Prednisolone

Indication:
Reduce inflammation in acute attacks of Crohns and Ulcerative colitis.
Maintain remission of the above.

Formulations:
Prednisolone Tabs 1mg, 5mg, 25mg
Soluble 5mg
Methylprednisolone succinate Inj 40mg, 125mg, 500mg, 1g

Dose:
Acute inflammation.
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.

Interactions:
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.

Notes:
Methylprednisolone succinate is indicated for IV therapy, not methylprednisolone acetate.
Converting methylprednisolone to prednisolone, reduce dose by 20%.

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