Prednisolone instructions for use and for what. Glucocorticosteroid drug with heavy forms of allergic reactions - ampoules and tablets Prednisolone: \u200b\u200binstructions for use and dosage of medication

Composition Prednisolone in ampoules: Active substance at a concentration of 30 mg / ml, as well as sodium Piroseninistomine (additive E223), Dinatari Edetat, Nicotinamide, sodium hydroxide, water d / and.

Composition Prednisolone in tablets: 1 or 5 mg of active substance, colloidal silica dioxide, magnesium stearate, stearic acid, starch (potato and corn), talc, monohydrate lactose.

Prednisolone Ointment Contains 0.05 g of an active substance, soft white paraffin, glycerin, stearic acid, methyl and propyl aprichedroxybenzoate, Cremophhor A25 and A6, purified water.

Form release

• A solution for B / V and V / m of the introduction of 30 mg / ml of 1 ml; 15 mg / ml 2 ml.
• Tablets 1 and 5 mg.
• Outdoor therapy ointment 0.5% (ATH code - D07AA03).
• Eye drops 0.5% (ATH code - S01BA04).

pharmachologic effect

Pharmacological group: Corticosteroids (Preparation group - I, this means that prednisone is the GCS of weak activity).

Prednisolone - hormonal or not?

Prednisolone is Hormonal drug For local and systemic use of average duration of action.

Is a dehydrated analogue of hormone adrenal . Its activity is four times higher than the activity of the hydrocortisone.

Warning development allergic reaction (In the event that the reaction has already begun, it stops it), suppresses activity immune system , it relieves inflammation, increases the sensitivity of β2-adrenoreceptors to endogenous catecholamines, has anti-shock action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics. Prednisolone - What is it?

The mechanism of action of prednisolone is associated with its ability to interact with certain intracellular (cytoplasmic) receptors. These receptors are in all tissues of the body, but most of all are in the liver.

As a result of this interaction, inducing proteins synthesis are formed (including which regulate vital intracellular processes) complexes.

Operates at all stages of the development of the inflammatory process: suppresses the synthesis of Pg at the level of arachidonic acid, and also prevents the formation of pro-inflammatory cytokines - IFN-β and IFN-γ, IL-1, FNF, neopterina; Increases the stability of plasma membranes to the effects of damaging factors.

It affects the metabolism of lipids and proteins, as well as to a slightly lesser extent - on the exchange of water and electrolytes.

Immunodepressive effect implemented due to the ability of the drug to cause involution lymphoid fabric Ugnet proliferation , migration in cells, and interaction V- and T-lymphocytes , inhibit the release of IFN-γ, IL-1 and IL-2 from macrophages and lymphocyte , reduce education .

Braking allergic reaction is carried out by reducing the secretion and synthesis of mediators , reducing the number of circulating basophilic leukocytes Release suppressing histamine from sensitized puffed cells and basophilic leukocytes , Suppression of development connective and lymphoid fabric , reducing the number of fat cells, V- and T-lymphocytes , reduce sensitivity of T-effectors to mediators allergies , suppression of education antibodies , change immune response.

Inhibits synthesis and secretion corticotropin and - secondary - endogenous GKS.

With outdoor use, inflammation relieves, inhibits the development allergic reaction , relieves itching and inflammation, reduces exudition suppresses activity immune system With respect to the reactions of hypersensitivity III-IV type.

Pharmacokinetics

After receiving the tablet quickly and maximally absorbed from the gastrointestinal tract. TCMMU - from 60 to 90 minutes. Up to 90% of the received dose of prednisolone is associated with plasma proteins.

Biotransformation The substance is subjected to liver. From 80 to 90% of metabolic products are excreted with urine and bile, about 20% of the dose - eliminated in its pure form. T1 / 2 - from 2 to 4 hours.

Indications for the use of prednisolone

What is the pill and solution for injection?

Systemic use is advisable at:

• allergic diseases (including when or , toxicodermia , serum disease , / Contact dermatitis , , , , stevens-Johnson syndrome , );
• malaya Korera , , revmokart ;
• sharp i. chronic diseaseswhich are accompanied by inflammation in the joints and the near-hand fabric (, non-specific tendosinite , seronegative spondylitritis , epicondylitis , (including post-traveled), etc.);
• diffuse diseases connective tissue ;
• astmatic status and ba;
• lung cancer (the medicine is prescribed in combination with cytostatics);
• interstitial diseases pulmonary fabric (fibrosis , etc.);
• eosinophilic and aspiration pneumonia , tuberculosis Meningite , lung tuberculosis (as a supplement to specific therapy);
• primary and secondary hypocorticism (including after adrenalctomy );
• congenital hyperplasia of adrenal glands (VGN) or their bark dysfunction ;
• granulomatous thyroid ;
• autoimmune diseases ;
• hepatitis ;
• inflammatory diseases of the GTC ;
• hypoglycemic states ;
• neftyal syndrome ;
• diseases of blood-forming organs and blood ( , anemia and associated with defeat hemostasis systems diseases);
• the edema of the brain (by a randomy, developing during a tumor, after surgery intervention or injury; in annotations and the Vidal directory, it is indicated that when the brain edema, treatment is starting with parenteral forms of the drug);
• autoimmune and other skin diseases (including dorring disease , , , , layella syndrome , exfoliative dermatitis );
• eye diseases (including autoimmune and allergic; including uveta , allergic ulcer , allergic conjunctivitis , sympathetic ophthalmia , horoidit , iridocyclit , ungvented keratitis etc.);
• developing on background oncological diseases hypercalcemia .

Indications for the use of injections are urgent states, for example, acute attack food allergies or anaphylactic shock . After several days of the parenteral use of the patient, as a rule, transferred to the tableted form of prednisolone.

The testimony for the use of tablets is a chronic character and flowing in the severe form of pathology (for example, ).

Also, the solution and tablets prednisone are used to prevent transplant rejection and nausea / vomiting cytostatics patients.

Prednisolone ointment: why and when the exterior use of the drug is shown?

As an outer agent, prednisolone is used from allergies and for the treatment of inflammatory skin diseases Nemikrobial etiology. Indications for the use of ointment:

• (contact, allergic and atopic);
• discoidal Red Volchanka ;
• psoriasis ;
• eczema ;
• erythrodermia ;
• hives .

Prednisolone: \u200b\u200bWhat are eye drops for?

Drops in the eyes are prescribed to relieve the front segment of inflammation of noncommunicable nature, as well as inflammations that develop after injury of the eye or ophthalmic surgery.

Local application Prednisolone reasonably under the following eye diseases:

• uveite ;
• irit. ;
• allergic conjunctivitis ;
• keratitis (in particular, discoid and parenchymal ; In cases where it is not damaged epithelial fabric cornea);
• scleerit ;
• episclerite ;
• blepharitis ;
• blefarkonjunokivitis ;
• sympathetic ophthalmia.

Contraindications

If necessary, the systemic use of the drug according to life indications of contraindications can only be the intolerance to one or more components included in their composition.

Patients S. heavy infectious diseases tablets and prednisolone injections are prescribed only against the background of specific therapy.

Contraindications to the intra-articular administration of the drug are:

• pathological bleeding (due to application anticoagulantov or endogenic );
• piogenic arthritis and periarticular infections (including a history of);
• cressing fracture of bone ;
• system infections ;
• "Dry" joint (lack of signs of the inflammatory process in the joint: for example, when osteoarthritis Without signs of inflammation synovial shell );
• pronounced deformation of Sustava , bone destruction or okolosuxtaous osteoporosis ;
• developed on the background Sustav's instability;
• aseptic necrosis of bone epiphysis that form a joint;
• pregnancy.

The prednisolone should not be applied at:

• mikosakh, virus and bacterial lesions of the skin ;
• skin manifestations ;
• skin tumors ;
• tuberculosis ;
• (in particular, with pink and ordinary eels);
• pregnancy.

Eye drops are not prescribed to patients with fungal and viral eye lesions disturbed by the integrity of the cornea epithelium, when trach , acute purulent and Viral conjunctivitis , purulent infection of century and mucous membrane , purulent ulcer corneal , Tuberculosis eye , as well as at the states developed after the removal of the foreign object from the horny shell of the eye.

