Prednisone/Prednisolone

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Systemic Glucocorticoid

Prescriber Highlights

  • Cats and patients in severe hepatic failure may not be able to efficiently convert prednisone to prednisolone 
  • Anti-inflammatory activity is 4 times more potent than hydrocortisone; also has some mineralocorticoid activity
  • Goal of therapy is to use as much as is required for effect but to use as little as possible for as short an amount of time as possible to avoid systemic side effects 

Uses, Indications

  • Physiologic replacement or supplementation (hypoadrenocorticism, relative adrenal insufficiency associated with septic shock)
  • Anti-inflammatory agent
  • Immunosuppressive agent
  • Antineoplastic agent

Contraindications, Precautions, Warnings

  • Contraindications
    • Systemic fungal infections, when administered IM in patients with idiopathic thrombocytopenia, and in patients hypersensitive to a specific compound
    • Congestive heart failure, diabetes, chronic nephritis, GI ulceration, and osteoporosis are relative contraindications
  • Precautions

Patients with renal disease may be more predisposed to developing GI side effects

  • Warnings

Patients receiving steroids chronically should be tapered off the drug

Side Effects

  • Polydipsia, polyuria, polyphagia, panting, weight gain, muscle wasting, behavioral changes, hair coat changes, vomiting, diarrhea
  • Long-term, high-dose therapy can lead to Cushingoid effects
  • GI ulceration reported, especially at high doses
  • Elevated liver enzymes, hypercoagulability, activation or worsening of diabetes mellitus
  • Cats experience a greater hyperglycemic effect than other species

Drug Interactions

  • NSAID administration is discouraged because of increased GI ulceration risk
  • Insulin requirements may increase in patients receiving glucocorticoids
  • Diuretics and digoxin may cause hypokalemia
  • For a complete list of drug interactions, visit plumbsveterinarydrugs.com

Monitoring

  • Dependent on reason for use, dosing schedule, duration of  therapy, patient’s age and condition
  • Weight, appetite, serum electrolytes, total plasma proteins, albumin, blood glucose, signs of edema

Client Information

  • Give with food
  • Many side effects are possible, especially when used long-term
  • Dogs can experience GI ulceration and should be monitored for dark, tarry stools or bloody vomit
  • Do not discontinue abruptly

Dosage Forms

  • Both veterinary- and human-labeled products are available: 
    • Prednisone tablets: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
    • Prednisolone tablets: 5 mg
    • Prednisolone sodium phosphate oral disintegrating tablets: 10 mg, 15 mg, 30 mg
    • Prednisone oral solution: 1 mg/mL
    • Ophthalmic solutions/suspensions are available

Compiled and summarized from Plumb’s Veterinary Drugs by Shannon Palermo, VMD

Information about this drug was adapted from Plumb’s Veterinary Drugs. Further details and more therapeutics can be found with a subscription at plumbsveterinarydrugs.com

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