collagenoses (corticosteroids are recommended during an exacerbation or in some cases as maintenance therapy): rheumatic or non-rheumatic myocarditis, dermatomyositis (for children, corticosteroids may be the recommended drug), SLE, granulomatous giant cell mesoarteritis, periarteritis nodosa, recurrent polychondritis, polymyalgia rheumatica, systemic vasculitis;

- dermatological diseases: atopic dermatitis, contact dermatitis, exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe form of erythema multiforme (Stevens-Johnson syndrome), mycosis fungoides, pemphigus, severe psoriasis, severe forms of eczema, pemphigoid;

- diseases of the gastrointestinal tract (in the acute phase, long-term therapy is not recommended): ulcerative colitis, Crohn's disease, severe celiac disease;

- hematological diseases: acquired autoimmune hemolytic anemia, congenital aplastic anemia, anemia due to selective bone marrow hypoplasia, secondary thrombocytopenia in adults, idiopathic thrombocytopenic purpura (Werlhof's disease) in adults;

- liver disease (there are controversies regarding the use of corticosteroids): alcoholic hepatitis with encephalopathy, active chronic hepatitis, non-alcoholic hepatitis in women, subacute liver necrosis;

- hypercalcemia in malignant neoplasms or sarcoidosis;

- not rheumatic diseases joints (short-term, as an additional treatment for exacerbations): acute and subacute bursitis, epicondylitis, nonspecific acute tendovaginitis, post-traumatic osteoarthritis;

- oncological diseases (as palliative therapy, along with specific antitumor therapy): acute and chronic lymphoblastic anemia, granular and agranular lymphomas, breast cancer, prostate cancer, multiple myeloma, fever associated with cancer;

- nephrotic syndrome (glucocorticoids are indicated to induce diuresis or achieve remission in case of proteinuria in idiopathic renal syndrome without uremia, or to improve kidney function in patients with lupus erythematosus). Long-term treatment may be necessary to prevent frequent relapses in idiopathic nephrotic syndrome;

- neurological diseases: tuberculous meningitis with impaired outflow of cerebrospinal fluid (with simultaneous antibacterial treatment), multiple sclerosis in the acute phase, myasthenia gravis (in the treatment of severe cases resistant to standard therapy; GCS may be more effective after thymectomy and in patients who fell ill at the age of more than 40 years; may be necessary for long-term treatment);

- eye diseases (severe acute and chronic allergic and inflammatory processes: iritis, iridocyclitis, chorioretinitis, disseminated posterior uveitis, optic neuritis, sympathetic choroiditis, inflammation anterior section eyeball, allergic conjunctivitis, keratitis (not associated with herpes virus or fungal infection), allergic peripheral corneal ulceration;

- diseases of the oral cavity (accompanied by severe pain and resistant to local therapy; herpes infection should be excluded before starting treatment): desquamative gingivitis (if the diagnosis is confirmed by biopsy and immunofluorescence), changes in the oral cavity in diseases amenable to corticosteroid therapy, such as systemic lupus erythematosus, pemphigus, pemphigoid, Stevens-Johnson syndrome, lichen planus;

- pericarditis (in order to reduce the severity of the inflammatory process and fever);

- respiratory diseases: bronchial asthma, berylliosis, Loeffler's syndrome, symptomatic sarcoidosis, aspiration pneumonia; fulminant or disseminated pulmonary tuberculosis (in combination with anti-tuberculosis therapy), chronic pulmonary emphysema (resistant to therapy with aminophylline and beta-agonists);

- rheumatic diseases (as adjuvant therapy during an exacerbation): ankylosing spondylitis, psoriatic arthropathy, rheumatoid arthritis, juvenile rheumatoid arthritis (with resistance to other therapies), acute gouty arthritis, bursitis in patients with osteoarthritis, Reiter's disease, rheumatic fever;

- for the prevention and treatment of transplant rejection (in combination with other immunosuppressive agents).

Dosing regimen

Set individually depending on the indications, the effectiveness of therapy and the patient's condition. It is recommended to take the entire daily dose of the drug 1 time / in the morning with meals (in accordance with the daily rhythm of secretion of endogenous glucocorticoids), but in some cases more may be needed. frequent use drug.

After obtaining the desired therapeutic effect, it is recommended to reduce the dose to the lowest effective one. Before the planned discontinuation of the drug, the dose should also be reduced gradually.

Daily dose for adults ranges from 5 to 60 mg, up to a maximum of 250 mg /

At multiple sclerosis during an exacerbation the drug is prescribed at a dose of 200 mg / day for 7 days, then 80 mg / day for a month.

children the drug is prescribed at a dose of 140 mcg to 2 mg / kg of body weight / in 3-4 doses.

If a dose is missed, the drug should be taken as soon as possible or, if the next dose is approaching, this dose should be skipped.

You should not take the drug in a double dose.

Side effect

Short-term use of prednisolone, like other corticosteroids, leads to undesirable effects only in exceptional cases. The risk of developing undesirable effects is observed, first of all, in patients taking prednisolone for a long time.