Side effects of prednisolone

At the frequency of development and severity of side effects of prednisolone affects the dose used, the duration, method, as well as the possibility of compliance with the circadian rhythm of the drug.

Systemic use means can cause:

• liquid delays and Na + in the body, development of nitrogenous deficit , hypographicalemic alkalosis , hypokalemia , glucosuria , hyperglycemia , weight gain;
• secondary hypocorticism and hypocituitarism (especially if the GCS reception coincides with the periods of stress - injuries, surgical operations, diseases, etc.), the increase in children in children, cushing syndrome Violations menstrual cycle, manifestation S. angle Lada-diabetes , reduction of glucose tolerance, increase the need for oral Hypoglycemic facilities and diabetic;
• increasing blood pressure, hsn (or strengthening its severity), hypercoagulation characteristic of for hypokalemia ECG-change, dissemination necrotic focus and slowdowns of scar formation with possible gap of heart muscle in patients with acute / subacle supporting endarteritis ;
• steroid myopathy , muscular weakness, aseptic necrosis The heads of the shoulder and femoral bone, the loss of muscle mass, the compression fracture of the spine and the pathological fractures of tubular bones, osteoporosis ;
• ulcerative Ezophagitis , , disorders of digestion, vomiting, nausea, strengthening appetite, development steroid ulcers with possible complications in the form of its sulfate and bleeding from the ulcerative defect, ;
• hypo- or skin hyperpigmentation skin atrophy and / or subcutaneous fiber , the appearance of acne, atrophic stripes, abscess , slow down wound healing, ekhimozov , petechiy , skin thinning, strengthening, erythema ;
• mental violations (Possible hallucinations, delia , , ), pseudo-pump syndrome brain (most often develops in children with a too fast dose reduction and manifests itself in the form of a decrease in visual acuity, headaches, diplopias), sleep disorders, vertigu , dizziness, headache, development with turbidity localization in the back of the lens, eye hypertension (There is probability damage spectator nerve ), steroid Exophthalma , , sudden blindness (with the introduction of a solution of d / and in the area of \u200b\u200bthe nasal sinuses, heads and necks);
• hypersensitivity reactions (both local and generalized);
• general weakness;
• trimming states.

Consequences of use on the skin:

• teleangiectasia ;
• purpura ;
• steroid ;
• burning, irritation, dryness and itchy skin.

When applied to extensive surfaces of the skin and / or when long use Mazi develop system effects, hypertrichosis Also possible atrophic changes and Secondary skin infection .

Treatment of eye drops may be accompanied by eye hypertension , damage to the optic nerve , violation of acuteness / narrowing of fields of view, increasing the likelihood perforations of horny shell eyes , Development cataracts with closet location in the back of the lens. In rare cases maybe spreading fungal or viral eye disease .

Signs of cancellation syndrome

One of the consequences of the use of GKS may become "Cancellation syndrome" . His severity depends on functional state core of adrenal glands . In light cases after the cessation of treatment, prednisolone is possible disabilities, weakness, fast fatigue, muscle pain, loss of appetite, hyperthermia, aggravation of the main disease.

In severe cases, the patient can develop Hypadrenal crisis who is accompanied by vomit convulsions , collapse . Without the introduction of GCS in a short time comes death from acute cardiovascular insufficiency .

Instructions for the use of prednisolone (method and dosage)

Instructions for the use of prednisolone in injections

The solution is administered intravenously, intramuscularly and intravantly.

The method of administration and dosage of prednisolone ( Prednisolone Nicomed , Prednisolone hemisuccinate ) They are selected by an individually attending physician, taking into account the type of pathology, the severity of the state of the patient, the localization of the affected organ.

With severe and threatening life of the states of the patient, pulse therapy is prescribed using over a short period of ultrahigh doses for a short period. For 3-5 days, 1-2 g of prednisiolone is administered daily by intravenous drip infusion. The duration of the procedure is from 30 minutes to 1 hour.

During treatment, the dosage is adjusted depending on the response of the patient's body to therapy.

Optimal is considered to introduce prednisolone in / c. For intra-articular administration, the ampoules with prednisone is used only in cases where the tissue inside the joint is affected by the pathological process.

Positive dynamics is a reason for transferring the patient to tablets or candles with prednisone. Treatment Tablets continue to developing remission.

If it is impossible to introduce prednisone in / in, the medicine should be introduced deep into the muscle. However, it should be borne in mind that with this method it is absorbed slower.

IN human organism ejection hormones adrenal glands In the bloodstream occurs between 6 and 8:00 am, so the injection should also be done at this time. All daily dose, as a rule, administered immediately. If this is not possible, in the morning clock is introduced at least ⅔ the prescribed dose, the remaining third should be entered at lunch (approximately at 12:00).

Depending on the pathology, the dose can fluctuate in the range of 30-1200 mg / day. (followed by its decline).

Children aged from two months to 1 year are administered from 2 to 3 mg / kg. Dosage to children from year to 14 years - 1-2 mg / kg (in the form of a slow, duration of 3 minutes, intramuscular injection). If necessary, after 20-30 minutes, the medicine is reused in the same dose.

With damage to large joints, 25 to 50 mg of prednisolone is administered to it. In the joints of the average size, from 10 to 25 mg are introduced, in small - from 5 to 10 mg.

Prednisolone tablets: Instructions for use

The patient's tablets are translated, following the principle of gradual cancellation of GKS.

In the case of the use of UGT, the patient is prescribed from 20 to 30 mg of prednisolone per day. Supporting dose - from 5 to 10 mg / day. With some pathologies - for example, neftyal syndrome - It is advisable to prescribe higher doses.

For children, the starting dose is 1-2 mg / kg / day. (Sharing it follows 4-6 receptions), which is supporting - from 0.3 to 0.6 mg / kg / day. When appointed, the daily secretory rhythm takes into account endogenous steroid hormones .

Recommendations for the use of drugs of different manufacturers are the same. That is, instructions on Tablets Nicomed It does not differ from the instructions for the tablets produced by Biosynthesis.

Prednisolone ointment: instructions for use

Ointment is a means of outdoor therapy. Apply to the affected areas of the skin it follows a thin layer from 1 to 3 r. / Day. Limited pathological foci can be applied an occlusal bandage to enhance the effect.

In the case of applications in children, older than one year old age, the drug should be applied as a short course as possible. Events can also be eliminated to enhance the suction and resorption of prednisiolone (occlusive, fixing, warming bandages).

Eye drops: instructions for use

Instillations with the drug are carried out 3 r. / Day., Instilled in conjunctival The cavity of the affected eye is 1-2 drops of solution. In the acute phase of the disease, the injection of the injection is allowed to repeat every 2-4 hours.

Patients who suffered an ophthalmic surgery are prescribed for 3-5 days after surgery.

How long can you take prednisone?

Therapy glucocorticosteroids aimed at achieving the maximum effect by minimally possible doses.

The duration of treatment depends on the diagnosis of the patient and the individual reaction to treatment. In some cases, the course lasts up to 6 days, with the UGT it is stretched for months. The duration of outdoor therapy with the use of ointment prednisone is usually from 6 to 14 days.

Dosage for animals

Dosage for dogs and for cats is selected individually depending on the testimony.

So, for example when infectious peritonite Cat should be given inside 1 r. / day. 2-4 mg / kg of prednisone, with chronic punching - 2 r. / Day. 2.5 mg.

Standard Dosage Dog - 1 mg / kg 2 r. / Day. Treatment lasts 14 days. Upon completion of the course, you must pass the tests and pass the doctor. When canceling the drug, reduce the dose for dogs should be 25% every 14 days.

Overdose

Overdose is possible with prolonged use of the drug, especially if high doses are prescribed to the patient. She manifests itself peripheral edema , Increased hell , strengthen side effects.

In case of acute overdose, it is necessary to rinse the stomach immediately or give a patient a vomit. There is no specific antidote of prednisone. When symptoms of an overdose of a chronic character appear, it is necessary to reduce the dose used.

Interaction

Interaction with other means is observed only with the systemic use of prednisolone.

