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Prednisone vs Prednisolone
Introduction
Prednisone and Prednisolone are two types of corticosteroids that work by reducing inflammation in patients with conditions such as arthritis, lupus, asthma or allergies. They both operate by suppressing the immune system to prevent it from producing substances that cause inflammation. Prednisone is a prodrug; it's converted into prednisolone in the liver before being used by the body. Therefore, people with liver disease may be better suited for prednisolone because this conversion process is not required. Both medicines have similar side effects including increased appetite, mood changes and difficulty sleeping but their severity can vary between individuals.
Prednisone vs Prednisolone Side By Side
| Attribute | Prednisone | Prednisolone |
|---|---|---|
| Brand Name | Prednisone | Prednisolone |
| Contraindications | Should not be taken with certain antifungal drugs and antibiotics without consulting a physician. Not advised to be taken shortly after live vaccines. | Should not be taken with certain antifungal drugs and antibiotics without consulting a physician. Not advised to be taken shortly after live vaccines. |
| Cost | Generic prednisone costs start at around $.05/day and not exceeding about $.50/day. | Generic prednisolone costs start at roughly between $.07/day and $.70/day. |
| Generic Name | Prednisone | Prednisolone |
| Most Serious Side Effect | Severe nervous system reactions - numbness, tingling, burning pain, muscle weakness, arm/leg/cramp spasms, fever, headache, dizziness. | Signs of allergic reaction such as difficulty breathing; swelling of your face, lips, tongue or throat. |
| Severe Drug Interactions | May interact harmfully with other medications, particularly certain antifungal drugs and antibiotics. | May interact harmfully with other medications, particularly certain antifungal drugs and antibiotics. |
| Typical Dose | Oral dosages range from 5-60 mg/day depending on the specific disease entity being treated. | Therapy typically begins at a dosage of 5-60 mg/day, depending on the specific disease and patient condition. |
What is Prednisone?
Prednisone and Prednisolone are both corticosteroids, a class of drugs that suppress the immune system and reduce inflammation. They were developed as synthetic versions of cortisol, a natural hormone produced by our adrenal glands. Prednisone was first approved by the FDA in 1955 and is usually taken orally but can be delivered intravenously or via inhalation. When ingested, Prednisone is converted to prednisolone in the liver before it becomes active in the body. It's often prescribed for many different inflammatory diseases including arthritis, lupus, psoriasis, allergic disorders and conditions affecting lungs like asthma.
On the other hand, Prednisolone works similarly but does not need to be converted by liver enzymes to become active; hence it may be preferred in patients with impaired liver function. Just like its counterpart -predinisone- predinisolone also helps keeping symptoms of inflammation at bay such as swelling and pain etc.
Both medications have an influence on multiple systems throughout the body which results them having more side effects than drugs targeted towards one specific area or function.
What conditions is Prednisone approved to treat?
Prednisone and Prednisolone are approved for the treatment of various conditions, including:
- Inflammatory diseases such as lupus, rheumatoid arthritis, and inflammatory bowel disease
- Different types of allergies
- Asthma exacerbations
- Certain autoimmune disorders
- Specific cancers in combination with other drugs Please note that while both drugs have similar uses, they may be prescribed differently based on a patient's individual health situation. Always consult your healthcare provider before making any changes to your medication regimen.
How does Prednisone help with these illnesses?
Prednisone is a corticosteroid that reduces inflammation in the body by suppressing various immune responses. It does this by binding to specific receptors in cells, which hinders the production of substances that trigger inflammatory and immune responses. Prednisolone, on the other hand, is also a corticosteroid with similar properties to prednisone but it acts slightly differently within the body due to its metabolic processing.
When absorbed into your bloodstream after administration, prednisone is converted by liver enzymes into prednisolone—its active form. This transformation allows it to exert its potent anti-inflammatory effects more effectively than when initially consumed as prednisone.
Both medications are used for managing conditions involving chronic inflammation like asthma, rheumatoid arthritis and certain skin disorders among others.
However, because of this conversion process from prednisone to prednisolone in the liver, individuals with impaired liver function may be better suited for direct administration of Prednisolone.
What is Prednisolone?
Prednisolone, a potent anti-inflammatory medication, is the metabolite of prednisone, which means that it is formed when prednisone is broken down in the body. Prednisolone works by inhibiting inflammation and suppressing the immune system. It was initially approved by the FDA in 1955, and like its parent drug prednisone, belongs to a class of drugs known as corticosteroids.