From the side of water and electrolyte balance: sodium and fluid retention, potassium loss, hypokalemic alkalosis.

From the side of the cardiovascular system: symptoms of circulatory failure, increased blood pressure, thrombophlebitis obliterans.

From the musculoskeletal system: muscle weakness, steroid myopathy (more common in women; usually begins with the muscles of the femoral girdle and spreads to the proximal muscles of the shoulder and arm; rarely affects the respiratory muscles), muscle loss, osteoporosis, vertebral compression fracture, aseptic necrosis of the heads of the femur and humerus, pathological fractures of long tubular bones.

From the digestive system: peptic ulcer and its consequences (perforation, bleeding), perforation of the large or small intestine (especially in patients with an inflammatory process in the intestine), pancreatitis, flatulence, ulcerative esophagitis, digestive disorders, increased appetite, nausea.

Dermatological reactions: atrophic streaks, acne, delayed wound healing, thinning of the skin, petechiae, hematomas, erythema, increased sweating.

Allergic reactions: allergic dermatitis, urticaria, angioedema, anaphylactic reactions.

From the side of the central nervous system: increased intracranial pressure with congestive nipple of the optic nerve (false brain tumor - most often in children, usually after too rapid dose reduction, symptoms - headache, blurred vision or double vision), convulsions, dizziness, headache, mental disorders (most often appear within the first 2 weeks of treatment; symptoms may mimic schizophrenia, mania, or delirium; most commonly seen with prednisolone 40 mg/day; women and patients with SLE are most susceptible to symptoms), sleep disturbances.

From the endocrine system: secondary insufficiency of the adrenal cortex and pituitary gland (when taken at a dose> 5 mg / day, especially in stressful situations such as illness, injury, surgery), Itsenko-Cushing syndrome, growth retardation in children, menstrual irregularities, reduced carbohydrate tolerance, manifestation of diabetes mellitus, increased need for insulin and hypoglycemic drugs in patients with diabetes mellitus, hirsutism.

From the side of the organ of vision: posterior pouch cataract (usually resolves after treatment is stopped, but may need to be treated) surgical treatment), increased intraocular pressure, glaucoma (usually after treatment for at least a year), exophthalmos.

Others: negative nitrogen balance, weight gain, increased appetite, bad feeling.

From the side of laboratory indicators: leukocytosis (>20,000 in 1 µl), lymphopenia, monocytopenia, hyperglycemia, glucosuria, hypercalcemia, increase in total cholesterol, LDL, triglycerides in serum, decrease in the concentration of 17-hydroxysteroids and 17-ketosteroids in urine, decrease in the uptake of labeled technitium Tc 99m in bone tissue and tumors of the brain, a decrease in the capture of labeled iodine 123 J and 131 J by the thyroid gland, a weakening of the reaction in skin allergic tests and a tuberculin test.

Taking the drug with meals may reduce gastrointestinal side effects. The effectiveness of neutralizing hydrochloric acid drugs in preventing the formation of ulcers, bleeding of the digestive tract or intestinal perforation in connection with the use of corticosteroids has not been confirmed.

In the event of a steroid myopathy, if it is impossible to refuse a glucocorticoid, replacing it with another one can reduce the manifestations. Due to increased protein catabolism during long-term treatment, an increase in dietary protein may be indicated. The risk of osteoporosis associated with long-term use of corticosteroids can be reduced by taking calcium and vitamin D or, if the patient's condition allows, by performing appropriate physical exercises.

In the event of psychosis or depression, if possible, reduce the dose or stop taking the drug. If necessary, phenothiazine or lithium compounds can be used. Tricyclic antidepressants are contraindicated as they may exacerbate mental disorders caused by corticosteroids.

Contraindications to the use of the drug PREDNISOLONE

- systemic mycoses;

- hypersensitivity to prednisolone or another component of the drug.

The use of prednisolone during pregnancy and lactation

Appointment of GCS to women childbearing age and pregnant women is possible only when the benefit of therapy for the mother outweighs the potential risk to the fetus.

AT experimental studies in animals, the use of corticosteroids caused an increase in the incidence of cleft palate, miscarriages, placental insufficiency and inhibition of fetal development. There are not enough controlled observations in humans. Although suspicions of a teratogenic effect of corticosteroids in humans have not been confirmed, there is evidence indicating an increased risk of developing placental insufficiency, low birth weight and fetal death in cases of GCS use during pregnancy.

Prednisolone stands out with breast milk in a small amount. It is believed that taking prednisolone in a dose of up to 5 mg by the mother during lactation does not cause undesirable effects in the child. However, the use of the drug in higher doses can cause growth inhibition in a child or a violation of the secretion of endogenous hormones of the adrenal cortex. If necessary, long-term administration of the drug during lactation should stop breastfeeding.

special instructions

Prednisolone contraindicated in patients with systemic mycoses and because of the risk of increased infection. When used to treat fungal infections, amphotericin B may sometimes be used to reduce side effects. antifungal drug, however, in these cases, circulatory failure and an increase in the size of the heart, as well as severe hypokalemia, may develop.