, antiepileptic means , barbiturates They contribute to the acceleration of the metabolism of prednisone and weaken its action. The efficacy of the drug is also reduced in combination with antihistamine drugs .

Carboanhydrase inhibitors, tiazid diuretics increase the likelihood of severe hypokalemia , Sodium containing means - increase blood pressure and swelling.

In combination S. The risk of developing hepatotoxic effects, in combination with tricyclic antidepressants it is possible to strengthen the taking prednisolone of mental disorders (including severity depression ) in combination with immunosuppressants - Risk of development infection and lymphoproliferative processes .

In combination with ASK, NSAID and alcohol increases the likelihood of development peptic disease and bleeding from ulcerative defects.

Oral contraceptive The means change the pharmacodynamic parameters of prednisolone, thereby enhancing its therapeutic and toxic effect.

Prednisolone relaxes anticocratic effect of anticoagulantov as well as action insulin and oral hypoglycemic products .

The use of prednisone in immunosuppressive doses in combination with alive vaccines can provoke viruses replication, decrease in antibodies, developing viral diseases. In case of use with inactivated vaccines The risk of reducing the production of antibodies and neurological disorders increases.

With prolonged use increases content in combination with diuretics Can provoke violations of electrolyte metabolism.

Terms of sale

To acquire prednisolone, you must have a prescription for the drug.

Recipe prednisolone on Latin (for the introduction of a child to a year):

RP: SOL. Prednnisoloni Hydrochloride 3% - 1.0

D.T.D. N 3 in amp.

S. V / m 0.7 ml (in / m - 2 mg / kg / day; in / in - 5 mg / kg / day)

Storage conditions

The ointment retains its properties at a temperature of 5-15 ° C, tablets and a solution for systemic use - at temperatures up to 25 ° C, the drops for the eyes - at a temperature of 15-25 ° C.

The contents of the open bottle with drops should be used within 28 days.

Shelf life

For ointments, tablets and solutions for systemic use - two years, for eye drops - three years.

special instructions

Prednisolone treatment must be stopped slowly, smoothly reducing the dose.

Patients having an anamnesis psychosians High doses are allowed to assign only under the strict control of the doctor.

How to "tear" from prednisone?

Treatment prednisolone should be completed gradually. Reducing the dose is carried out, reducing the dose used weekly to ⅛ or taking the last dose every other day and reducing it to ⅕ (this method is faster).

With a rapid way per day without prednisone, the patient shows the stimulation of adrenal glands using UHF Il DKV on their projection, reception ascorbic acid (500 mg / day), the introduction of insulin in increasing doses (start-up - 4 units, in the future for each reception it is raised by 2 units; the highest dose is 16 units).

Insulin It should be pricked before breakfast, for 6 hours after injection, a person must remain under observation.

If prednisone is assigned to bronchial asthma it is recommended to go to inhalation steroids . If the indication for use is an autoimmune disease - on soft cytostats .

Features of the diet when receiving prednisolone

In addition, it is necessary to limit the amount of high-calorie food with a high content of carbohydrates and fats (their consumption against the background of GKS therapy helps to increase blood glucose and rapid weight gain), salt and fluid.

When cooking, you need to use products that contain potassium salts, calcium and protein (dietary varieties of meat, dairy products, fruits, solid cheeses, baked potatoes, prunes, apricots, nuts, zucchini, etc.).

What can replace prednisone?

Analogs in composition for dosage forms For system use: Prednisolone Nicomed (in ampoules), Prednisolone Nicomed , Decksoft , PRENACID , Dexamethamblong , Ozdex. .

Compatible with alcohol

Alcohol and GKS are incompatible.

Prednisolone during pregnancy

Pregnancy and lactation are contraindications to the appointment of GCS. The use of these funds is allowed only on life indications.

Newborn, whose mothers during pregnancy received prednisone, due to the probability of development hypocorticism must be under the supervision of the doctor.

In animal experiments were installed teratogenicity of the drug .

In severe forms of allergic reactions in addition to antihistamine drugs, hormonal means are prescribed. With acute and chronic process, accompanied by inflammation, acute symptoms, without glucocorticosteroids can not do.

Prednisolone in tablets shows an active anti-inflammatory action, it will stop dangerous signs with serious problems on the background different species Allergies. In critical situations, the preparation of prednisone in the form of a solution for injections is effective.

Composition

The drug with an active antiallergic and anti-inflammatory action belongs to the group "glucocorticosteroids". High activity in the suppression of signs of the pathological process provides the existing substance prednisolone.

Each tablet contains 5 mg of the active component. In the pharmacy, the drug enters the package No. 30 and No. 100. Against the background of a low price, the active suppression of inflammatory processes is noted.

Act

Prednisolone-based preparation shows positive effects during the relief of signs of acute allergic reactions. The drug inhibits the accumulation of leukocytes, macrophages on the lesion site, suppresses the production and release of inflammation mediators, enhances the synthesis of lipomodulin. The active impact quickly removes the ethnicity, strong itching, removes redness, reduces skin reactions.

Effect of glucocorticosteroid:

• anti-allergic;
• anti-face;
• anti-acudative;
• anti-inflammatory;
• immunodepressive.

Indications for use

The potent drug is prescribed to suppress the inflammatory process with different groups of diseases. During the development of allergic reactions, the prednisolone drug also exhibits active action. For this reason, the steroid remedy is recommended in the composition complex therapy Many types of allergies in severe form.

Indications for destination Prednisolone based tablets:

• (signs are marked all year round or at a certain season);
• serum disease;
• severe negative reactions to the reception or administration of drugs;
• severe form of psoriasis;
• dermatitis. Varieties: Herpetyform buglese, heavy seborrheic, exfoliative.

Contraindications

It is forbidden to apply a potent agent in the following cases:

• vaccination period;
• cushing syndrome;
• tendency to thrombosis;
• hypertension (heavy form);
• chickenpox;
• ulcer 12-rectory or stomach;
• renal failure;
• herpes - ishing or simple.

During pregnancy, prednisolone is prescribed with extreme caution, only under states threatening the mother's life. During the lactation period, it is undesirable to take a glucocorticosteroid tablets, especially when identifying the baby increased level Bilirubin.

Instructions for use and dosage

• take pills inside, you do not need to warm up;
• for each patient, the dosage picks up the attending physician;
• an important point is the time of reception of the drug. The patient is obliged to take the whole dose or 75% at 8 am, the remainder in the evening. Such method takes into account the secretory rhythm GKS;
• adults: Replacement therapy, relief of acute states - from 20 to 30 mg per day, the optimal supporting dose is lower - from 5 to 10 mg per day. The period of therapy is not more than 10-14 days. During treatment, blood indicators are monitored, in the occurrence of stressful situations, the parenteral administration of a potent means is recommended. Strict control of the doctor is necessary when recorded in an outpatient map about psychosis in history;
• children: At the beginning of therapy, each kilogram of the weight of the child is required from 1 to 2 mg of prednisolone with the distribution of daily dose by 4-6 receptions. When normalizing the status, the dosage is reduced. It is forbidden to maintain the concentration of the active substance on high level The whole period of treatment: overdose is possible, severe reactions occur. For supporting therapy, it is sufficient to 300 to 600 μg of the active substance per 1 kg of weight. The optimal treatment option is intermittent dosage: 3 days reception, 4 days break. With such a scheme, the risk of a rise in the growth and development of the child is reduced.

Important! The prednisone drug is allowed to children only in cases where other drugs do not help. In critical situations, glucocorticosteroids are prescribed to babies up to 1 year. Self-treatment is prohibited, the dosage is calculated by the doctor, based on the mass of the body of a small patient.

Probable side effects

Glucocorticosteroids often provoke negative reactions to the components of the drugs. Prednisone is no exception. The patient should know information on the side effects of the hormonal agent.

