prednisone: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
prednisone: clinical details
Prescribing considerations
- Confirm the selected preparation contains prednisolone sodium phosphate rather than prednisone.
- Use requires continuing assessment of clinical benefit against infection, metabolic, psychiatric, ocular, cardiovascular, gastrointestinal and skeletal risks.
- Assess prior systemic corticosteroid exposure and risk of hypothalamic–pituitary–adrenal suppression before withdrawal.
- Review vaccination status, infection exposure and need for a steroid treatment or emergency card.
- Account for sodium content and preservative hypersensitivity when selecting the oral solution.
Contraindications and cautions
- Hypersensitivity to prednisolone or an excipient.
- Systemic infection unless appropriate anti-infective treatment is being used.
- Live-virus immunisation as specified by the selected product information.
Monitoring
- Clinical response and features of adrenal suppression or withdrawal.
- Infection and relevant exposure to chickenpox, shingles, measles or tuberculosis.
- Blood pressure, weight, fluid retention, glucose and electrolytes where clinically relevant.
- Bone health, muscle symptoms and skin effects during prolonged treatment.
- Mood, behaviour, sleep and other psychiatric symptoms.
- Visual symptoms and ocular complications.
- Growth in children and adolescents.
- Renal function and blood pressure particularly in systemic sclerosis.
Clinical pharmacology
Prednisolone sodium phosphate provides prednisolone, a synthetic glucocorticoid. It is readily absorbed orally, substantially protein-bound, metabolised mainly in the liver and eliminated predominantly in urine as unchanged medicine and metabolites.
Formulation and product differences
- The selected product is an oral solution supplied with a graduated oral syringe and bottle adaptor.
- It contains parahydroxybenzoate preservatives that may cause delayed allergic reactions, plus sodium and orange flavour containing propylene glycol.
- The unopened product requires refrigeration and protection from light. After opening, follow the product-specific temperature and discard-after-opening instructions.
prednisone preparations and strengths
Oral solution
Route: Oral
Strengths: 10 mg/mL
prednisone interactions
Check prescribed, over-the-counter and herbal products with a pharmacist or prescriber. Important interactions include:
Aspirin and NSAIDs, including ibuprofen
Combined use increases the risk of gastrointestinal ulceration and bleeding.
Warfarin and other coumarin anticoagulants
The anticoagulant effect and bleeding risk may increase, requiring closer coagulation monitoring.
Rifampicin, rifabutin and enzyme-inducing antiseizure medicines
They can increase corticosteroid metabolism and reduce its clinical effect.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.