In the event of various stressful situations, patients taking corticosteroids should be given a fast-acting corticosteroid in a high dose.

Sudden withdrawal of the drug can lead to the development of adrenal insufficiency, so the drug should be canceled, gradually reducing the dose.

Prednisolone can mask the symptoms of infectious diseases, reduce the body's resistance to infection. Perhaps the manifestation of latent amoebiasis. For people who come from tropical countries, or patients with dysentery caused by unknown causes, amoebiasis should be excluded before prescribing GCS.

With prolonged use of prednisolone, cataracts, glaucoma with possible damage to the optic nerves may occur, and the risk of developing secondary fungal or viral infections also increases.

When used in high doses prednisolone may cause an increase in blood pressure, water and sodium retention, and increased excretion of potassium, in such cases it may be necessary to limit the content of sodium and increase potassium in the diet. Prednisolone also causes increased excretion of calcium.

When applied Prednisolone should not be vaccinated with live virus vaccines due to the possibility of viral replication and the development of viral diseases, as well as a decrease in antibody production. The introduction of inactivated viral or bacterial vaccines may not cause the expected increase in antibody titer, except in cases of vaccination of patients receiving corticosteroids as replacement therapy (for example, in Addison's disease).

The use of the drug in patients with active tuberculosis should be limited to cases of disseminated or fulminant tuberculosis and only when specific anti-tuberculosis therapy is carried out simultaneously. Patients with latent tuberculosis or a positive tuberculin test taking prednisolone . should be monitored for the possibility of developing tuberculosis, and with long-term GCS therapy, such patients should receive prophylactic anti-tuberculosis therapy.

Cancellation of the drug after long-term use may lead to the development of corticosteroid withdrawal syndrome (symptoms may include elevated temperature, myalgia, arthralgia, feeling unwell). These symptoms can appear even in cases where there is no development of adrenal insufficiency. In order to mitigate some of the symptoms of GCS withdrawal syndrome (without inhibition of the hypothalamus-pituitary-adrenal system), acetylsalicylic acid or other NSAIDs can be prescribed.

In patients with hypothyroidism or cirrhosis of the liver, the effect of prednisolone is enhanced.

For herpetic eye infection prednisolone prescribed with caution due to the risk of corneal perforation.

Prednisolone should be used in the minimum effective dose (if dose reduction is possible, it should be gradually reduced).

Against the background of the use of prednisolone, mental disorders (such as euphoria, insomnia, drastic changes mood, personality changes, severe depression, symptoms of psychosis), and pre-existing emotional instability or a tendency to psychotic reactions may increase during treatment.

Prescribed with caution prednisolone in combination with acetylsalicylic acid patients with hypoprothrombinemia.

The drug should be used with caution in nonspecific ulcerative colitis (if there is a threat of perforation); abscesses or other purulent infections, intestinal diverticulosis, fresh intestinal anastomoses, active or latent peptic ulcer, renal failure, arterial hypertension, osteoporosis, myasthenia gravis, diabetes, liver dysfunction, glaucoma, fungal or viral infections, hyperlipidemia, hypoalbuminemia.

It should be borne in mind that in the case of perforation of the gastrointestinal tract in patients taking prednisolone at high doses, symptoms of peritonitis may be mild or not appear at all.

When using the drug, it should be borne in mind that in some cases, corticosteroids can increase or decrease the number and motility of spermatozoa.

The use of corticosteroids may in some cases be useful in the adjunctive treatment of certain diseases associated with HIV infection. However, due to the risk of developing severe, treatment-resistant infections and neoplasms, the decision to use corticosteroids in HIV-infected patients and patients with a developed clinical picture of AIDS should be made after a careful balance of benefits and risks.

Pediatric use

With prolonged use Prednisolone in pediatric practice, careful monitoring of the growth and development of children is necessary.

Influence on the ability to drive vehicles and control mechanisms

It is believed that the drug does not cause a decrease in psychophysical functions and the ability to drive motor vehicles.

Overdose

Taking corticosteroids, even in very high doses, usually does not cause symptoms of acute overdose. Long-term use of corticosteroids can lead to many different symptoms. characteristic of increased activity of hormones of the adrenal cortex, such as: mental disorders, obesity, sodium and water retention, weight gain, excessive hair growth (drug hypertrichosis), the appearance of acne, striae, increased blood pressure, decreased resistance to infections, osteoporosis, digestive manifestations tract.

Treatment: in case of acute overdose, it is recommended to induce vomiting and gastric lavage. There is no specific antidote. Overdose treatment is based on maintaining the life-supporting functions of the body.

drug interaction

With the simultaneous use Prednisolone with NSAIDs, ethanol increases the risk of erosive and ulcerative lesions and bleeding of the gastrointestinal tract.

At joint application Prednisolone with amphotericin B, carbonic anhydrase inhibitors, the risk of developing hypokalemia, myocardial hypertrophy and circulatory failure increases.

With the simultaneous use Prednisolone with paracetamol, the likelihood of hypernatremia, peripheral edema, increased calcium excretion increases, the risk of hypocalcemia, osteoporosis, paracetamol hepatotoxicity increases.