Side effects from prednisolone manifests itself in different ways:

• increasing blood pressure, thrombosis, heart failure, excess blood flowing;
• increase in body weight, sodium delay in the body, fabric delay, decrease in potassium concentration, excess of blood glucose levels;
• loss of muscle mass, dying tissue of articular heads, osteoporosis, fractures of long bones, myopathy;
• strengthening appetite, pancreatitis, vomiting, heartburn, nausea, bloating, ulcerative esophagitis, development of ulcerative lesions of the stomach and 12-rings (bleeding);
• dizziness, hallucinations, euphoria, insomnia, an increase in intraocular pressure, cataract, vision;
• petechia, sweating, erythema, poor healing of wounds, impaired skin pigmentation, thinning of the epidermis;
• , dermatitis, anaphylactic shock;
• violation of adrenal functions, pituitary glands, hypothalamus, growth slowdown in childhood, menstrual cycle failures;
• cancellation syndrome total weakness, disguise infectious pathologies, loss of consciousness, sharp deterioration in the quality of vision.

special instructions

Prednisolone is a potent drug. Before use, the patient is obliged to clarify the dosage, the rules for use in the attending physician. Violation of recommendations is caused side effects.

Important moments:

• before appointing medication in tablets or injections, the patient must be examined: the elimination of restrictions will prevent complications during therapy. It is important to check the condition of digestive organs, eyes, lungs, urinary system;
• during therapy, the patient periodically passes the blood test to control the indicators. A study of the level of glucose and electrolytes is carried out;
• immunization during oral admission or prednisone injections is prohibited;
• with heavy diseases developing on the background bacterial infectionThe simultaneous reception of antibiotics is required.

Cost

Hormonal drug for integrated therapy of heavy varieties of allergic reactions is inexpensive:

• price prednisolone Tablets, packaging №100 - from 85 to 115 rubles;
• prednisolone ointment, 10 g - from 25 to 40 rubles;
• the solution for injection 1 mg, 3 ampoules - from 33 to 45 rubles.

Analogs

There are several drugs that replace prednisolone in pharmacies. The selection of the composition with a similar action is the competence of the attending physician. It is important accounting of age, contraindications, severity of an allergic reaction.

Analogs of prednisolone:

• Medopred.
• Prednisol.
• New prednisone.
• Decortin.

Prednisolone in ampoules

Features of using the injection solution:

• the current component is the same as in tablets;
• prednisolone injections effectively stop the inflammatory process;
• dosage, the method of maintaining depend on the nature of the disease, the severity of the reaction, the age of the patient;
• the introduction of drugs in allergic diseases is carried out intramuscularly or intravenously. The second method has more advantages, fewer side effects;
• important moment: Injection of the drug during the emission of adrenal hormones (period from 6 to 8 hours). In the same period, the doctors recommend using a glucocorticosteroid solution;
• the optimal option is the introduction of the entire dose of the drug in the morning. If it is impossible to accomplish this condition, then 2/3 of the volume of the drug is prescribed in the morning, at 12 o'clock - the remaining part;
• in the asthma status of injection of anti-inflammatory agents, four days are carried out, with the disappearance of heavy symptoms on the fifth day, the drug is canceled;
• with allergic reactions, every 8 hours intravenously administered from 100 to 200 mg of prednisone;
• prices are prescribed in critical situations. The liquid form penetrates the problem of the problem zones faster, it slows down the release of histamine, suppresses the sensitivity of effector cells, blocks the synthesis and secretion of inflammation mediators.

This article can be found in the instructions for the use of drug. hormonal drug Prednisolone. Presented reviews of site visitors - consumers this medicine, as well as the opinions of medical professionals on the use of prednisolone in their practice. A big request to more actively add your reviews about the preparation: helped or did not help the medicine to get rid of the disease, which complications were observed and side effects, possibly not stated by the manufacturer in annotations. Analogs of prednisolone in the presence of available structural analogs. Use for the treatment of shock and urgent states, allergic reactions, inflammatory manifestations in adults, children, as well as during pregnancy and breastfeeding.

Prednisolone - Synthetic glucocorticoid preparation, dehydrated analog of hydrocortisone. It has an anti-inflammatory, anti-allergic, immunosuppressive effect, increases the sensitivity of beta-adrenoreceptors to endogenous catecholamine.

Interact with specific cytoplasmic receptors (receptors for GCS are in all tissues, especially there are many of them in the liver) with the formation of a complex inducing proteins (including enzymes that regulate vital processes in cells.)

Protein exchange: Reduces the number of globulins in plasma increases the synthesis of albumin on the liver and kidneys (with an increase in albumin / globulin coefficient), reduces the synthesis and enhances the catabolism of the protein in muscle tissue.

Lipid sharing: increases the synthesis of higher fatty acids and triglycerides, the fat redistributes (fat accumulation occurs mainly in the field of shoulder belt, facial, belly) leads to the development of hypercholesterolemia.

Carbohydrate: increases the absorption of carbohydrates from the gastrointestinal tract; increases the activity of glucose-6-phosphatase (increasing the flow of glucose from the liver into blood); Increases the activity of phosphoenolpiruwatkarboxylase and the synthesis of aminotransferase (activation of gluconeogenesis); Promotes the development of hyperglycemia.

Water and electrolyte exchange: delays sodium and water in the body, stimulates the removal of potassium (mineralocorticoid activity), reduces the absorption of calcium from the gastrointestinal tract, reduces the mineralization of bone tissue.

The anti-inflammatory effect is associated with the oppression of release of eosinophils and fat cells of inflammation mediators; induction of lipocortion formation and reducing the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; Stabilization of cell membranes (especially lysosomal) and organelle membranes. Acts on all stages of the inflammatory process: inhibits the synthesis of prostaglandins at the level of arachidonic acid (lipocortine inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperosis, leukotrienes, contributing to the processes of inflammation, allergies, etc.), the synthesis of "pro-inflammatory cytokines" (interleukin 1, Tumor necrosis factor Alpha et al.); Increases the stability of the cell membrane to the action of various damaging factors.

The immunosuppressive effect is due to the resulting lymphoid tissue involution, the inhibition of lymphocyte proliferation (especially T-lymphocytes), suppressing the migration of B cells and the interaction of T- and limfocytes, the braking of the release of cytokines (interleukin-1, 2; gamma interferon) from lymphocytes and macrophages and a decrease in antibody formation.

The antiallergic effect develops as a result of a decrease in the synthesis and secretion of allergy mediators, inhibition of release of the release from sensitized fat cells and basophils of histamine and other biologically active substances, reducing the number of circulating basophilies, t- and limmphocytes, fat cells; suppressing the development of lymphoid and connective tissue, reducing the sensitivity of effector cells to allergy mediators, inhibition of antibody formation, changes in the immune response of the body.

For obstructive diseases respiratory tract The action is mainly due to the braking of inflammatory processes, the prevention or decrease in the severity of edema of mucous membranes, a decrease in the eosinophilic infiltration of the submembraty layer of the epithelium of the bronchi and sediments in the mucous membranes of circulating immune complexes, as well as inhibition of erosion and desquamation of the mucous membrane. Increases the sensitivity of beta-adrenoreceptors of bronchi small and medium caliber to endogenous catecholamps and exogenous sympathomimetics, reduces the viscosity of the mucus by reducing its products.

Suppresses the synthesis and secretion of the ACTH and the secondary - synthesis of endogenous glucocorticosteroids.

Inhibits the connective tissue reactions during the inflammatory process and reduces the possibility of forming scar tissue.

Pharmacokinetics

The prednisone is metabolized in the liver, partly in the kidneys and other tissues, mainly by conjugation with glucurium and sulfuric acids. Metabolites are inactive. It is displayed with bile and with urine by glomerular filtration and by 80-90% reabsorbated by tubules.

