Prednisone




Prednisone
Systematic (IUPAC) name
17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl- 7,8,9,10,12,13,14,15,16,17-decahydro-6H- cyclopenta[a]phenanthrene-3,11-dione
Identifiers
CAS number 53-03-2
ATC code H02AB07
PubChem 5865
DrugBank APRD00340
Chemical data
O5 
Mol. mass 358.428 g/mol
Pharmacokinetic data
Bioavailability 70%
Metabolism prednisolone (liver)
Half life 1 hour
Excretion Renal
Therapeutic considerations
Pregnancy cat.

C

Legal status

Prescription only

Routes Oral, Nasal, Rectal, Injection, IV

Prednisone is a synthetic steroid.

Uses

Prednisone is particularly effective as an immunosuppressant, and affects virtually all of the immune system. It can, therefore, be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe poison ivy dermatitis, systemic lupus erythematosus, ulcerative colitis, Rheumatoid Arthritis, Bell's Palsy, Crohn's disease, and Sarcoidosis), various kidney diseases including nephrotic syndrome, and to prevent and treat rejection in organ transplantation. This medicine may also reduce the sex drive. Prednisone has also been used in the treatment of migraine headaches.

Prednisone tablets are furthermore used in the pharmaceutical industry for the calibration of dissolution testing equipment according to the USP (United States Pharmacopeia).

Usual initial dosage ranges from 20 mg - 80 mg per day (also 1 mg/kg in children up to 50 mg). Intravenous application may be employed for cerebral inflammation, as in the period attacks caused by multiple sclerosis.

History

Prednisone was invented in the early 1950s when Arthur Nobile at cortisone, such as water retention, high blood pressure and muscle weakness, could be removed by oxidisation of the drug through exposure to microbes. The drug was introduced by Schering in the mid-1960s.

Dependency

Adrenal suppression occurs if prednisone is taken for longer than 7 days, a condition wherein the body is unable to synthesize natural corticosteroids and becomes dependent on the prednisone taken by the patient. For this reason, prednisone should not be stopped abruptly if taken for longer than seven days; rather the dosage must be reduced slowly. This reduction may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis, which may be life-threatening. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects (see "Dosing Considerations").

Side-effects

Short-term side-effects, as with all glucocorticoids, include high blood diabetes mellitus, and depression upon withdrawal.

Major

  • weight gain
  • facial swelling
  • depression, mania, or other psychiatric symptoms
  • unusual fatigue or weakness
  • Mental confusion/indecisiveness
  • blurred vision
  • abdominal pain
  • peptic ulcer
  • infections
  • painful hips or shoulders
  • osteoporosis
  • acne breakouts
  • insomnia
  • severe joint pain
  • cataracts

Minor

  • weight gain
  • Stretch marks
  • nervousness
  • acne
  • rash
  • increased appetite
  • hyperactivity
  • frequent urination
  • Diarrhea
  • Removes Intestinal flora
 
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