Prednisolone should be used with caution in:
the elderly, women who are pregnant or breastfeeding, patients who have been in contact with anyone who has chickenpox or shingles, family history of diabetes or the eye condition glaucoma, brittle or weak bones (osteoporosis), high blood pressure, stomach ulcer, fits (epilepsy), tuberculosis (an infection), septicaemia (a serious infection), thyroid gland inactivity (hypothyroidism), patients who have taken prednisolone or a similar medicine before and had muscle problems (steroid myopathy), those with heart, kidney or liver problems, patients who currently have or in the past had any mental illness, patients who are being treated with vaccines, those who have ever had severe depression or manic depression (this includes having had depression before whilst taking prednisolone or a similar medicine or a member of your close family has had these illnesses), previous infection caused by a virus or fungus (including athletes foot, thrush or cold sores), intolerance to some sugars (some medicines contain the sugar lactose), using soft contact lenses (if using prednisolone eye drops).
It should not be used in:
people with an allergy to prednisolone or to any of the other ingredients in the medicine (signs of allergy can include rash, itching, difficulty breathing, or swelling of the lips, face, throat or tongue), cold sores that affect the eyes, an untreated infection, glaucoma (if using prednisolone eye drops), a perforated ear drum or fungal infection of the ear (if using prednisolone ear drops), patients vaccinated with live vaccines
Also see list of precautions and interactions
Store below 25ºC in a dry place and protect from light. Do not use prednisolone drops for longer than 28 days after the seal on the bottle has been broken.
Prednisolone is used to reduce inflammation in the body.
It is a glucocorticoid, sometimes known as a steroid or corticosteroid.
It is used to treat many illnesses, including serious illness, involving inflammation in the body, and to stop reactions known as autoimmune reactions which occur when the body's immune system attacks the body itself and causes damage.
In general this drug is used for allergies including severe allergic reactions, inflammation affecting the lungs (including asthma), blood vessels, heart, bowel (including ulcerative colitis and proctitis), kidneys, muscles and joints (including rheumatoid arthritis, rheumatic fever and systemic lupus erythematosus or SLE), eye, ear or nervous system
Benefits of being on this drug can include a reduction in inflammation which could otherwise continue to make your condition worse.
Listed below are the typical uses of prednisolone.
Allergies including severe allergic reactions
- Inflammation affecting the lungs (including asthma), blood vessels, heart, bowel, kidneys, muscles and joints (including rheumatoid arthritis), eye, ear or nervous system
- Skin conditions
- Some infections
- Some cancers including leukaemia, lymphoma and myeloma
- To prevent organ rejection after transplantation.
On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.
- To increase steroid levels when the body is not making enough natural steroid on its own
- To treat high calcium levels
HOW TO USE/TAKE
How often do I take it?
- Prednisolone tablets should be taken by mouth usually in the morning after breakfast, swallowed whole with a glass of water. Prednisolone soluble tablets are best taken dissolved in a glass of water. For certain conditions, prednisolone injection may be injected into the muscle (intramuscular) once or twice a week or injected as a single injection directly into a joint (intra-articular or intra-synovial). Prednisolone eye and ear drops may be used three or four times daily or more frequently, depending on the condition being treated. Remove contact lenses before using prednisolone eye drops and wait at least 15 minutes before putting the contact lenses back in (do not use with soft contact lenses). Prednisolone enemas and suppositories are for rectal (back passage) use. Prednisolone enemas are usually used once a day at night. Prednisolone suppositories are usually used in the morning and at night after emptying your bowels.
- If you take prednisolone for more than 3 weeks, you should be given a 'Steroid Treatment Card' which provides important details about your treatment. This card should be carried with you at all times and shown to any doctor or nurse treating you.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Prednisolone eye drops may cause temporary blurred vision. If this happens to you then do not drive or operate machinery until your sight returns to normal. Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop. If you doctor decides to stop your prednisolone, your dose may need to be reduced gradually.
PREDNISOLONE SIDE EFFECTS
- Infections (your resistance to infection may be lowered and you may catch more colds, existing infections may become worse or if you have had tuberculosis in the past it may return)
- Increased appetite
- Feeling full or bloated
- Heart burn
- Stomach pain
- Weight gain or loss
- High blood pressure
- Unusual tiredness confusion, muscle weakness or muscle cramps. This may be caused by low levels of potassium in your body
- Mood changes
- Difficulty sleeping
- Worsening of schizophrenia
- Worsening of epilepsy (more fits)
- Skin problems including thinning, acne, flushing, redness and appearance of reddish/purple lines
- Unusual bruising
- Wounds that do not heal
- Bones fracture or tendons tear more easily (osteoporosis)
- Filling or rounding out of the face
- Irregular periods which may stop altogether
- Unusual increase in hair growth on the body or face
- Reduced growth in babies, children and teenagers
- Feeling more thirsty and passing water (urine) more often than usual (this may be a sign of diabetes)
- Water and salt retention in the body
- Blood clots
- Blood problems (leukocytosis)
- Eye problems including cataracts and increased pressure in the eye (glaucoma), worsening or return of previous eye infections, ulcers on the surface of the eye (cornea), a hole in the eyeball (if you have a disease which causes thinning of the surface of the eye), enlarged pupils, drooping of the eyelid, blurred vision and other changes to your sight, swelling and redness of the outer surface of the eye, itching, burning, irritation, stinging, redness of the skin around your eyes
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
- Mental health problems such as feeling depressed (including thinking about suicide), feeling high (mania) or moods that go up and down, feeling anxious, difficulty sleeping, difficulty thinking, feeling confused and losing your memory, feeling, seeing or hearing things which do not exist, having strange or frightening thoughts, changing how you act or having feelings of being alone.