Indications

• shock conditions (burn, traumatic, operational, toxic, cardiogenic) - with ineffectiveness vasoconductive means, plismant drugs and other symptomatic therapy;
• allergic reactions (sharp heavy forms), hemotransfusion shock, anaphylactic shock, anaphylactoid reactions;
• brain edema (including on the background of brain tumor or related surgical intervention, radiation therapy or head injury);
• bronchial asthma (severe form), asthmatic status;
• systemic diseases of the connective tissue (systemic red lupus, sclerodermia, nodular periaryitis, dermatomyosis, rheumatoid arthritis);
• acute and chronic inflammatory diseases joints - gouty and psoriatic arthritis, osteoarthritis (including post-trap), polyarthritis, shoulder periarthritis, ankylosing spondylitrite (Bekhterev's disease), juvenile arthritis, style syndrome in adults, bursitis, nonspecific tendosiveit, synovit and epicondylitis;
• skin disease - bubble, psoriasis, eczema, atopic dermatitis (common neurodermatitis), contact dermatitis (with a lesion of a large leather surface), toxidermy, seborrheic dermatitis, exfoliative dermatitis, toxic epidermal necroliz (Layella syndrome), bullous herpetyiform dermatitis, Stevens-Johnson syndrome;
• allergic eye diseases: conjunctivitis allergic forms;
• inflammatory eye diseases - sympathetic ophthalmia, severe sluggish front and rear uveitis, neuritis the visual nerve;
• congenital hyperplasia of adrenal glands;
• blood Diseases and Blood Organization System - Agranulocytosis, Päyelopathy, Autoimmune hemolytic anemia, acute lympho and myeloid leukemia, lymphogranulomatosis, thrombocytopenal purple, secondary thrombocytopenia in adults, erythroblasting (erythrocyte anemia), congenital (erythroidish) hypoplastic anemia;
• berylliosis, Lefeler syndrome (unnecessary dr. therapy); lung cancer (in combination with cytostatics);
• multiple sclerosis;
• prevention of the reaction of the transplant rejection during organ transfers;
• hypercalcemia amid oncological diseases, nausea and vomiting during cytostatic therapy;
• myeloma disease;
• thyrotoxic crisis;
• acute hepatitis, hepatic coma;
• reducing the inflammatory phenomena and the prevention of scapov's escautionalities (in the poisoning of miltyant fluids).

Forms of release

Tablets 1 mg and 5 mg.

A solution for intravenous and intramuscular administration (injections in ampoules for injection) 30 mg / ml.

Eye drops 0.5%.

Outfolding ointment 0.5%.

Instructions for use and dosage

Injection

The dose of prednisolone and the duration of treatment is established by a doctor individually depending on the testimony and severity of the disease.

Prednisolone is administered intravenously (drip or jet) in droppers or intramuscularly. V / in the drug is usually introduced first inwards, then drip.

With acute adrenal insufficiency, one-time dose is 100-200 mg for 3-16 days.

In bronchial asthma, the drug is administered depending on the severity of the disease and efficiency comprehensive treatment from 75 to 675 mg on a course of treatment from 3 to 16 days; In severe cases, the dose can be increased to 1400 mg per course of treatment and more than a gradual decline in the dose.

With asthmatic status, prednisolone is administered at a dose of 500-1200 mg per day, followed by a decrease of up to 300 mg per day and the transition to supporting doses.

With thyrotoxic crisis, 100 mg of the drug in the daily dose of 200-300 mg is injected; If necessary, the daily dose can be increased to 1000 mg. The duration of administration depends on therapeutic effect, usually up to 6 days.

With a shock resistant to standard therapy, prednisone at the beginning of therapy is usually introduced insert, after which they go to drip administration. If for 10-20 minutes the blood pressure does not increase, the jet introduction of the drug is repeated. After removing from the shock state, drip administration continues to stabilize the blood pressure. One-time dose is 50-150 mg (in severe cases - up to 400 mg). Repeated the drug is injected after 3-4 hours. The daily dose can be 300-1200 mg (followed by a decrease in the dose).

With acute hepatic renal failure (with acute poisoning, in postoperative and postpartum period etc.), prednisolone is introduced at 25-75 mg per day; In the presence of testimony, the daily dose can be increased to 300-1500 mg per day and above.

For rheumatoid arthritis and the systemic red lupus prednisolone is administered in addition to the system reception of the drug at a dose of 75-125 mg per day not more than 7-10 days.

With acute hepatitis, prednisolone is introduced at 75-100 mg per day for 7-10 days.

With poisoning migration fluids with burns digestive tract And the upper respiratory tract prednisolone is prescribed at a dose of 75-400 mg per day for 3-18 days.

If it is impossible in / in administration, prednisolone is introduced in the same doses. After relieving the acute state, prescribed the prednisone in tablets, followed by a gradual decrease in the dose.

With prolonged reception of the drug, the daily dose should be reduced gradually. Long therapy can not be stopped suddenly!

Pills

The entire daily dose of the drug is recommended to take a one-time or double daily dose every other day, taking into account the circadian rhythm of the endogenous secretion of glucocorticosteroids in the range from 6 to 8 hours in the morning. A high daily dose can be distributed on 2-4 receptions, while in the morning you should take a large dose. Tablets should be taken inward during or immediately after eating, drinking a small amount of liquid.

With acute states and as replacement therapy Adults are prescribed in the initial dose of 20-30 mg per day, the supporting dose is 5-10 mg per day. If necessary, the initial dose can be 15-100 mg per day, supporting - 5-15 mg per day.

For children, the initial dose is 1-2 mg / kg of body weight per day in 4-6 receptions, supporting - 300-600 μg / kg per day.

Upon receipt of the therapeutic effect, the dose is gradually reduced - 5 mg, then 2.5 mg at intervals of 3-5 days, canceling at first later techniques. With prolonged reception of the drug, the daily dose should be reduced gradually. Long therapy can not be stopped suddenly! The abolition of the maintenance dose is carried out by the slower, the longer glucocorticosteroid therapy was used.

In stressful influences (infection, allergic reaction, injury, operation, mental overload), in order to avoid exacerbation of the main disease, the prednisiolone dose must be temporarily increased (in 1.5-3, and in severe cases - 5-10 times).

Side effect

• reduction of glucose tolerance;
• steroid diabetes or manifestation of latent diabetes;
• inhibition of adrenal function;
• itsenko-Cushing syndrome (moon-shaped face, the obesity of a pituitary type, girsutism, an increase in blood pressure, dysmenorrhea, amenorrhea, muscle weakness, strry);
• delay in sexual development in children;
• nausea, vomiting;
• steroid ulcer stomach and duodenal gut;
• erosive esophagitis;
• gastrointestinal bleeding and perforation of the tract wall;
• increase or decrease in appetite;
• indigestion;
• flatulence;
• ikota;
• arrhythmias;
• bradycardia (right up to the heart stop);
• ECG changes characteristic of hypokalemia;
• increased blood pressure;
• disorientation;
• euphoria;
• hallucinations;
• affective insanity;
• depression;
• paranoia;
• an increase in intracranial pressure;
• nervousness or anxiety;
• insomnia;
• dizziness;
• headache;
• convulsions;
• an increase in intraocular pressure with possible damage to the optic nerve;
• a tendency to the development of secondary bacterial, fungal or viral eye infections;
• trophic corneal changes;
• increased calcium elimination;
• improving body weight;
• increased sweating;
• fluid delay and sodium in the body (peripheral edema);
• hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
• slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones);
• osteoporosis (very rarely - pathological fractures of bones, aseptic necrosis of the head of the shoulder and femur);
• breaking muscle tendons;
• reduction of muscle mass (atrophy);
• slow down wound healing;
• acne;
• strya;
• skin rash;
• anaphylactic shock;
• development or aggravation of infections (jointly used immunosuppressants and vaccination are facilitated by the emergence of this side effect);
• cancellation syndrome.

Contraindications

For short-term applications on life indications, the only contraindication is increased sensitivity To prednisone or components of the drug.

The drug contains lactose. Do not take the drug patients with rare hereditary diseasesSuch as lactose intolerance, lactase deficiency like LAPPA or glucose-galactose malabsorption.

Application in pregnancy and breastfeeding

During pregnancy (especially in 1 trimester) apply only on life indications.

Since glucocorticosteroids go to breast milk, if necessary, the use of the drug during the period breastfeeding, breastfeeding is recommended to stop.

special instructions

Before the start of treatment (if it is impossible due to the urgency of the state - in the treatment process) the patient must be examined for the identification of possible contraindications. Clinical examination should include a study of the cardiovascular system, x-ray study lungs, study of the stomach and duodenal intestine, urinary systems, organs of vision; Control of blood formula, glucose content and electrolytes in blood plasma. During treatment with prednisone (especially long), observation of the eyepiece, control of blood pressure, state of water electrolyte balance, as well as pictures of peripheral blood and blood glucose level.

