What is prednisolone?
Prednisolone (1.2-Dehydrocortisol; formerly also Metacortandralon or delta hydrocortisone called) is a synthetic glucocorticoid. Prednisolone is an active metabolite of prednisone.
1957 prednisolone was marketed as "Solu-Decortin H" Merck's first time on the German market.
Physical Properties
Prednisolone is a solid crystalline substance that occurs in two polymorphic forms a hydrate. The commercial product melts at 239 ° C with a heat of fusion of 33.1 kJ · mol-1. The second polymorph has a melting point at 243 ° C with a heat of fusion of 23.7 kJ · mol-1. Both crystal forms are thus mutually enantiotropically, wherein the lower melting polymorph is the thermodynamically most stable form at room temperature. The hydrate has a 1.5-stoichiometry and can be crystallized from methanol-water mixtures. The Hydratwasserabgabe achieved already at 30 ° C with the formation of the higher melting crystalline form. All three crystal forms show different solubility.
Effect
Prednisolone has a pronounced immunosuppressive and anti-inflammatory above, anti-allergic effect. It is drug of choice for systemic anti-inflammatory and immunosuppressive effects.
Areas of application
The drug is widely used both in free form and as prednisolone acetate where it is necessary to suppress acute inflammatory responses. These include: Shock / anaphylactic shock, severe progressive forms of allergic reactions, for example after wasp sting, cerebral edema, meningitis, after neurosurgical operations, transplants (at risk of organ rejection), inhalation of toxic substances such as chlorine gas, croup, serious infectious diseases or. in acute worsening of chronic obstructive pulmonary disease (COPD) and severe asthma stage 4 in rheumatoid diseases, inflammatory eye diseases, inflammatory bowel disease, multiple sclerosis and autoimmune diseases, skin diseases (especially eczema), and - is though not reliable and valid - at the treatment of sudden hearing loss.
When triggered by immune diseases pericardial inflammation active compounds can be administered on the basis of glucocorticoids.
Another application of prednisolone is the preventive treatment of cluster headache.
Side effects of prednisolone
The side effects are extremely numerous and can be dangerous. Thus, for example, results from the immunosuppressive effect of an increased susceptibility to infection of the affected patient. Further, for example, makes a catabolic effect on prolonged intake for damage to the bones (osteopenia or osteoporosis) and iatrogenic (caused by medical therapy) Cushing's syndrome. It can also lead to the development of diabetes mellitus.
Upon termination of a longer-lasting treatment with prednisolone or other steroids, it may be necessary to reduce the daily dose slowly, which is referred to as "tapering". If it does not, it can lead to acute steroid withdrawal syndrome come, which is similar to an adrenal insufficiency. Blood level monitoring of spontaneous morning Kortisolwertes, (which should be about 500 nmol / l) immediately after the end of prednisolone can help you recognize that.
Equivalent doses
The relative anti-inflammatory dose equivalent in other preparations that must be considered when prednisolone is to replace the revenue with another glucocorticoid, can be seen from the following equation:
5 mg prednisolone 5 mg prednisone = 0.7 mg of dexamethasone 4 mg triamcinolone = 4 mg methylprednisolone = 20 mg hydrocortisone = 25 mg cortisone.
Trade names
Mono products:
Prednisolone (A), Decortin H (D), Dermosolon (D), Dontisolon (D), Hefasolon (D), Hexacorton (CH), Infectocortikrupp (D), Inflanefran (D), Klismacort (D), Kuehlprednon (A), H (D), Khai Lygal tincture (D), Prednisolut (D), Premandol (CH), solu-Decortin H (D), solu-Dacortin (A), Spiricort (CH), Ultracortenol (D, A, CH), prednisone 5 léčiva (CZ, SK), numerous generic (D, A, CH)
Combination products:
Alpicort (D, A, CH), Aquapred (D), Bismolan-H (D), Corti Blephamide (D, CH), Imacort (CH), Imazol comp (D), in flan Ghent (D), Leioderm P (D), Linoladiol H (D), Locaseptil (CH), Mycinopred (CH), Oxytetracycline prednisolone (D), Scheriproct (A, CH)