Prednisolone can be prescribed for various conditions including certain types of arthritis; severe allergic reactions; multiple sclerosis; lupus; and certain conditions that affect the lungs, skin, eyes, kidneys blood cells or stomach. Common side effects include increased appetite and weight gain but unlike other similar medications such as SSRIs (like Prozac), it does not inhibit serotonin reuptake nor does it cause sedation or sexual dysfunction. Prednisolone acts on cortisol receptors instead – having an effect on nearly every system in your body - which makes this medication highly effective at reducing inflammation throughout your body.
What conditions is Prednisolone approved to treat?
Prednisolone is a corticosteroid that has been approved for the treatment of various conditions such as:
- Inflammatory disorders including asthma, allergic reactions and rheumatoid arthritis
- Autoimmune diseases like lupus and certain types of anemia
- Certain forms of kidney disease
How does Prednisolone help with these illnesses?
Prednisolone, akin to prednisone, is a corticosteroid that has potent anti-inflammatory and immunosuppressive properties. It works by mimicking the effects of hormones your body naturally produces in your adrenal glands. When prescribed in doses that exceed your body's usual levels, it can help reduce inflammation thereby relieving symptoms like swelling and allergic-type reactions. Prednisolone stands out because it is metabolized by the liver into its active form more efficiently than prednisone, making it potentially more effective for patients with liver issues or those who have trouble converting prednisone into its active state. Similar to norepinephrine’s action on depression in Wellbutrin, Prednisolone acts on immune response reducing inflammation and related symptoms. Just as Wellbutrin may be preferred when typical SSRI antidepressants are not effective enough, Prednisolone could be chosen over Prednisone in specific patient cases where enhanced drug metabolism might be beneficial.
How effective are both Prednisone and Prednisolone?
Prednisone and prednisolone are both corticosteroids, widely used to reduce inflammation in conditions such as asthma, rheumatoid arthritis, and certain skin diseases. They were introduced during the 1950s and have been integral agents in a variety of treatment protocols due to their potent anti-inflammatory properties. The effectiveness of these two drugs is very similar; when administered orally, prednisone is converted by the liver into its active form, prednisolone.
A study from 1971 directly compared these two medications in patients with chronic bronchial asthma finding them equally efficacious in controlling symptoms. Prednisolone exhibited greater bioavailability than prednisone which may result in less interindividual variability but overall there was no significant difference between the two regarding efficacy or safety profiles.
An extensive review conducted on systemic corticosteroids for inflammatory disorders revealed that both drugs show high rates of success starting from early stages of treatment. The side effect profile is comparable amongst many other corticosteroids with common side effects including fluid retention, increased appetite leading to weight gain and mood swings among others.
In terms of prescription frequency, while both are commonly prescribed due to their broad indications for use across various medical specialties. In comparison studies done on oral steroids given for COPD exacerbations showed little significant differences between the two drugs implying that they can be used interchangeably based on availability or patient-specific factors like comorbid hepatic disease where conversion might be impaired.
Although considered first-line treatment options for various inflammatory conditions it's important to note that long-term use should be avoided if possible due to potential serious adverse events including osteoporosis, diabetes mellitus and adrenal suppression.
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At what dose is Prednisone typically prescribed?
Oral dosages of Prednisone range from 5-60 mg/day depending on the specific disease entity being treated. It's generally recommended to start at a lower dose, and then increase after a few weeks if there is no response. For children and adolescents, dosage may vary based on their weight and condition being treated, typically between 0.05–2 mg/kg/day divided into two or three doses. In any case, it’s crucial not to exceed the maximum recommended dosage as determined by your healthcare provider.
Similarly, oral dosages for Prednisolone also range widely from 5-60 mg per day based on the disease severity. The pediatric dose can be anywhere from 0.14–2mg/kg daily in three or four divided doses usually yielding serum concentrations similar to those seen in adults taking therapeutic doses.
Always remember that these medications should only be taken under medical supervision due to potential side effects and interactions with other medicines you might be taking.
At what dose is Prednisolone typically prescribed?