In order to reduce side phenomena Antacids can be prescribed, as well as increase the flow of potassium into the body (diet, potassium preparations). Food should be rich in squirrels, vitamins, with limiting the content of fats, carbohydrates and cooking salts.

The effect of the drug is enhanced in patients with hypothyroidism and cirrhosis of the liver.

The drug can strengthen existing emotional instability or psychotic disorders. When indicating psychosis, a history of prednisone in high doses is prescribed under the strict control of the doctor.

In stressful situations during supporting treatment (for example, surgical operations, injury or infectious diseases) should conduct a dose correction of the drug due to improving the need for glucocorticosteroids.

It should be carefully observed for patients within a year after the end of long-term therapy prednisone due to possible development relative deficiency of adrenal cortex in stressful situations.

In case of a sudden cancellation, especially in the case of the previous use of high doses, the development of the abolition syndrome (anorexia, nausea, inhibition, hirellized muscular and skeletal pain, the general weakness), as well as the aggravation of the disease, was appointed prednisolone.

During treatment, prednisone should not be carried out in connection with a decrease in its effectiveness (immune response).

Assigning prednisone at interco-terrain infections, septic conditions and tuberculosis, it is necessary to simultaneously treat antibiotics of bactericidal action.

In children during prolonged treatment, prednisolone needs careful monitoring of growth dynamics. Children who were in contact with sick cute or wind shelterprophylactically prescribed specific immunoglobulins.

Due to the weak mineralocorticoid effect for substitution therapy in adrenal insufficiency, prednisolone is used in combination with mineralocorticoids.

In patients with diabetes mellitus, the content of blood glucose should be monitored and corrected therapy if necessary.

X-ray control over the bone-articular system (spinal shots, brushes) are shown.

Prednisolone in patients with latent infectious diseases of the kidneys and urinary tract Capacked leukocyturia, which may have a diagnostic value.

In the illness of the Addison, the simultaneous purpose of barbiturates should be avoided - the risk of developing acute adrenal insufficiency (addisonic crisis).

Medicinal interaction

The simultaneous purpose of prednisone with the inductors of hepatic microsomal enzymes (phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration.

The simultaneous purpose of prednisone with diuretics (especially tiazide and carbonic henhydrate inhibitors) and amphotericin in can lead to an increase in the elimination of potassium from the body.

The simultaneous purpose of prednisolone with sodium-containing drugs leads to the development of edema and increased blood pressure.

The simultaneous purpose of prednisone with amphotericin B increases the risk of heart failure.

The simultaneous purpose of prednisone with heart glycosides impairs their portability and increases the likelihood of the development of ventricular extrasystole (due to the caused hypokalemia).

The simultaneous purpose of prednisolone with indirect anticoagulants - Prednisolone enhances the anticoagulant effect of Cumarine derivatives.

The simultaneous purpose of prednisolone with anticoagulants and thrombolitics increases the risk of developing bleeding from an ulcers in the gastrointestinal tract.

The simultaneous purpose of prednisone with ethanol (alcohol) and non-steroidal anti-inflammatory drugs enhances the risk of erosive-ulcerative lesions in the gastrointestinal tract and the development of bleeding (in combination with NSAIDs in the treatment of arthritis it is possible to reduce the dose of glucocorticosteroids due to the amount of the therapeutic effect).

The simultaneous purpose of prednisone with paracetamol increases the risk of hepatotoxicity (induction of hepatic enzymes and the formation of toxic paracetamol metabolite).

The simultaneous purpose of prednisone with acetylsalicylic acid accelerates its elimination and reduces the concentration in the blood (with the abolition of prednisolone, the level of salicylates in the blood increases and the risk of developing side effects).

The simultaneous purpose of prednisone with insulin and oral hypoglycemic drugs, hypotensive means reduces their effectiveness.

The simultaneous purpose of prednisone with vitamin D reduces its effect on the suction of CA in the intestine.

The simultaneous purpose of prednisolone with somatotropic hormone Reduces the effectiveness of the latter, and with a prazicvantel - its concentration.

Simultaneous purpose of prednisone with m-cholinoblockers (including antihistamines And tricyclic antidepressants) and nitrates contribute to an increase in intraocular pressure.

The simultaneous purpose of prednisone with isoniazide and mexylene nephethin increases the metabolism of isoniazide, Mexyleletine (especially in "fast" acetyluoris), which leads to a decrease in their plasma concentrations.

The simultaneous purpose of prednisolone with carbonic henching inhibitors and amphotericin in increases the risk of osteoporosis.

The simultaneous purpose of prednisolone with Indomethacin is the ousting prednisone from communication with albumin, increases the risk of developing its side effects.

The simultaneous purpose of prednisone with ACTG enhances the effect of prednisolone.

The simultaneous purpose of prednisone with ergocalciferol and the parathgamon prevents the development of osteopathy caused by prednisolone.

The simultaneous purpose of prednisone with cyclosporin and ketoconazole - Cyclosparin (inhibits metabolism) and ketoconazole (reduces clearance) increases toxicity.

The appearance of hirsutism and acne contributes to the simultaneous use of other steroid hormones (androgen, estrogen, anabolics, oral contraceptives).

The simultaneous purpose of prednisone with estrogen and oral estrogen-containing contraceptives reduces the clearance of prednisolone, which may be accompanied by an increase in the severity of its therapeutic and toxic effects.

The simultaneous purpose of prednisone with mitotan and other inhibitors of the function of the adrenal cortex can determine the need to increase the dose of prednisolone.

With simultaneous use with alive antiviral vaccines and against the background of other types of immunization increases the risk of activating viruses and the development of infections.

With the simultaneous use of prednisolone with antipsychotic means (neuroleptics) and Azatirapic, the risk of cataract developments increases.

The simultaneous purpose of antacids reduces the suction of prednisolone.

With simultaneous use with anti-immediate drugs, it is reduced, and the clien's prednisolone increases with thyroid hormones.

With simultaneous use with immunosuppressants, the risk of developing infections and lymphoma or other lymphoproliferative violations associated with the Epstein-Barr virus is increased.

Tricyclic antidepressants can enhance the severity of depression caused by the reception of glucocorticosteroids (not shown for therapy of the side effects).

Increases (with long therapy) the content of folic acid.

Hypokalemia caused by glucocorticosteroids may increase the severity and duration of muscle blockade against the background of muscle relaxants.

In high doses reduces the effect of somatropin.

Analogs medicinal preparation Prednisolone

Structural analogues for the acting substance:

• Decortin H20;
• Decortin H5;
• Decortin H50;
• Medopred;
• Prednisol;
• Prednisone 5 mg of yenafarm;
• Prednisone buffus;
• Prednisone hemisuccinate;
• Prednisone nicomed;
• Prednisone-ferment;
• Prednisolone sodium phosphate;
• Saline-decortin H25;
• Saline decortin H250;
• Salley decortin H50.

In the absence of analogues of drugs on the active substance, you can follow the links below on the disease, which helps the appropriate drug, and see the analogues on therapeutic effects.

Drug Prednisolone Instructions for use refers to hormonal glucocorticosteroids. Tablets 1 mg and 5 mg, injections in ampoules for injections, drop eye drops, ointment 0.5% have a pronounced anti-inflammatory effect and help with pathologies associated with an autoimmune pathological process. Patient reviews and recommendations doctors report that this drug helps in the therapy of shock and urgent states, allergic reactions, inflammatory manifestations.

Release form and composition

Prednisolone is released in the following forms:

1. A solution for intravenous and intramuscular administration (injections in ampoules for injection) 30 mg / ml.
2. Tablets 1 mg and 5 mg.
3. Outfolding ointment 0.5%.
4. Eye drops 0.5%.

Prednisone ointment contains 0.05 g of the same active substance. In ampoules there is an active substance at a concentration of 30 mg / ml, in tablets - 1 or 5 mg.

What does prednisone help (pills and injection solutions)?

