Reduce inflammation in acute attacks of Crohns and Ulcerative colitis.
Maintain remission of the above.
Prednisolone Tabs 1mg, 5mg, 25mg
Methylprednisolone succinate Inj 40mg, 125mg, 500mg, 1g
Prednisolone 2mg/kg daily (max 40mg)
(if used >7days, decrease over 14 days)
Hydrocortisone is required to cover periods where the patient is to be nil by mouth or in the post operative period.
Acute inflammation: 50mg qds
Peri-operative cover: 20mg qds
Side effects: Dyspepsia, peptic ulceration, myopathy, osteoporosis, adrenal suppression, hirsutism, weight gain, negative nitrogen and calcium balance, increased appetite, immunosupression, fluid and electrolyte disturbances.
NSAIDs – increased risk of bleeding
Carbamazepine, Phenobarbitone, Phenytoin – increased rate of metabolism of steroid.
Cyclosporin – increased prednisolone levels with increased cyclosporin levels with high dose methylprednisolone.
Diuretics – increased risk of hypokalaemia.
Methylprednisolone succinate is indicated for IV therapy, not methylprednisolone acetate.
Converting methylprednisolone to prednisolone, reduce dose by 20%.