Prednisolone therapy typically begins at a dosage of 5-60 mg/day, depending on the specific disease and patient condition. This dose can be administered in one single morning dose or divided into two doses, taken with meals. The maximum daily dosage varies widely based on the severity of the condition being treated - for some severe diseases it may go up to 200 mg/day. If there is no response to treatment after a week or more, your doctor might consider adjusting your prednisolone regimen accordingly. Always remember to take this medicine as directed by your healthcare provider because sudden stoppage could lead to withdrawal symptoms.
What are the most common side effects for Prednisone?
While both prednisone and prednisolone are corticosteroids used to reduce inflammation, they can cause different side effects. Prednisone's possible side effects include:
- Mood changes, such as anxiety or nervousness
- Difficulty sleeping (insomnia)
- Increased appetite leading to weight gain
- Fluid retention causing swelling in your lower legs
- High blood pressure
- Nausea
- Indigestion causing stomach pain
On the other hand, common side effects of prednisolone include:
- Indigestion or heartburn
- Sleep problems (insomnia)
- Increased sweating
- An increased appetite which may result in weight gain -Slow wound healing -Dizziness or spinning sensation -Menstrual period changes.
Always consult with a healthcare provider when deciding between these medications.
Are there any potential serious side effects for Prednisone?
While Prednisone and Prednisolone are both effective corticosteroids, they can sometimes cause severe side effects. These include:
- Signs of allergic reaction like hives, difficulty breathing, or swelling in your face or throat
- Changes in mood or behavior such as feeling irritable, agitated, hostile, aggressive.
- Feelings of depression including thoughts about suicide or self-harm
- Blurred vision; seeing halos around lights; eye pain; increased thirst and urination; rapid weight gain especially in the face and midsection
- Low potassium levels - leg cramps, constipation irregular heartbeats fluttering in your chest increased thirst or urination muscle weakness limp feeling
- Severe nervous system reactions - numbness tingling burning pain muscle weakness arm/leg/cramp spasms fever headache dizziness If you experience any of these symptoms seek immediate medical attention.
What are the most common side effects for Prednisolone?
Prednisolone, while similar to Prednisone, does have its own distinct set of potential side effects. These may include:
- Upset stomach or vomiting
- Heartburn
- Trouble sleeping
- Increased appetite and weight gain
- Accelerated heartbeat
- Menstrual changes in women
- Increased sweating
- Mood swings, feelings of nervousness or restlessness
- Headaches and dizziness
Additionally, patients on long-term prednisolone therapy might also experience blurred vision due to an increased risk of cataract formation or worsening glaucoma.
Are there any potential serious side effects for Prednisolone?
While Prednisolone is generally considered safe, in some cases, it can cause serious side effects. It's important to note that these reactions are rare but should be addressed immediately if they occur:
- Signs of allergic reaction such as difficulty breathing; swelling of your face, lips, tongue or throat
- Changes in personality or mood swings
- Depression and increased anxiety
- Bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds
- Eye pain and vision changes including blurred vision, tunnel vision and seeing halos around lights
- Rapid weight gain with swelling in your hands and feet
-Severe headaches accompanied by dizziness or fainting
Prolonged sleep problems
If you experience any of the above side effects while taking prednisolone, stop using it immediately and consult a healthcare professional.
Contraindications for Prednisone and Prednisolone?
Both prednisone and prednisolone, like most corticosteroids, can cause a variety of side effects. Should you notice severe symptoms such as vision problems, swelling, rapid weight gain or extreme tiredness after starting these medications, it is crucial to seek immediate medical attention.
Neither prednisone nor prednisolone should be taken if you are using other medications without first consulting your physician due to potential harmful interactions. This includes certain antifungal drugs and antibiotics. Also ensure that at least 2 weeks have passed since the last dose of any live vaccine before beginning treatment with these steroids.
It's also important to note that sudden discontinuation of either medication could lead to adrenal insufficiency. Always follow your doctor’s instructions for tapering off these drugs gradually rather than stopping them abruptly.
How much do Prednisone and Prednisolone cost?
For the brand name versions of these drugs:
- The price of 100 tablets of Prednisone (10 mg) averages around $120, which works out to about $1.20–$3.60 per day depending on your dose.
- The price for 30 tablets of Prednisolone (5 mg) is approximately $55, working out to almost $1.83 per day.
Thus, if you are in the higher dosage range for Prednisone (i.e., 30mg/day or higher), then brand-name Prednisolone can be less expensive on a per-day treatment basis.