Systemic testimony of medication include application at:

• asthmatic status and ba;
• hypoglycemic states;
• allergic diseases (including with allergies of food or drug, toxicodermia, serum disease, atopic / contact dermatitis, pollinosis, allergic rhine, urtic, Stevens-Johnson syndrome, swelling of quinque);
• primary and secondary hypocorticism (including adrenalctomy);
• lung cancer (medication is prescribed in combination with cytostatics);
• malaya Korea, rheumatic fever, rheumatar;
• congenital hyperplasia of adrenal glands (VGN) or dysfunction of their bark;
• autoimmune diseases;
• eye diseases (including autoimmune and allergic; including uveitis, allergic ulcerative keratitis, allergic conjunctivitis, sympathetic ophthalmia, choroidite, iridocyclite, non-resident keratitis, etc.);
• acute and chronic diseases that are accompanied by inflammation in the joints and the occasional tissue (synotic, nonspecific tendosynemite, seronegative spondylitis, epicondylitis, osteoarthritis (including post-traveled), etc.);
• developing against the background of hypercalcemia oncological diseases;
• diseases of blood-forming organs and blood (leukemia, anemia and related to the damage system of the hemostasis of the disease);
• interstitial diseases of the pulmonary fabric (fibrosis, acute alveolo, sarcoidosis, etc.);
• granulomatous thyroidity;
• eosinophilic and aspiration pneumonia, tuberculous meningitis, pulmonary tuberculosis (as a supplement to specific therapy);
• nephrotic syndrome;
• inflammatory gastrointestinal diseases;
• diffuse diseases of the connective tissue;
• hepatitis;
• scarmed sclerosis;
• the edema of the brain (by a diprand, developing during a tumor, after surgery intervention or injury; in annotations and the vidal directory, it is indicated that with the edema of the brain, treatment is starting with parenteral forms of the drug);
• autoimmune and other skin diseases (including Durring disease, psoriasis, bubble, bubble, Layella syndrome, exfoliative dermatitis).

The testimony for the use of tablets is a chronic character and flowing in the severe form of pathology (for example, bronchial asthma). Indications for the use of injections are urgent states, for example, an acute attack of food allergies or anaphylactic shock.

After several days of the parenteral use of the patient, as a rule, transferred to the tableted form of prednisolone. Also, the solution and tablets are used to prevent the transplant rejection and nausea / vomiting relocation in the receiving cytostatic patients.

Prednisolone ointment: Why and when is it shown to use it?

As an outer agent, prednisolone is used from allergies and for the treatment of inflammatory skin diseases of non-microbial etiology. And so, indications for the use of ointments:

• erythrodermia;
• limited neurodermatitis;
• psoriasis;
• dermatitis (contact, allergic and atopic);
• discoidal red lupus;
• toxicodermia;
• eczema;
• hives.

Why do eye drops prednisone prescribe?

Drops in the eyes are prescribed to relieve the front segment of inflammation of noncommunicable nature, as well as inflammations that develop after injury of the eye or ophthalmic surgery. The local application of the medication is reasonable for the following diseases of the eyes:

• sympathetic ophthalmia;
• episclerite;
• scarlet;
• allergic conjunctivitis;
• blefarkonjunctivitis;
• keratitis (in particular, disco and parenchymal; in cases where the epithelial tissue of the cornea) is not damaged;
• irit;
• blufarite;
• iridocyclitis;
• uveite.

Instructions for use

Prednisolone in ampoules

The dose and duration of treatment is established by a doctor individually depending on the testimony and severity of the disease. Prednisolone is administered intravenously (drip or jet) in droppers or intramuscularly. V / in the drug is usually introduced first inwards, then drip.

• With acute hepatitis, prednisolone is introduced at 75-100 mg per day for 7-10 days.
• With acute hepatic renal failure (with acute poisoning, in postoperative and postpartum periods, etc.), prednisolone is introduced at 25-75 mg per day; In the presence of testimony, the daily dose can be increased to 300-1500 mg per day and above.
• With rheumatoid arthritis and systemic red lupus, prednisone is administered in addition to the systemic reception of the drug at a dose of 75-125 mg per day not more than 7-10 days.
• With thyrotoxic crisis, 100 mg of the drug in the daily dose of 200-300 mg is injected; If necessary, the daily dose can be increased to 1000 mg. The duration of administration depends on the therapeutic effect, usually up to 6 days.
• In bronchial asthma, the drug is administered depending on the severity of the disease and the effectiveness of complex treatment from 75 to 675 mg per course of treatment from 3 to 16 days; In severe cases, the dose can be increased to 1400 mg per course of treatment and more than a gradual decline in the dose.
• With asthmatic status, prednisolone is administered at a dose of 500-1200 mg per day, followed by a decrease of up to 300 mg per day and the transition to supporting doses.
• With a shock resistant to standard therapy, prednisone at the beginning of therapy is usually introduced insert, after which they are moving to drip administration. If for 10-20 minutes the blood pressure does not increase, the jet introduction of the drug is repeated. After removing from the shock state, drip administration continues to stabilize the blood pressure. One-time dose is 50-150 mg (in severe cases - up to 400 mg). Repeated the drug is injected after 3-4 hours. The daily dose can be 300-1200 mg (followed by a decrease in the dose).
• With acute adrenal insufficiency, one-time dose is 100-200 mg for 3-16 days.
• In poisoning, migratory fluids with the burns of the digestive tract and the upper respiratory tract, prednisolone is prescribed at a dose of 75-400 mg per day for 3-18 days. If it is impossible to / in administration, the solution is introduced in the same doses.

After relieving the acute state, prescribed the prednisone in tablets, followed by a gradual decrease in the dose.

Very important! With prolonged reception of the drug, the daily dose should be reduced gradually. Long therapy can not be stopped suddenly!

Poblisolone tablets

Designed for oral administration. They are used inside, usually after eating, 1 time per day, which is associated with the daily rhythm of the secretion of glucocorticosteroids of adrenal cortex (sometimes, if necessary, the multiplicity of tablet reception can be increased).

The dose is established by the doctor individually, which depends on the type, severity and features of the course of the pathological process in the patient's body. After achieving the necessary therapeutic effect, the dose gradually decreases to its conservation.

The average daily dose for an adult varies within 5-60 mg. The maximum daily dose should not exceed 200 mg (applied in acute flow sclerosis scarm Within 7 days, then the dose gradually decreases to 80 mg per day).

Children dosage is mounted at the rate of 0.14 mg of prednisone per 1 kg of the body weight of the child. In case of passing a tablet, it must be accepted as quickly.

Ointment

Apply externally, causing a thin layer on the affected skin. Equal bandages can be used to enhance the effect on limited sections. Recommended dosing: Apply 1-3 times a day, the duration of the course is usually 6-14 days; In the process of fuzzy, the use of the drug is allowed 1 time per day.

In order to prevent relapses and in the treatment of chronic diseases, the use of ointment continues for some time after the complete disappearance of all the symptoms, but no longer 14 days. Plots with more dense skin (palms, foot, elbows), as well as places where ointment is easily erased, you can lubricate more often.

Eye drops: instructions for use

Instillations The drug is carried out 3 p. / Day., Instilled in the conjunctival cavity of the affected eye 1-2 drops of solution. In the acute phase of the disease, the injection of the injection is allowed to repeat every 2-4 hours.

Patients who suffered an ophthalmic surgery are prescribed for 3-5 days after surgery.

pharmachologic effect

The prednisolone medicine is synthetic glucocorticoid, dehydrated analogue of the hydrocortisone. It has anti-inflammatory, anti-allergic, desensitizing, anti-shift, antitoxic and immunosuppressive, antitoxic and anti-acudative effect.

Interacting with specific cytoplasmic receptors, prednisone forms a complex penetrating into the cell core, stimulates the synthesis of matrix RNA (ribonucleic acid) induced by protein biosynthesis (including lipocortine) encouraging cell effects.

The angry enzyme phospholipase A2, lipocortine suppresses the release of arachidonic acid, as well as the synthesis of prostaglandins and leukotrienes, contributing to inflammatory, allergic and other pathological processes.

