indication

For the treatment of drug-induced allergic reactions, perennial or seasonal allergic rhinitis, serum sickness, giant cell arteritis acute rheumatic or nonrheumatic carditis, systemic dermatomyositis, systemic lupus erythematosus, atopic dermatitis, contact dermatitis, exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe (Stevens-Johnson syndrome) erythema multiforme, mycosis fungoides, pemphigus, severe psoriasis, acute adrenocortical insufficiency, Addison's disease, secondary adrenocortical insufficiency, congenital adrenal hyperplasia, hypercalcemia associated with neoplasms, nonsuppurative thyroiditis, ulceratice colitis, Crohn's disease, acquired hemolytic anemia, congenital hypoplastic anemia, erythroblastopenia, adult secondary thrombocytopenia, adult idiopathic thrombocytopenia purpura, acute or subacute bursitis, epicondylitis, acute nonspecific tenosynovitis, acute or chronic lymphocytic leukemia, Hodgkin's or non-Hodgkin's lynphomas, Waldenstrom's macroglobulinemia, primary brain tumors (adjunct), nephrotic syndrome, tuberculous meningitis, multiple sclerosis, myasthenia gravis. cerebral edema, chorioretinitis, diffuse posterior choroiditis, aleergic conjunctivitis, Herpes zoster ophthalmicus, anterior segment inflammation, iridocyclitis, iritis, keratitis, optoc neuritis, sympathetic ophthalmia, corneal marginal allergic ulcers, symptomatic sarcoidosis, Loeffler's syndrome not manageable by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy and aspiration pneumonitis.

pharmacology

Prednisone, the most commonly-prescribed corticosteroid, is used to treat allograft rejection, asthma, systemic lupus erythematosus, and many other inflammatory states. Prednisone has very little mineralocorticoid activity.

mechanism of action

Prednisone is a glucocorticoid receptor agonist. It is first metabolized in the liver to its active form, prednisolone. Prednisolone crosses cell membranes and binds with high affinity to specific cytoplasmic receptors. The result includes inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, suppression of humoral immune responses, and reduction in edema or scar tissue. The antiinflammatory actions of corticosteroids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.

biotransformation

Hepatic.

absorption

Readily absorbed from the gastrointestinal tract.

half life

2 to 3 hours

drug interactions

Acenocoumarol: The corticosteroid, prednisone, alters the anticoagulant effect, acenocoumarol.

Acetylsalicylic acid: The corticosteroid, prednisone, may decrease the effect of the salicylate, acetylsalicylic acid.

Ambenonium: The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, ambenonium.

Amobarbital: The barbiturate, amobarbital, may decrease the effect of the corticosteroid, prednisone.

Anisindione: The corticosteroid, prednisone, alters the anticoagulant effect of anisindione.

Aprobarbital: The barbiturate, aprobarbital, may decrease the effect of the corticosteroid, prednisone.

Bismuth Subsalicylate: The corticosteroid, prednisone, may decrease the effect of the salicylate, bismuth subsalicylate.

Butabarbital: The barbiturate, butabarbital, may decrease the effect of the corticosteroid, prednisone.

Butalbital: The barbiturate, butalbital, may decrease the effect of the corticosteroid, prednisone.

Butethal: The barbiturate, butethal, may decrease the effect of the corticosteroid, prednisone.

Chlorotrianisene: The estrogenic agent, chlorotrianisene, may increase the effect of corticosteroid, prednisone.

Clomifene: The estrogenic agent, clomifene, may increase the effect of corticosteroid, prednisone.

Conjugated Estrogens: The estrogenic agent may increase the effect of corticosteroid, prednisone.

Dicumarol: The corticosteroid, prednisone, alters the anticoagulant effect of dicumarol.

Diethylstilbestrol: The estrogenic agent, diethylstilbestrol, may increase the effect of corticosteroid, prednisone.

Dihydroquinidine barbiturate: The barbiturate, dihydroquinidine barbiturate, may decrease the effect of the corticosteroid, prednisone.

Edrophonium: The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, edrophonium.

Estradiol: The estrogenic agent, estradiol, may increase the effect of corticosteroid, prednisone.

Estriol: The estrogenic agent, estriol, may increase the effect of corticosteroid, prednisone.

Estrone: The estrogenic agent, estrone, may increase the effect of corticosteroid, prednisone.

Estropipate: The estrogenic agent, estropipate, may increase the effect of corticosteroid, prednisone.

Ethinyl Estradiol: The estrogenic agent, ethinyl estradiol, may increase the effect of corticosteroid, prednisone.

Ethotoin: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, prednisone.

Fosphenytoin: The enzyme inducer, fosphenytoin, may decrease the effect of the corticosteroid, prednisone.

Heptabarbital: The barbiturate, heptabarbital, may decrease the effect of the corticosteroid, prednisone.

Hexobarbital: The barbiturate, hexobarbital, may decrease the effect of the corticosteroid, prednisone.

Itraconazole: The imidazole, itraconazole, may increase the effect and toxicity of the corticosteroid, prednisone.

Ketoconazole: The imidazole, ketoconazole, may increase the effect and toxicity of the corticosteroid, prednisone.

Magnesium salicylate: The corticosteroid, prednisolone, may decrease the effect of magnesium salicylate.

Mephenytoin: The enzyme inducer, mephenytoin, may decrease the effect of the corticosteroid, prednisone.

Mestranol: The estrogenic agent, mestranol, may increase the effect of corticosteroid, prednisone.

Methohexital: The barbiturate, methohexital, may decrease the effect of the corticosteroid, prednisone.

Methylphenobarbital: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, prednisone.

Midodrine: Increased arterial pressure

Neostigmine: The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, neostigmine.

Pentobarbital: The barbiturate, pentobarbital, may decrease the effect of the corticosteroid, prednisone.

Phenobarbital: The barbiturate, phenobarbital, may decrease the effect of the corticosteroid, prednisone.

Phenytoin: The enzyme inducer, phenytoin, may decrease the effect of the corticosteroid, prednisone.

Primidone: The barbiturate, primidone, may decrease the effect of the corticosteroid, prednisone.

Pyridostigmine: The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, pyridostigmine.

Quinestrol: The estrogenic agent, quinestrol, may increase the effect of corticosteroid, prednisone.

Quinidine barbiturate: The barbiturate, quinidine barbiturate, may decrease the effect of the corticosteroid, prednisone.

Rifampin: The enzyme inducer, rifampin, may decrease the effect of the corticosteroid, prednisone.

Salicylate-sodium: The corticosteroid, prednisone, may decrease the effect of the salicylate, salicylate-sodium.

Salsalate: The corticosteroid, prednisone, may decrease the effect of the salicylate, salsalate.

Secobarbital: The barbiturate, secobarbital, may decrease the effect of the corticosteroid, prednisone.

Tacrine: Tacrine and Prednisone may independently exacerbate muscle weakness in myasthenia gravis patients. Monitor for additive muscle weakness effects.

Talbutal: The barbiturate, talbutal, may decrease the effect of the corticosteroid, prednisone.

Trastuzumab: Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.

Trisalicylate-choline: The corticosteroid, prednisone, may decrease the effect of the salicylate, trisalicylate-choline.

Vecuronium: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Prednisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Warfarin: The corticosteroid, prednisone, alters the anticoagulant effect of warfarin.