What is prednisolone used for?

Prednisolone is commonly used for various inflammatory, autoimmune, hormonal, and other conditions where a corticosteroid may be used, which include the following.

• Severe allergic conditions
• Certain disorders of your skin, hormonal system, digestive tract, blood, nervous system, eyes, kidneys, or lungs
• Certain types of cancer (to ease symptoms)
• Rheumatic diseases (such as rheumatoid arthritis), which are painful and inflammatory conditions that affect your joints, tendons, ligaments, bones, and muscles

Prednisolone may also be used for other conditions as determined by your healthcare provider.

How does prednisolone work (mechanism of action)?

Prednisolone belongs to a group of medicines called corticosteroids. It changes how your body uses sugar, fat, and protein, suppresses certain immune responses, and reduces inflammation. 

How is prednisolone supplied (dosage forms)?

Brands and other names

• Orapred
• Pediapred
• Prelone

Dosage forms and strengths

• 10 mg, 15 mg, 30 mg orally disintegrating tablets
• 5 mg oral tablets
• 5 mg/5 mL, 10 mg/5 mL, 15 mg/5 mL, 20 mg/5 mL, 25 mg/5 mL oral solution

Prednisolone is also available in an eye drop. See Prednisolone ophthalmic for more information.

How should I store prednisolone?

Oral Liquid. Some prednisolone oral liquids should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). They can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting them. Some prednisolone oral solutions should be stored at temperatures between 36 F to 77 F (2 C to 25 C) and may be refrigerated. Ask your pharmacist if you are unsure how to store your prednisolone oral solution. Keep the container tightly closed.

Oral Tablet and Orally Disintegrating Tablet. Prednisolone oral tablets and orally disintegrating tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). They can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting them. Store in a cool, dry place. Keep the orally disintegrating tablets in the blister until just before taking one, and keep them away from moisture.

Side Effects

What are the most common side effects of prednisolone?

The most common side effects of prednisolone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Fluid retention
• Increased blood sugar (see below)
• Increased blood pressure (see below)
• Mood and behavior changes (see below)
• Increased appetite or weight gain

There may be other side effects of prednisolone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of prednisolone?

While less common, the most serious side effects of prednisolone are described below, along with what to do if they happen.

Severe Allergic Reactions. Prednisolone may cause allergic reactions, which can be serious. Stop taking prednisolone and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Reduced Adrenal Function. Long-term use of prednisolone may cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.

• Nausea and vomiting
• Weakness, tiredness, or lack of energy
• Low blood pressure

Cushing’s Syndrome. Rarely, taking prednisolone for a long time may increase your risk for Cushing’s syndrome. Cushing’s syndrome is a condition that happens when your body is exposed to too much cortisol (the stress hormone). The risk may be higher in children. Stop taking prednisolone and call your healthcare provider if you have any of the following symptoms of Cushing’s syndrome.

• A rounded, rosy color of the face
• Weight gain, especially in the upper body
• A fat buildup in the upper back or base of the neck
• Thinning skin that bruises easily
• Feeling very weak or tired
• Depression or anxiety
• High blood sugar
• High blood pressure
• Sleep problems

High Blood Sugar. Prednisolone may increase your blood sugar levels. Talk to your healthcare provider about how to maintain healthy blood sugar levels. Keep all appointments with your healthcare provider to check your blood work. Call your healthcare provider if you have the following symptoms of high blood sugar.

• Thirsty more than usual
• Peeing more than usual
• Increase in hunger
• Tiredness
• Feeling sick to your stomach
• Confusion
• Your breath smelling fruity

Infections. Prednisolone may increase your risk of infections, including serious infections. Call your healthcare provider right away if you have an infection or any of the following symptoms.

• Burning or stinging when you pee 
• Cough or coughing up blood
• Fever, sweats, chills, or muscle aches
• Shortness of breath
• Diarrhea or stomach pain
• Weight loss

Reactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Prednisolone may increase your risk of a latent microbe becoming active again, causing an infection. Before you start treatment with prednisolone, tell your healthcare provider if you have ever had tuberculosis (TB), hepatitis B, or any other serious infections.

Increased Blood Pressure (Hypertension). Prednisolone may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Mood Changes. Prednisolone can cause changes in your mental status, including mood swings, personality changes, and depression. Tell your healthcare provider if you notice any changes in mood, thoughts, or behaviors.