The prednisone inhibits the release of the hypophysome β-lipotropin, but the concentration of the circulating β-endorphine does not reduce, suppresses the secretion of TGT (thyrotropic hormone) and FSH (follicular-wing hormone), increases the excitability of the CNS (Central nervous system), reduces the number of lymphocytes, eosinophils, increases the number of blood cells, stimulating the production of erythropoethines.

The ointment prednisone in external use has anti-inflammatory, anti-allergic, anti-plaster and anti-or-allergic effect; inhibits the formation of arachidonic acid, the formation and release of inflammatory mediators (prostaglandins, histamine, lysosomal enzymes, leukotrienes, etc.); Suppresses inflammatory skin reactions, reduces in the focus of inflammation vasodilation and increased vessel permeability.

Contraindications

For short-term use on life indications, the only contraindication is increased sensitivity to prednisone or drug components.

The drug contains lactose. Patients with rare hereditary diseases such as lactose intolerance, lactase lactase deficiency like LAPPA or glucose-galactose malabsorption are not taken.

With caution, the drug should be prescribed with the following diseases and states:

With unfinished reception of tablets, prednisolone side effects are developing extremely rare. With a longer use of the drug, the development of negative reactions from various organs and systems is possible:

• The nervous system is an increase in intracranial pressure, which is accompanied by a syndrome of a congestion disk of the optic nerve (more often develops in children), sleep disorders, convulsions, severe dizziness, headache, fainting.
• The digestive system is the steroid ulcer of the stomach or duodenum, associated with the fact that the prednisolone oppresses the synthesis of prostaglandins of the digestive tract, performing a protective function, bodybreaks or bleeding from it, periodic nausea, vomiting, increase the appetite, inflammation of the pancreas (pancreatitis), esophagus (Pancreatitis) Ezophagitis) with the formation of an ulcer in it, violation of the process of digestion, increased gas formation In the intestine (meteorism).
• Water-electrolyte balance is the delay in water and salts in the body, accompanied by an increase in blood pressure, as well as the development of blood circulation deficiency.
• The metabolism is a negative nitrogen balance in the body, which is caused by the increased destruction of proteins, an increase in body weight.
• The endocrine system is a violation of the functional activity of the adrenal cortex (adrenal insufficiency), suppressing the growth process in children, increasing blood sugar (hyperglycemia), violation of the menstrual cycle in women, manifestation of hidden (latent) diabetes, girsutism (increased column skin Pokrovwhich is especially noticeable in women).
• Musculoskeletal system - muscle weakness, increased fragility Bones (osteoporosis), which causes subsequent pathological fractures, including a compression fracture of some vertebrae.
• Higher nervous activity - The symptoms of psychosis may appear, especially in the first 2 weeks after the start of reception of the tablets prednisolone, more often develops in women and in individuals with red systemic lupus.
• The eyes - cataract, an increase in intraocular pressure, as a result of which the glaucoma is developing, Exophthalm.
• Leather and subcutaneous fiber - thinning (atrophy) of the skin, strlica on it, deterioration of wound healing, erythema (leather redness), increased sweating (hyperhydrosis), the appearance of acne, point hemorrhage on the skin (petechia).
• Indicators laboratory studies - Reducing the number of leukocytes (leukopenia), platelets (thrombopement), an increase in the level of calcium in the blood, urine, an increase in the level of triglycerides, total cholesterol, as well as lipoproteins of low and very low density.
• Allergic reactions - rarely on the background of receiving tablets prednisolone, it is possible to develop anaphylactic shock with polyorgan deficiency and progressive decrease in blood pressure.

In the case of the development of side effects, the question of the abolition of tablets prednisolone The doctor solves individually, depending on their species, nature and severity.

Ointment

Possible side effects due to ointment application prednisone: steroid eels, purpura, teleangectasia, burning, itching, irritation and dry skin.

Long-term use and / or application of ointment on large surfaces can cause the development of hypercorticism due to the resorbative effect of prednisolone. In such cases, the use of the drug is required to stop and refer to the specialist. In the exacerbation of the described side effects, or the appearance of any other reactions not specified in this Instruction should be reported by a doctor.

Eye drops

After instillation of prednisolone, there is a transient feeling of burning. The result of long-term use may be an increase in intraocular pressure, and in connection with the preparations containing GCS, use no more than 10 days and under regular control of intraocular pressure. The continuous use of the eye suspension for 3 months and more can cause the development of rebonxular cataracts.

Signs of cancellation syndrome

One of the consequences of the use of GCS can be the "cancellation syndrome". Its severity depends on the functional state of the adrenal cortex. In light cases, after discontinuation of treatment, prednisolone is possible disabilities, weakness, fast fatigue, muscle pain, loss of appetite, hyperthermia, aggravation of the underlying disease.

In severe cases, a patient may develop a hypo-tubereal crisis, which is accompanied by vomiting, convulsions, collapse. Without the introduction of GCS in a short time, death comes from acute cardiovascular insufficiency.

Children, during pregnancy and breastfeeding

During pregnancy (especially in 1 trimester) apply only on life indications. Since glucocorticosteroids go into breast milk, if necessary, applying a drug during breastfeeding period, breastfeeding is recommended to stop.

In Pediatrics, GCS applies only by absolute Indications, under the careful observation of the doctor, as they are able to cause a slowdown in children and teenagers. Usually the risks of development of such side effect Allows you to avoid or minimize the destination of prednisolone every other day.

special instructions

Patients having a history of psychosis, high doses are allowed to assign only under the strict control of the doctor.

How to "tear" from prednisone?

Treatment prednisolone should be completed gradually. Reducing the dose is carried out, reducing the dose used weekly to ⅛ or taking the last dose every other day and reducing it to ⅕ (this method is faster).

With a quick way per day without prednisone, the patient shows the stimulation of adrenal glands with the use of UHF Il DKV on their projection, the reception of ascorbic acid (500 mg / day), the introduction of insulin in increasing doses (start-up - 4 units, in the future for each reception it increases 2 units; Higher dose - 16 units).

Insulin pricks before breakfast, for 6 hours after injection, a person must remain under observation.

If prednisone is assigned to bronchial asthma, it is recommended to switch to inhalation steroids. If the indication for use is an autoimmune disease - on soft cytostatics.

Medicinal interaction

Due to the high pharmacological activity, prednisolone, like other GCS, can weaken or increase the effect of many medicinal substances or drugs.

If it is necessary to use a solution, tablets or eye drops, prednisolone, in combination with other drugs, the attending physician should consider and take into account their possible interaction. Data O. medicinal interaction Mazi is absent.

Due to the possible pharmaceutical incompatibility of the solution, prednisolone with other drugs entered intravenously, it is recommended to be administered separately: Bolus, or through another dropper. Mixing of prednisone and heparin solutions occurs with the formation of a precipitate.

Analogs of the drug

The structure determines the analogues:

1. Decortin H20; H50; H5.
2. Medopred.
3. Prednisol.
4. Prednisone 5 mg of yenafarm; buffet; hemisuccinate; Nomed; -Fenene.
5. Prednisolone sodium phosphate.
6. Saline-decortin H25; H250; H50.

Vacation conditions and price

The average price prednisolone (tablets 5 MG No. 100) in Moscow is 60 rubles. Cost of injections - 32 rubles for 3 ampoules of 30 mg. Eye drops can be bought for 796 rubles, ointment for 16 rubles.

Recommended by prescription.

Store in a place protected from light and inaccessible to children, at a temperature: tablets - up to 25 ° C, ointment, injection solution - up to 15 ° C, mortar - do not freeze; eye drops - 15-25 ° C, opened the bottle to use for 4 weeks. The shelf life depends on the manufacturer (look at the package).

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Composition

active substance: 1 ml of the solution contains prednisitotypes to prednisone - 30 mg;

excipients: Sodium hydrophosphate anhydrous, sodium dihydrophosphate dihydrate, propylene glycol, water for injection.

Maintenance physicochemical properties: Transparent colorless or almost colorless solution.

Pharmacotherapeutic group

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Pharmacokinetics

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Contraindications

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With asthmatic status, prednisolone is administered at a dose of 500-1200 mg per day, followed by a decrease of up to 300 mg per day and the transition to supporting doses.

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Overdose

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