- Very sore throat and white areas inside your mouth (oral thrush)
- Headache, which is usually worse in the morning, on coughing or straining
- Feeling sick (nausea)
- Eyesight problems
- Painful eyes
Stop taking your medicine and see a doctor or go to a hospital straight away if you develop any of the following symptoms:
- Puffy swollen face, tongue or body which may cause shortness of breath, difficulty swallowing, shock and collapse. An itchy, lumpy rash (hives) or nettle rash (urticaria) may also develop.
- Very severe abdominal pain which may be a sign of inflammation of the pancreas (pancreatitis)
- You pass black tarry stools or notice fresh or clotted blood in your stools (faeces). There may also be dark bits that look like coffee grounds in your vomit. These may be signs of a stomach ulcer.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Some side effects (such as stomach problems) with prednisolone can happen straight away while others (such as weakness of the arms and legs, and a round face) may only happen after weeks or months on treatment.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking prednisolone, tell your doctor or pharmacist if you are allergic to it; or to other steroids (corticosteroids or glucocorticoids); or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: an allergy to prednisolone or to any of the other ingredients in the medicine (signs of allergy can include rash, itching, difficulty breathing, or swelling of the lips, face, throat or tongue), cold sores that affect the eyes, an untreated infection, glaucoma (if using prednisolone eye drops), a perforated ear drum or fungal infection of the ear (if using prednisolone ear drops), patients vaccinated with live vaccines.
Whilst taking prednisolone, keep away from people who have chicken-pox or shingles if you have never had these illnesses, as they could affect you severely. If you do come into contact with someone with chicken pox or shingles then see your doctor immediately.
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: you have been in contact with anyone who has chickenpox or shingles, family history of diabetes or the eye condition glaucoma, brittle or weak bones (osteoporosis), high blood pressure, stomach ulcer, fits (epilepsy), tuberculosis (an infection), septicaemia (a serious infection), thyroid gland inactivity (hypothyroidism), have taken prednisolone or a similar medicine before and had muscle problems (steroid myopathy), heart, kidney or liver problems, have now or in the past had any mental illness, are being treated with vaccines, have ever had severe depression or manic depression (this includes having had depression before whilst taking prednisolone or a similar medicine or a member of your close family has had these illnesses), previous infection caused by a virus or fungus (including athletes foot, thrush or cold sores), intolerance to some sugars (some medicines contain the sugar lactose), you use soft contact lenses, you are pregnant or breast-feeding.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- The intake of alcohol does not appear to affect prednisolone.
The elderly: prednisolone should be used with caution in the elderly as it may be associated with more serious side effects than in younger people.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Prednisolone may be prescribed cautiously if you are pregnant, if your doctor considers that the benefit of treatment outweighs the risk.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Prednisolone may be prescribed cautiously if you are breastfeeding, if your doctor considers that the benefit of treatment outweighs the risk.
Ask your doctor or pharmacist if you have any doubts or questions about this.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: None known.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Medicines to treat high blood pressure
- Water tablets (diuretics)
- Digoxin (heart tablet)
- Medicines for asthma (bambuterol, salbutamol, salmeterol, theophylline)
- Erythromycin (an antibiotic)
- Ketoconazole (for fungal infections)
- Ritonavir (for viral infections)
- Human growth hormone (somatropin)
- Medicines for epilepsy (carbamazepine, phenobarbital, other barbiturates, phenytoin, primidone, phenylbutazone, acetazolamide)
- Medicines for diabetes including insulin
- Medicines for infection including tuberculosis (rifabutin, rifampicin, amphotericin)
- Medicines to thin the blood (anticoagulants)
- Medicines containing oestrogen (the pill [oral contraceptives], hormone replacement therapy)
- Medicines to suppress your immune system (ciclosporin)
- Non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin
- Aminoglutethimide (used for some types of cancer)
- Methotrexate (used for some types of cancer)
- Acetazolamide (for glaucoma)
- Carbenoxolone (used to treat ulcers)
- Mifeprostone (used for termination of pregnancy)
- Recent vaccines
- Are using soft contact lenses
This information does not contain all possible interactions. Therefore, before using prednisolone, tell your doctor or pharmacist of all the products you use.
If you (or someone else, including a child) has taken too many prednisolone tablets tell your doctor immediately or go to your nearest casualty department immediately. Take any remaining medicine with you. Administering too many prednisolone drops into the eye or ear is unlikely to cause serious side effects; however, if you are concerned, contact your doctor or the nearest hospital casualty department.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of prednisolone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose of prednisolone, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. If you forget to use a prednisolone enema, contact your doctor who will tell you what to do. If you only remember at the time of your next enema, use a single enema and continue as usual (do not double up the dose to make up for the missed one).