Weak Bones. Taking prednisolone for a long time may cause your bones to become weaker, leading to reduced bone density (osteopenia). It may also cause a more serious condition called osteoporosis, which can cause your bones to break (fracture) more easily. Tell your healthcare provider if you break a bone, and get a bone mineral density test if one is ordered for you.    

Vision Problems. Prednisolone may cause cataracts and glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms.

• Cloudy or foggy vision
• Nearsightedness
• Changes in how you see colors
• Problems with glare (such as traffic lights when driving at night)
• Loss of vision
• Eye pain or redness
• Severe headache or vomiting
• Seeing bright, colorful circles around lights (vision halos)

Slowed Growth in Children. Prednisolone, when taken by children, can slow down growth. The risk may be higher in children who take it for a long time. Tell your child’s healthcare provider if you have concerns about your child’s growth.

Muscle Problems. Prednisolone may cause muscle problems, including muscle pain, weakness, and tenderness called myopathy. Stop taking prednisolone and get help right away if you have any of the following symptoms of myopathy.

• Muscle pain, stiffness, or cramps
• Muscle spasms
• Low energy levels or feeling easily tired, especially with activity

Warnings & Precautions

Who should not use prednisolone?

Allergies to Ingredients. People who are allergic to any of the following should not take prednisolone.

• Prednisolone
• Orapred
• Pediapred
• Prelone
• Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific prednisolone products they stock.

Whole-Body Fungal Infections. People who have fungal infections in their body should not take prednisolone oral liquid or tablets.

What should I know about prednisolone before using it?

Do not take prednisolone unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share prednisolone with other people, even if they have the same condition as you. It may harm them.

Keep prednisolone out of the reach of children.

If you are prescribed prednisolone oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

If you are prescribed prednisolone orally disintegrating tablets, do not cut, split, or break the tablets or use partial tablets. When you are ready to take a dose, peel open the blister and place the tablet on your tongue. The tablet may be swallowed whole or allowed to melt in the mouth, with or without water.

Do not stop taking prednisolone without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.

• Fatigue
• Fever
• Joint or muscle pain
• Lightheadedness
• Loss of appetite
• Difficulty breathing
• Vomiting
• Weight loss
• Headaches

Avoid exposure to chickenpox or measles while you are taking prednisolone. If you think you have been exposed to chickenpox or measles, tell your healthcare provider right away.

What should I tell my healthcare provider before using prednisolone?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if prednisolone is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Prednisolone may interact with other medicines and supplements. Before taking prednisolone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Vaccines. Talk with your healthcare provider about any vaccines that you may need. You may not be able to receive certain vaccines right before or while using prednisolone. Tell your healthcare provider about any vaccines you have recently received or have scheduled.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

• Heart disease, such as heart failure or recent heart attack
• High blood pressure
• Infections, including serious infections you have had in the past (such as hepatitis B)
• Kidney problems
• Stomach or bowel problems, including ulcers
• Thyroid problems, such as hypothyroidism
• Liver damage and scarring (cirrhosis)
• Nerve or muscle problems, such as myasthenia gravis
• Mental health problems
• Diabetes

Pregnancy. Prednisolone may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take prednisolone while you are pregnant or trying to get pregnant.

Breastfeeding. Prednisolone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use prednisolone while breastfeeding.

Interactions

Does prednisolone interact with foods or drinks?

There are no known interactions between prednisolone and foods or drinks. Prednisolone orally disintegrating tablets may be taken with food to lower the risk of stomach upset.

It is unknown if drinking alcohol will affect prednisolone.

Does prednisolone interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using prednisolone.

• A macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
• A cholinesterase inhibitor, such as rivastigmine or donepezil (which is a medicine commonly used for Alzheimer’s disease) or pyridostigmine (which is a medicine commonly used for myasthenia gravis)
• Warfarin, which is a blood thinner
• A medicine for diabetes
• Isoniazid or rifampin (Rifadin), which is a medicine used to treat an infection called tuberculosis
• Cholestyramine (Prevalite), which is a medicine to lower cholesterol
• Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
• Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
• Estrogen, which is found in certain birth control pills, patches, creams, rings, or vaginal suppositories 
• A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
• Any medicine for seizures, such as carbamazepine or phenytoin
• Ketoconazole, which is a medicine used for fungal infections
• Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
• A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
• A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure

Many other medicines may alter the blood levels of prednisolone. Tell your healthcare provider about all medicines that you take or have recently taken.

Overdose/Missed Dose

What should I do if I accidentally use too much prednisolone?

If you or someone else has used too much prednisolone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of prednisolone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.