For the generic versions of Prednisone and Prednisolone costs are significantly lower:
- Generic prednisone is available in packs ranging from 10 up to 500 tablets with approximate costs starting at around $.05/day and not exceeding about $.50/day.
- Generic prednisolone also comes in packs ranging from 10 up to 500 tablets but starts at a slightly higher cost compared to its counterpart - roughly between $.07/day and $.70/day.
Remember that cost should not be your primary consideration when choosing between these two medications; rather focus on their efficacy, side effects profile as well as any other medical conditions you may have. Always consult with your healthcare provider before making any changes related to medication usage.
Popularity of Prednisone and Prednisolone
Prednisone and prednisolone are two types of corticosteroids commonly prescribed to patients suffering from a wide variety of inflammatory conditions such as allergies, arthritis, asthma, lupus, and certain cancers.
In 2020 in the United States, around 21 million prescriptions were filled for Prednisone making it one of the top most-prescribed drugs. Prednisone accounted for roughly 39% of all corticosteroid prescriptions dispensed in the US that year.
On the other hand, prednisolone was prescribed approximately to about 3 million people in the USA during that same period. This accounts for just over 5% of overall corticosteroid prescriptions. The prevalence of both these medications has been steady over recent years due largely to their effectiveness in treating numerous health conditions characterized by inflammation.
Conclusion
Both Prednisone and Prednisolone have long-standing records of usage as corticosteroids, which are used to reduce inflammation in conditions such as arthritis, asthma, and allergic reactions. They have been extensively studied and demonstrated to be effective anti-inflammatory agents. Both drugs can be used interchangeably; however, their use depends on the patient's health status.
Prednisone is a prodrug that gets converted into prednisolone in the liver. This means people with liver problems may not metabolize prednisone efficiently, thus prednisolone might be a better choice for them since it doesn't require liver activation.
On the other hand, Prednisolone is directly active and can be utilized by individuals who have impaired or compromised liver function more effectively than Prednisone.
Both medications are available in generic form which represents significant cost savings especially for patients who pay out of pocket. The effects of both drugs may take some time to manifest depending on the condition being treated.
The side effect profile is similar between these two corticosteroids with common side effects including increased appetite, weight gain, insomnia among others. Long-term use can lead to more serious complications such as osteoporosis or adrenal insufficiency so they're usually prescribed for short periods unless absolutely necessary otherwise. As always patients should work closely with their healthcare provider when taking these types of medications due to potential risks associated with long term usage.
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Refrences
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- Feber, J., Al-Matrafi, J., Farhadi, E., Vaillancourt, R., & Wolfish, N. (2009, May). Prednisone dosing per body weight or body surface area in children with nephrotic syndrome—is it equivalent?. Pediatric Nephrology. Springer Science and Business Media LLC.http://doi.org/10.1007/s00467-008-1089-2
- YASUDA, K., GOSHIMA, E., ADACHI, K., FUWA, Y., YAMAKITA, N., & MIURA, K. (1990, April). Changes in the Pharmacokinetics of Plasma Total and Free Prednisolone during Daily and Intermittent Regimens*. The Journal of Clinical Endocrinology & Metabolism. The Endocrine Society.http://doi.org/10.1210/jcem-70-4-957
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- Zecca, C., Disanto, G., Riccitelli, G. C., Candrian, U., Deandrea, M., Limone, P. P., … Gobbi, C. (2021, May). A randomized pilot trial of oral prednisone taper vs placebo following iv methylprednisolone for multiple sclerosis relapses: Effects on adrenal function and clinical efficacy. Multiple Sclerosis and Related Disorders. Elsevier BV.http://doi.org/10.1016/j.msard.2021.102867
- Xu, J., Winkler, J., & Derendorf, H. (2007, February 23). A Pharmacokinetic/Pharmacodynamic Approach to Predict Total Prednisolone Concentrations in Human Plasma. Journal of Pharmacokinetics and Pharmacodynamics. Springer Science and Business Media LLC.http://doi.org/10.1007/s10928-007-9050-8
- Lesko, A., Kalafat, N., & Afreen, M. (2021, December 31). Four Case Reports of Acute Psychosis Secondary to Low Doses of Prednisone/Prednisolone. Cureus. Springer Science and Business Media LLC.http://doi.org/10.7759/cureus.20853
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