When used together Prednisolone with anabolic steroids, androgens, the risk of developing peripheral edema, acne increases.

With the simultaneous use Prednisolone with anticholinergics (atropine), an increase in intraocular pressure is possible.

When used together Prednisolone With indirect anticoagulants, heparin, streptokinase and urokinase may change the effectiveness of the latter, increases the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract. The dose should be set on the basis of indicators of hemostasis (primarily prothrombin time).

Tricyclic antidepressants may exacerbate prednisolone-related psychiatric disorders. They should not be used to treat this complication.

With the simultaneous use Prednisolone weakens the hypoglycemic effect of oral hypoglycemic agents and insulin (dose adjustment may be required depending on the concentration of glucose in the blood serum).

When used together Prednisolone and antithyroid drugs and thyroid hormones, changes in thyroid function are possible (dose adjustment or withdrawal of the antithyroid drug or thyroid hormones may be required).

Prednisolone there is an increase in the hyperglycemic action of asparaginase.

When combined with oral hormonal contraceptives containing estrogens, it should be borne in mind that estrogens can change the metabolism of prednisolone and its protein binding, which leads to an increase in half-life and enhances the effect of prednisolone.

With the simultaneous use Prednisolone and cardiac glycosides increases the risk of developing cardiac arrhythmias and other toxic effects of glycosides associated with hypokalemia.

With the simultaneous use Prednisolone weakens the action of diuretics, hypokalemia may develop.

Ephedrine can accelerate the metabolism of glucocorticoids (a change in the dose of prednisolone may be necessary).

When used together with Prednisolone you may need to increase the dose of folic acid preparations.

Liver enzyme inducers reduce the effect of corticosteroids.

When used together Prednisolone and immunosuppressive drugs increase the risk of developing infections, lymphomas and other lymphoproliferative diseases.

With the simultaneous use Prednisolone and isoniazid, a decrease in the concentration of the anti-tuberculosis drug in the blood plasma is possible, mainly in people with rapid acetylation (dose adjustment may be required).

When used together Prednisolone and mexiletin, it is possible to accelerate the biotransformation and reduce the concentration of mexiletin in the blood plasma.

Mitotane reduces the activity of the adrenal cortex and during its use the use of corticosteroids is usually necessary, but at doses higher than usual, since mitotane changes the metabolism of glucocorticoids.

Prednisone-associated hypocalcemia may exacerbate synaptic blockade induced by non-depolarizing muscle relaxants, leading to an increase in the duration of respiratory depression and paralysis.

Against the background of simultaneous reception Prednisolone there is an increase in the excretion of salicylates and a decrease in their concentration in the blood plasma, which is accompanied by the risk of ulceration and bleeding of the gastrointestinal tract.

With excessive intake of sodium in the body against the background of the use Prednisolone possible development of edema, arterial hypertension, so it may be necessary to limit the diet of sodium and drugs with a high sodium content. Sometimes the use of corticosteroids requires additional administration of sodium.

When vaccinating with live viral vaccines during the period of GCS use in immunosuppressive doses, the development of viral diseases is possible, as well as a decrease in the effectiveness of vaccinations. When vaccinated with other vaccines, the risk of developing neurological complications and reducing the production of antibodies increases.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Thanks

Prednisolone is a synthetic glucocorticoid hormone(glucocorticosteroid), similar in spectrum therapeutic activity 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, bronchial tubes, etc.) and profuse exudation, which are potentially life-threatening.

This drug is used only as part of complex therapy to relieve severe inflammation, edema, itching, exudation and proliferation in vasculitis, rheumatism, arthritis, myocarditis, pericarditis, dermatomyositis, scleroderma, periarteritis, bronchial asthma, Quincke's edema, Bechterew's disease, drug allergy, 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 the pharmaceutical plant in Nizhny Novgorod, Samara, Tomsk and other cities, but was always sold in pharmacies under the same name "Prednisolone".

Today, many pharmaceutical factories, wanting 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 any subjective reasons people might like it 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.

Since Prednisolone has a very powerful effect, 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 maintain a normal state and prevent the worsening 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 joint pathologies (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 products, 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 (provoked by the ingestion of foreign bodies, sputum, water, tissue decay products, etc. into the lungs);
• Beryllium;
• Loeffler's syndrome;
• Lung cancer;
• Chorea;
• Hepatitis;
• Pathology of the 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 the general condition of the 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. That is, the optimal time for the injection of the solution is the interval between 6-00 and 8-00 in the morning. 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:

• AT 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 the 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 in order to prevent 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

The 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 the acute condition returns to normal, 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.

Daily dosage solution 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;
• Over 14 years old - adult dosages.

After Prednisolone (edema, overweight)

With enough persistence in going to the gym 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 using Prednisolone leads to an increase in the amount of subcutaneous tissue in 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.

prednisone for allergies

Prednisolone is a hormonal drug that is usually used for acute illnesses and life threatening states. When is it prescribed to children and in what form is it used? How does such a medication act on a child's body, and what adverse reaction can a child experience during treatment with Prednisolone?

