Prednisolone is a steroid medication used to treat certain types of allergies, inflammatory conditions, autoimmune disorders, and cancers. Some of these conditions include adrenocortical insufficiency, high blood calcium, rheumatoid arthritis, dermatitis, eye inflammation, asthma, and multiple sclerosis. It can be taken by mouth, injected into a vein, used topically as a skin cream, or as eye drops.Side effects with short-term use include nausea and feeling tired. More severe side effects include psychiatric problems, which may occur in about 5% of people. Common side effects with long term use include bone loss, weakness, yeast infections, and easy bruising. While short-term use in the later part of pregnancy is safe, long-term use or use in early pregnancy is occasionally associated with harm to the baby. It is a glucocorticoid made from hydrocortisone (cortisol).Prednisolone was discovered and approved for medical use in 1955. It is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. In 2019, it was the 139th most commonly prescribed medication in the United States, with more than 4 million prescriptions.
Adverse effects
Adverse reactions from the use of prednisolone include:
Increased appetite, weight gain, nausea, and malaise
Increased risk of infection
Cardiovascular events
Dermatological effects including reddening of face, bruising/skin discoloration, impaired wound healing, thinning of skin, skin rash, fluid build up and abnormal hair growth
Hyperglycemia; patients with diabetes may need increased insulin or diabetic therapies
Menstrual abnormalities
Lower response to hormones, especially during stressful instances such as surgery or illness
Change in electrolytes: rise in blood pressure, increased sodium and low potassium, leading to alkalosis
GI system effects: swelling of stomach lining, reversible increase in liver enzymes, and risk of stomach ulcers
Muscular and skeletal abnormalities, such as muscle weakness/muscle loss, osteoporosis (see steroid-induced osteoporosis), long bone fractures, tendon rupture, and back fractures
Neurological effects, including involuntary movements (convulsions), headaches, and vertigo
Behavioral disturbances
Nasal septum perforation and bowel perforation (in some pathologic conditions).Withdrawal from prednisolone after long-term or high-dose use can lead to adrenal insufficiency. Pregnancy and breastfeeding
Although there are no major human studies of prednisolone use in pregnant women, studies in several animals show that it may cause birth defects including increase cleft palate. Prednisolone should be used in pregnant women when benefits outweigh the risks and children born from mothers using prednisolone during pregnancy should be monitored for impaired adrenal function. Prednisolone is found in breast milk of mothers taking prednisolone. Pharmacology
As a glucocorticoid, the lipophilic structure of prednisolone allows for easy passage through the cell membrane where it then binds to its respective glucocorticoid receptor (GCR) located in the cytoplasm.