Class: Adrenal Corticosteroid
Dosage Forms. Tablet: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg; Tablet, Delayed Release: 1 mg, 2 mg, 5 mg; Solution: 5 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
Dosing for indications listed below: Adults and Pediatric: 5-60 mg po daily; for all patients, adjust dose according to patient response
1. Allergic states (eg, asthma, etc)
2. Dermatologic diseases (eg, exfoliative erythroderma, etc)
3. Endocrine disorders (eg, adrenocortical insufficiency, etc)
4. Gastrointestinal diseases (eg, regional enteritis, ulcerative colitis, etc)
5. Hematologic disorders (eg, acquired hemolytic anemia, etc)
6. Neoplastic diseases (eg, palliative management of leukemias and lymphomas, etc)
7. Nervous system (eg, multiple sclerosis, cerebral edema, etc)
8. Renal diseases (eg, idiopathic nephrotic syndrome, systemic lupus erythematosus, etc)
9. Respiratory diseases (eg, idiopathic eosinophilic pneumonia, etc)
10. Rheumatic disorders (eg, rheumatoid arthritis, etc)
1. Graft versus host disease: 60 mg/m2 po daily
MOA. Glucocorticosteriods are naturally occurring and synthetic adrenocortical steroids that cause varied metabolic effects, modify the body’s immune responses to diverse stimuli, and are used primarily for their anti-inflammatory effects in disorders of many organ systems.
Drug Characteristics: Prednisone
Medication Safety Issues: Prednisone
Drug Interactions: Prednisone
Adverse Reactions: Prednisone
Efficacy Monitoring Parameters. Improvement or resolution of clinical signs and symptoms; monitor for decrease in ESR, or improvement of PFT.
Toxicity Monitoring Parameters. Monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency, and infection; frequency and severity of adverse effects are dependent on the length of treatment and dose.
Key Patient Counseling Points. For short-term treatment, inform patients to take doses with meals to prevent GI upset. For high-dose or longer term treatment, inform patients to monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency, and infection.
Clinical Pearls. See National Heart, Lung and Blood Institute guidelines for dosing of prednisone for moderate to severe asthma exacerbation; after chronic use (>2 wk), dose tapering required prior to discontinuation of therapy.