Release form

Prednisolone is manufactured by several companies, and sometimes there is a word next to the name of the drug indicating the manufacturer (for example, Prednisolone Nycomed). The drug is represented by the following types.

• Tablets. Usually they are flat-cylindrical and white in color, and one pack contains from 10 to 120 tablets (most often, polymer bottles of 100 pieces are produced).
• Ointment, which is used for external processing. This is a thick white mass placed in aluminum tubes in an amount of 10 g or 15 g.
• Ampoules with solution which can be injected into a muscle or injected into a vein. Such ampoules contain 1 or 2 ml of a clear solution. The liquid is colorless, yellowish or yellow-greenish. One package includes 3, 5 or more ampoules.

In suppositories, drops, capsules, syrup or other forms, Prednisolone is not released.

Compound

All dosage forms of the drug contain prednisolone as the main ingredient. It is presented in the following dosages:

• in 1 tablet - 1 mg or 5 mg;
• in 1 ml solution for injection - 15 mg or 30 mg in the form of sodium phosphate;
• in 1 gram of ointment - 5 mg.

Excipients in different forms and drugs from different manufacturers are different, so the exact composition should be found in the instructions or on the packaging of a particular medication.

Operating principle

Prednisolone is a synthetic hormone from the group of glucocorticosteroids and acts in a similar way to hormonal compounds that are produced in the adrenal glands.

Such a substance:

• relieves shock and prevents death in a state of shock;
• eliminates quickly and effectively inflammatory process, regardless of its severity and localization;
• suppresses exudation - active release of fluid from inflamed tissues;
• stops the development of an allergic reaction and eliminates allergy symptoms such as rash, swelling, itching and others;
• stops the active reproduction of cells at the site of damage, which prevents the appearance of scars;
• suppresses the immune system.

All these effects of Prednisolone develop very quickly, and the effect of the drug itself is very strong, so it is used in case of a threat to life or in cases where other medicines have been ineffective. If there is a possibility of replacing such a drug with other drugs, it should be used.

Prednisolone also has the following properties:

• stimulation of protein breakdown in tissues and blood flow, as well as the synthesis of protein molecules in liver cells;
• increased blood glucose levels;
• retention of Na + and water, which causes swelling;
• increased excitability of nerve cells in the brain;
• reduction of potassium absorption in the gastrointestinal tract and stimulation of its excretion from the body;
• redistribution of fat reserves with an increase in its amount in the upper body;
• lowering the threshold of convulsive readiness;
• inhibition of the production of glucocorticoids, as well as FSH and TSH.

Such effects of the drug are not curative, but should be taken into account, since they cause side effects.

Indications

Bronchial asthma

joint inflammation

• acute disorder adrenal function;
• allergic conjunctivitis;
• uveitis and other inflammatory eye diseases;
• agranulocytosis, acute leukemia, thrombocytopenic purpura, hemolytic anemia and other pathologies of the hematopoietic system;
• organ transplant;
• acute hepatitis or hepatic coma;
• thyrotoxic crisis or thyroiditis;
• myeloma;
• sarcoidosis, tuberculosis, aspiration pneumonia and other severe lung diseases;
• poisoning with alkalis and other caustic liquids.

Poisoning

Prednisolone ointment is prescribed for eczema, atopic dermatitis, contact dermatitis, toxidermia, psoriasis and other skin diseases. In addition, this form is prescribed for tendovaginitis, bursitis and keloid scars.

At what age are they prescribed?

There are no age restrictions for the treatment of children with Prednisolone, but due to the fact that such a medication can adversely affect growth processes in childhood, this hormone is prescribed only if there are serious indications and only under medical supervision.

In addition, it is important not to forget that such a remedy is used only in acute conditions and they always try to prescribe it in the minimum dose and for the shortest possible time.

Contraindications

If Prednisolone is prescribed to a child for health reasons, then there is only one contraindication for its use - intolerance to such a medicine. Nevertheless, many diseases require increased attention of the doctor when prescribing Prednisolone. Such diseases include various pathologies of the gastrointestinal tract, infections (chickenpox, measles, herpes, tuberculosis, etc.), endocrine diseases, severe liver pathologies, glaucoma, and so on.

If a child has any serious illness, the issue of using Prednisolone is decided individually.

Side effects

During treatment with Prednisolone in injections or tablets, various negative effects can be observed, for example:

• vomiting or nausea;
• decreased activity of the adrenal glands;
• decreased glucose tolerance;
• development of Itsenko-Cushing's syndrome;
• change in appetite;
• the development of diabetes mellitus (it is called steroid);
• the appearance of erosive esophagitis, bleeding from the wall of the stomach or intestines, as well as steroid ulcers of the gastrointestinal tract;
• growth retardation;
• delayed sexual development;
• violation of the rhythm of heartbeats, increased blood pressure, bradycardia;
• bloating;
• mental disorders, such as depression or paranoia;
• rise in intracranial or intraocular pressure;
• headaches or insomnia;
• increased sweating;

insomnia

growth retardation

Side effects

• weight gain;
• eye infection (secondary);
• the appearance of peripheral edema;
• weakness, fatigue, muscle pain and other symptoms of hypokalemia;
• the appearance of striae or acne;
• allergic reactions in the form of skin rash, itching or other symptoms;
• exacerbation of infectious diseases;
• withdrawal syndrome.

