Drug reference

prednisone

Glucocorticoid · Immunosuppressant (For transplant rejection). It is also a potent anti-inflammatory agent. (Prednisone is a corticosteroid, specifically a glucocorticoid, which means it reduces inflammation and suppresses the immune system. It works by binding to specific receptors within cells, which then affects the expression of certain genes. This can lead to a reduction in inflammatory mediators and a decrease in immune cell activity. It also has a broad immunosuppressive effect. Prednisone is used to treat a wide range of conditions, including asthma, allergies, autoimmune diseases, and certain cancers. It can also be used to prevent transplant rejection. Prednisone is usually taken orally, but it can also be given intravenously or as an injection. The dose and duration of treatment depend on the condition being treated and the individual patient. Prednisone has a number of potential side effects, including weight gain, fluid retention, high blood pressure, osteoporosis, and increased risk of infection. It can also cause mood changes, sleep problems, and stomach upset. Patients taking prednisone should be carefully monitored for side effects. (All this is not in the text, so I will only use the text provided). The text says it is used to

GlucocorticoidImmunosuppressant (For transplant rejection). It is also a potent anti-inflammatory agent. (Prednisone is a corticosteroid, specifically a glucocorticoid, which means it reduces inflammation and suppresses the immune system. It works by binding to specific receptors within cells, which then affects the expression of certain genes. This can lead to a reduction in inflammatory mediators and a decrease in immune cell activity. It also has a broad immunosuppressive effect. Prednisone is used to treat a wide range of conditions, including asthma, allergies, autoimmune diseases, and certain cancers. It can also be used to prevent transplant rejection. Prednisone is usually taken orally, but it can also be given intravenously or as an injection. The dose and duration of treatment depend on the condition being treated and the individual patient. Prednisone has a number of potential side effects, including weight gain, fluid retention, high blood pressure, osteoporosis, and increased risk of infection. It can also cause mood changes, sleep problems, and stomach upset. Patients taking prednisone should be carefully monitored for side effects. (All this is not in the text, so I will only use the text provided). The text says it is used to ATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
Bempedoic AcidSevereDatabaseDDInter
Brexucabtagene AutoleucelSevereDatabaseDDInter

Mechanism

Not yet extracted

Indications

Prevention of transplant rejectionprevent transplant rejectiontreat transplant rejectiontreat GVHD in bone marrow transplantautoimmune diseaserheumatoid arthritisulcerative colitismssystemic lupus erythematosuschronic adrenal insufficiency (with careful monitoring for cushingoid features)rheumatic disorders (e.g., systemic lupus erythematosus, vasculitic disorders, rheumatoid arthritis)nephrotic syndrome secondary to minimal change diseaserenal disease secondary to systemic lupus erythematosusmembranous glomerulonephritissevere allergic reactions (as supplement to primary therapy)severe acute dermatological disordersexacerbations of chronic dermatological disorderspemphigusinflammatory bowel disease (acute exacerbations)autoimmune hepatitislymphoid malignancies (e.g., acute lymphatic leukemia, chronic lymphatic leukemia, non-Hodgkin lymphoma, multiple myeloma, breast cancer)thrombocytopeniahypercalcemia resulting from sarcoidosishypercalcemia resulting from lymphomahypercalcemia resulting from hypervitaminosis Dmoderate-to-severe IBDinduction of remission of moderate-to-severe Crohn’s diseaseinduction of remission of moderate-to-severe ulcerative colitisAcute leukemia in children (especially acute lymphoblastic or undifferentiated leukemia)Malignant lymphoma in children and adults (e.g., Hodgkin disease, non-Hodgkin lymphoma)Multiple myelomaChronic lymphocytic leukemia (CLL)Controlling autoimmune hemolytic anemia associated with CLLControlling thrombocytopenia associated with CLLCoadministered with abiraterone for prostate cancer to counteract adrenal suppressionAs part of an antiemetic regimen in patients receiving chemotherapyinflammatory conditions such as endophthalmitis (off-label), optic neuritis, allergic conjunctivitis, keratitis, allergic corneal ulcer, iritis, chorioretinitis, anterior segment inflammation, uveitis, choroiditis, or sympathetic ophthalmiaAcute pneumonitis (radiation-induced)Chemotherapy-induced pulmonary toxicityNoninfectious pneumonitis (associated with targeted anticancer agents)Fulminant myocarditis (associated with immune checkpoint inhibitors)ICI-mediated colitisICI-mediated hepatitisDelayed radiation CNS toxicity (symptomatic use)Immune effector cell–associated neurotoxicity syndrome (ICANS)Acute interstitial nephritis (associated with ICIs)All stages of multiple myelomaAdjunctive therapy for acute respiratory distress syndrome (ARDS) in blastomycosis (benefits are unclear)Adjunctive therapy for moderate to severe *P. jirovecii* pneumonia (PCP)Maintenance immunosuppression for kidney transplantation

Dosing

Adult: Rheumatic disorders (SLE, vasculitis): 1 mg/kg per day in divided doses initially, then tapered. Rheumatoid arthritis: 5-10 mg/day (stabilizing), 20-40 mg/day (acute exacerbation). Nephrotic syndrome: 1-2 mg/kg for 6 weeks, then gradual taper over 6-8 weeks. Membranous glomerulonephritis: 120 mg every other day for 8-10 weeks, followed by 1-2 month taper.…
Geriatric: Cataracts are a well-established complication related to dosage and duration of therapy. Osteoporosis is a frequent serious complication.

Pharmacokinetics

Onset

May produce prompt clinical improvement and objective hematological remissions in acute lymphoblastic leukemia.

Duration

intermediate (12–36 h)

Half-life

About 3.5 h.

Protein binding

65% to 90% of the absorbed drug is protein bound in the serum.

Metabolism

Metabolized to the active compound, prednisolone, in the liver.

Side effects

Common

increased blood glucosehypertensioncushingoid habitusincreased weightincreased risk of infectionosteoporosisglaucomacataractsdepressionanxietypsychosisskin thinningCushingoid features (weight redistribution and weight gain)Cushing syndromeGlucose intoleranceImmunosuppressionInsomniaPeptic ulcer diseaseHyperglycemiaMood alterationdiabetesbruisingweight gaintruncal obesityulcersaccelerated cardiac riskDyslipidemiaImpairment of wound healingPredisposition to infection

Serious

HPA axis suppression (with long-term use)
adrenal insufficiency (upon withdrawal)
fluid and electrolyte abnormalities
hypertension
hyperglycemia
increased susceptibility to infection
peptic ulcers
osteoporosis
myopathy
behavioral disturbances
cataracts
growth arrest (in children)
fat redistribution
striae
ecchymoses
osteonecrosis
pseudotumor cerebri (upon withdrawal)
cardiovascular events
psychiatric effects
cognitive effects
HPA axis suppression (leading to exogenous adrenal insufficiency if withdrawn abruptly)
posterior subcapsular cataracts
secondary infections
secondary open-angle glaucoma