Prednisolone: What It’s For, Dosage & Side Effects

Updated in December 2023

Prednisolone is an anti-inflammatory steroid, indicated for the treatment of rheumatism, hormonal changes, infections, allergies and skin or eye problems. It can also be used in the treatment of cancer. 

This medication is available in pill form, as an oral suspension or as eye drops, which can be obtained at the pharmacy with a prescription. 

Prednisolone use should be followed as instructed by a doctor. Prolonged and unnecessary use of this medication can lead to the appearance of side-effects, like increased cholesterol and triglycerides. 

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What It’s For

Prednisolone is indicated for the treatment of inflammatory and autoimmune disease, like: 

  • Endocrine changes, Like adrenocortical insufficiency, congenital adrenal hyperplasia, non-suppurative thyroiditis, and hypercalcemia related to cancer 
  • Rheumatism, like psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, bursitis, acute non-specific tenosinovitis, post-traumatic osteorthritis, acute gout arthritis, osteoarthritic sinovitis and epicondilitis 
  • Collagen disease, which can happen with systemic lupus erythematosus and acute rheumatic carditis
  • Skin disease, like pemphigus, some dermatitis, fungal infections and severe psoriasis
  • Allergies, like allergic rhinitis, contact and atopic dermatitis, and hypersensitivity to drugs
  • Ophthalmic disease, like corneal ulcers, herpes sores in the eyes, anterior segment disease, choroiditis, allergic conjunctivitis, optic neuritis
  • Respiratory disease, like symptomatic sarcoidosis, Löefler’s syndrome, some cases of tuberculosis, and aspiration pneumonia 
  • Blood disorders, like idiopathic thrombocytopenic purpura and secondary thrombocytopenia in adults, hemolytic anemia, erythrocytic anemia and erythroid anemia 
  • Cancer, during palliative treatment of leukemia and lymphoma 

In addition, prednisolone can also be used for the treatment of acute exacerbations of multiple sclerosis, to reduce swelling in some cases of idiopathic nephrotic synrdrom and to manage symptoms of ulcerative colitis or enteritis. 

The dosage of prednisolone varies in relation to the patient’s weight, age and illness. The dose and route will be determined by the doctor. 

1. Oral pills (from 5 to 20 mg)

  • Adults: The initial dose varies from 5 to 60 mg per day, equivalent to one 5 mg pill or three 20 mg pills 
  • Children: The initial dose varies from 5 to 20 mg per day, equivalent to one 5 mg pill or one 20 mg pills 

Dosing should be reduced gradually over a few days when prescribed. Pills should be swallowed whole with a cup of water, without breaking or chewing them. 

2. Oral syrup (3 mg/mL ou 1 mg/mL)

  • Adults: The dose varies from 5 to 60 mg per day
  • Babies: The recommended dose varies from 0.14 to 2 mg for ever 1 kg of weight per day. This dose should be divided into 3 to 4 daily doses 

The amount to measure will depend on the solution’s concentration. Dosing should also be reduced gradually over a few days when prescribed.

3. Eye drops (11mg/mL)

  • Adults: The dose varies from 5 to 60 mg per day, equivalent to 9 or 109 drops per day 
  • Children: The recommended dose varies from 0.14 to 2 mg for ever 1 kg of weight per day. This dose should be divided into 3 to 4 daily doses 

Each drop contains 0.55 mg of prednisolone. The amount to measure will depend on the solution’s concentration. Dosing should also be reduced gradually over a few days when prescribed for more than a few days.

Dosing and duration of treatment will be prescribed by the doctor. These will depend on the illness being treated, the age and the patient’s response to treatment.  

Possible side effects 

The most common side effects that can occur during treatment are increased appetite, indigestion, peptic ulcers, pancreatitis, ulcerative esophagitis, nervousness, fatigue and insomnia. 

In addition, you may experience allergic reactions, eye changes (like cataracts or glaucoma), secondary fungal or viral eye infections, reduced tolerance to carbohydrates, or increased need for insulin or diabetes medication. 

High doses of corticosteroids can also increase triglyceride levels. 

Who should not take it 

Prednisolone is contraindicated for people with systemic fungal infections, uncontrolled infections and for patients allergic to prednisolone or any of its components. 

In addition, this medication should be used by pregnant or breastfeeding women without the doctor’s knowledge. 

What is the difference between prednisolone and prednisone? 

Prednisone is an inactive substance that needs to be transformed into prednisolone in the liver in order for it to have a therapeutic effect. 

Taking prednisone or prednisolone will have the same effect, as prednisone will be transformed into prednisolone in the fever. Prednisolone is better for patients with a history of liver disease, as it does not require additional intervention from the liver to have an effect.