The use of the ointment can provoke the appearance of "asterisks", skin itching, excessive dryness, acne, burning and other skin problems.

If a significant area of ​​the skin is treated with such Prednisolone, the consequences of the treatment will be similar to the side effects from injections or taking pills.

Fast fatiguability

Body mass gain

Instructions for use

form of medicine, the right dosage and the duration of the use of Prednisolone is determined by the doctor, taking into account many factors, among which are the diagnosis, the patient's condition, the age of the child, and his weight in kilograms. Prednisolone for injection can be administered intravenously both by jet and through a dropper (the drug must be diluted with saline). It is intravenous injections that are used in acute conditions when immediate assistance is required.

If injections into a vein are not possible, the drug is administered intramuscularly, and when the condition improves, injections are replaced with tablets. If the drug is prescribed for a long period, it should be discontinued gradually, reducing the daily dose. The longer the treatment was carried out, the slower the drug is canceled.

Tableted Prednisolone is most often given once at 6-8 o'clock in the morning, since it is at this time that glucocorticoids are secreted in the human body. If the dosage is very large, it can be divided into several doses. In this case, the medication is given in a larger dose in the morning, and the remaining amount is taken at 12 o'clock. Prednisolone tablets are recommended to be taken with meals or immediately after meals. The medicine is washed down with a small amount of liquid.

Prednisolone is a glucocorticoid drug that is not too intense in effect, has a synthetic nature. It is hormonal and is most often used for systemic treatment.

Available in the form of tablets, suspensions and injection solutions. The basic active ingredient is prednisolone.

The tablet has a flat-cylindrical shape, white color consists of:

• 5 mg of the active ingredient;
• Ca stearate;
• C6H10O5)n - potato starch;
• lactose monohydrate.

The injection solution is clear and discolored, rarely has a slight tint. In its composition:

1. 30 mg prednisolone;
2. Disodium salt of ethylenediaminetetraacetic acid;
3. Na hydrogen phosphate;
4. Dihydrogen phosphate Ka;
5. 97% ethanol alcohol;
6. injection water.

The composition of the suspension and solution for injection are very similar.

Pharmacodynamics

There is a suppression of leukocyte macrophage (tissue) numbers. The migration of leukocytes to the areas affected by inflammatory processes is limited. The possibility of phagocytosis in a macrophage is violated, the synthesis of interleukins of different groups is inhibited.

Lysosomal membranes are stabilized, the concentration of proteolytic enzyme formations in the inflamed area decreases. It also reduces vascular permeability, because histamine is released. The work of fibroblasts and the synthesis of collagen fibers is suppressed.

Phospholipase A2 is activated, which reduces the synthesis of prostaglandins and leukotrienes. The release of cyclooxygenase is inhibited, which also suppresses the production of prostaglandins. The number of circulating lymphocyte, basophil, monocyte, eosinophil decreases, because they move from the bloodstream to the lymph and its tissues. Synthesis of antibodies can be suppressed.

The release of adrenocorticotropic hormone and β-lipotropin is inhibited, while the concentration of circulating β-endorphin does not fall. The production of thyroid-stimulating hormone and follicle-stimulating hormone is suppressed. The vessels have a vasoconstrictor effect. It has a dose-dependent effect on: metabolic processes of protein, carbohydrate and fat.

Gluconeogenesis is stimulated and the uptake of amino acids by the cells of the liver and kidneys is improved, the activity of the enzymes of the process is enhanced. Glycogen deposition increases, the work of glycogen synthetase and the synthesis of glucose molecules from the products of protein metabolism also increases. A high concentration of sugar triggers increased insulin synthesis.

The drug inhibits the process of sugar capture by fat cells, so lipolysis begins. But due to the increase in the amount of insulin, lipogenesis is stimulated, due to which fat accumulates anyway.

Catabolism occurs in:

• Lymph tissues;
• Connective;
• Muscular;
• Fatty;
• Cutaneous;
• Bone.

It does not greatly destabilize the water-electrolyte exchange (Na and H2O ions are retained, and Ca and Ka are removed). The possibility of the occurrence of Itsenko-Cushing's syndrome and osteoporosis significantly limits the duration of prednisone therapy.

High dosages can increase GM excitability and lower the seizure threshold. It is a mediator of excessive synthesis of pepsin and hydrochloric acid in the gastrointestinal tract, which can cause ulcerative formations.

Systemic use causes such effects:

1. Antiallergic;
2. Anti-inflammatory;
3. Antiproliferative;
4. Immunosuppressive.

Compared with other drugs from the group, the% effectiveness of prednisolone is higher.

Pharmacokinetics

Oral consumption of the drug helps it to be well absorbed in the gastrointestinal tract. The level of maximum concentration in plasma is fixed for 1-2 hours after use. Has high bioavailability. Tightly binds to plasma proteins (about 96%), a large part of it is bonded to transcortin and albumin.

It is metabolized mainly in the cells of the liver, kidneys, bronchus and small intestine. Oxidized forms can be glucuronized and sulfated. About 22% of the drug in its basic form is excreted by the kidneys, the rest takes the form of conjugated and free metabolites. The half-life of the drug is 3 hours. Prednisolone can penetrate the placental barrier, enters breast milk.

In what situations is it prescribed?

The spectrum of use of prednisolone is very wide.

It is prescribed for the following phenomena:

• Preventive measures to avoid transplant rejection;
• Prevention and suppression of vomiting and nausea during cytostatic therapeutic;
• Increased calcium concentration due to cancer;
• Eye diseases of an autoimmune and allergic nature: allergic conjunctivitis, ulcerative formations on the cornea due to allergies, non-purulent keratitis, iridocyclitis, iritis, anterior and posterior inflammatory processes vascular network sluggish eye, optic neuritis;
• Cerebral edema during surgery, after trauma and radiation exposure, in the presence of tumors in the brain (the drug is used in the parenteral glucocorticosteroid group);
• Skin and autoimmune diseases and disorders: Lyell's syndrome, eczema formations, seborrheic and exfoliative dermatitis, psoriatic crusts, bullous dermatitis herpetiformis, blister formations;
• Blood and hematopoietic organs: decrease in the number of leukocytes, suppression of proliferation, multiple myeloma, acute myeloid and lymphoid leukemias, malignant diseases of the lymph and lymphoid tissues, susceptibility to bleeding due to thrombocytopenia, secondary thrombocytopenia, various types of anemia (autoimmune hemolytic and erythroid- hypoplastic in congenital form);
• Gastrointestinal disorders: inflammatory bowel disease, ulcerative colitis in a non-specific form, local enteritis;
• Nephrotic syndromes;
• Different types of hepatitis;
• Diseases of an autoimmune nature;
• Hypoglycemic disorders;
• Chronic and acute forms of allergies: to drugs, food, serum sickness, rhinitis, angioedema, seasonal rhinoconjunctivitis, atopic and contact forms of dermatitis involving large areas of the skin, urticaria, Stevens-Johnson syndrome, acute inflammatory reactions in the skin;
• Thyroiditis subacute form;
• adrenogenital syndrome;
• Congenital adrenal hyperplasia;
• Kidney failure of a secondary and primary nature, often prescribed after surgery to remove the adrenal glands;
• Pulmonary and meningitis tuberculosis, additional drugs are also taken;
• Eosinophilic pneumonia of Leffler and aspiration, inflammatory processes in the connective lung tissues;
• Lung cancer, treatment is carried out in combination with cytostatics;
• Sarcoidosis in severe forms, acute alveolitis, fibrous formations in the lungs;
• The presence of bronchial asthma or a predisposition to it;
• Rheumatoid and juvenile arthritis, arthritis against the background of psoriasis and gout, ankylosing spondylitis, osteoarthritis, scapulohumeral periarthritis, bursitis, Still's syndrome, degenerative-dystrophic processes in the places where muscle tissue is attached to the bone, inflammation in the synovial articular membrane, inflammation of the tendons in a non-specific form;
• Multiple sclerosis;
• Lupus erythematosus;
• Connective tissue diseases of the autoimmune type;
• Nodular diseases of small blood vessels;
• Systemic disease of connective tissues in smooth and skeletal muscles.

Remember that you cannot set the rhythm of therapy on your own, this must be done by a doctor. It is possible that the patient will need supportive therapy or a preliminary clinical examination. Wrong treatment can cause very complex and sometimes fatal consequences.

Contraindications

If the therapy is short-term, the only contraindication will be intolerance to the individual components of the drug.

How to use?

Tablets are taken orally and are not chewed, washed down with a glass of water. When using the drug, the circadian rhythm of GCS secretion is taken into account: the largest dose is taken in the morning (preferably before 9 am), and the rest in the evening. At the end of therapy, the dosage of the drug is reduced gradually, it is impossible to abruptly stop taking the drug.

For adults: in substitution therapy and acute forms of diseases, the daily dose can be up to 30 mg. The daily maintenance dosage is up to 10 mg. In some situations, the initial dosage may reach up to 100 mg / day, maintenance - 15 mg / day.

For children: the starting dose per day is up to 2 mg per 1 kg of the child's weight, this amount of funds is distributed for 4 or more doses. To maintain therapy, children should consume no more than 600 micrograms per kilogram of body weight.

Injections are given intramuscularly (into the buttock, injected deeply) and intravenously. It is recommended to inject up to 46 mg of the product (about 1.5 ampoules). In some cases, up to 60 mg of the drug is administered additionally.

If the patient has any type of shock: up to 300 mg given as a drip infusion or intravenously(but very slowly). If the shock is cardiogenic, it is possible to enter 1 or more grams of the drug. In case of psycho-emotional disorders, injections are made very carefully, it is more expedient to carry out therapy with prednisolone in tablet form.

The volume of a single dose in young patients: a child from two to 12 months - about 3 mg per kg of weight intravenously or intramuscularly, from a year to 14 - 2 mg per kg intravenously with a duration of at least 3 minutes or intramuscularly. If necessary, the administration of the drug is duplicated half an hour after the first injection.

This drug can have a serious effect on the functioning of the liver and kidneys in both adults and children.

It also contains lactose and its derivatives, so it cannot be used to treat diabetics and those who cannot tolerate milk sugar.

Use in pregnant women and children

This remedy negatively affects the course of pregnancy. In the 1st trimester, the remedy is used only based on vital signs. If the drug cannot be replaced by anything, then patients with a normal pregnancy can be prescribed the same treatment as women who are not in a position.

Long-term use of the drug during the period of gestation is fraught with a delay in the development of the baby inside the womb and the appearance of a gothic sky, but these risks are insignificant. Here in the 3rd semester, it is better for women to completely avoid taking prednisone, because the fetus may experience an atrophic process in the adrenal glands.

With this phenomenon, replacement therapy is necessary, which is undesirable for a newborn.

During the lactation period, drugs of this group are also taken carefully. This is due to the fact that in small concentrations, prednisolone still enters the mother's milk. In order to identify the likely symptoms of adrenal suppression, you need to constantly monitor babies who are breastfed (if their mothers take prednisolone and its derivatives).

Medical procedures in children in the growth phase, using glucocorticosteroids, are carried out only if there are exceptional indications and under the constant supervision of a pediatrician. If a child has asthma, then the drug can not be used simultaneously with sympathomimetic aerosols.

If a child is being treated with this drug and at the same time is in contact with patients with chickenpox and measles, he is prescribed drugs from the group of specific immunoglobulins.

Side effects

The extent and degree of expression of these effects varies with the interval of intake, the volume of doses consumed and the possibility of adhering to the circadian regimen.

• Cardiovascular system - increased heart rate, violation of the sinus rhythm of heart contractions, a steady increase in pressure in the arteries, the onset or recurrence of heart failure, failures in ECG results(similar to elevated potassium levels). In the presence of an acute and subacute form of a heart attack, necrotic foci grow, scarring is inhibited, which is fraught with a rupture of the heart muscles;
• Lymphatic system and blood - the appearance of leukocytes in the urine and stimulation of bonding in various dispersion systems, which can cause thromboembolism and thrombosis;
• Nervous system (CNS and peripheral) - headache and dizziness, a false tumor in the cerebellum, convulsions may appear, intracranial pressure increases;
• Subcutaneous tissue and skin in general - regeneration processes slow down, dotted hemorrhages appear, hematomas, hemorrhages in the mucous membranes and different layers of the skin, stretch marks, the epidermal layer becomes thinner, different kind rash, hypo- and hyperpigmentation, development of purulent lesions;
• Connective tissue, bones and muscles - ossification is inhibited in babies (growth zones in the epiphysis are closed), osteoporosis begins, bones break intensely, necrotic processes begin in the femoral head and humerus, myopathy, atrophic processes in the muscles, tendons may rupture;
• Sensory systems - an increase in pressure inside the eye with grazing of the optic nerve, the risk of subcapsular cataract and the development of a secondary infection of a viral, bacterial and fungal nature increases. The cornea may change and the eyeball will move forward;
• Digestive tract - flatulence, pain in the epigastric region, the patient vomits and feels sick, ulcers and perforations appear in the cavities, erosive esophagitis, jumps in the intensity of appetite, hiccups. May increase the activity of liver transaminases and alkaline phosphatase;
• Endocrine system - the indicator of glucose tolerance falls, chronic diabetes mellitus begins or becomes active, the hypothalamic-pituitary-adrenal system is inhibited, the development of children is inhibited, the onset of menstruation in girls. Perhaps the appearance of Itsenko-Cushing's syndrome;
• General metabolism - an increase in the amount of potassium, the processes of disintegration of protein formations intensify, weight grows, sodium and water are retained, increases in heart rate, myalgia, spasms and weakness of muscle tissues;
• Immune system - anaphylactic shock, angioedema, different types of rashes, scabies, urticaria;
• Psycho-emotional disorders - manic-depressive psychosis, hallucinations, causeless paranoia, depression, irritability, sleep disturbances and anxiety;
• With invasions and infections, the body's resistance to third-party pathogens decreases;
• Others: ulcers, swelling in different areas, urolithiasis.

Interaction with other tools

Simultaneous consumption of prednisolone can stimulate different effects. The most common complexes:

Long-term therapy with prednisolone increases the amount of folic acid in the body. It also reduces the absorption of calcium in the intestines and weakens the effect of D-group vitamins.

It is forbidden to mix the drug with others in the same syringe and one infusion medium. If the solution is combined with heparin, precipitation occurs.

The drug is absolutely incompatible with sympathomimetic agents in the aerosol format to eliminate panic attacks in children over 12 (respiratory paralysis may develop).