Looking for:
Prednisone 5 mg tablet picture.Prednisolone Stock Photos and Images |
Prednisone 5 mg tablet picture -
Prednisone 5 mg tablet picture -
Prednisolone hi-res stock photography and images - Alamy.
Skeletal formula. RF 2KBF — 3D image of Prednisolone acetate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white backgr. RF 2B21T59 — Prednisolone corticosteroid drug molecule, illustration. Structural chemical formula on the dark blue background. Sheet of paper in a cage. Is an anti-inflammatory and pain-killing drug requiring a prescription drug.
Packages of Prednisolon. Prednisolon pills in cardboard box. Sterile eye drops in white plastic bottle packag. RM 2AJNTF3 — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders. RF 2KBJ — 3D image of Prednisolone sodium phosphate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white.
Corticosteroid drugs, including cortisone, hydrocortisone and prednison. Atoms are represented as spheres with conventional color coding: hydrogen white , carbon grey , oxygen r. A synthetic anti-inflammatory glucocorticoid derived from cortisone. RM 2ACG8ED — Arm of an elderly female patient, showing spontaneous bruising bleeding of the skin from the anti-clotting drug warfarin and oral steroid prednisolo.
Pharmaceutical industry. Pharmacy or drugstore products. Healthcare and medicine. Health budget. Pharmaceutical manufacturing. Loteprednol ophthalmic suspension and Prednisolone acetate. Sterile eye drops. RM 2AJNT46 — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders.
RF 2KBR — 3D image of Prednisolone tebutate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white backgr. If chickenpox develops, treatment with antiviral agents may be considered.
Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations.
Also existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection: diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis: and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporine. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles and, if exposed, to obtain medical advice. The initial dosage of prednisone may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated. In situations of less severity lower doses will generally suffice, while in selected patients higher initial doses may be required.
The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory clinical response, prednisone should be discontinued and the patient transferred to other appropriate therapy. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached.
It should be kept in mind that constant monitoring is needed in regard to drug dosage. If after long-term therapy the drug is to be stopped, it recommended that it be withdrawn gradually rather than abruptly.
Multiple Sclerosis In the treatment of acute exacerbations of multiple sclerosis daily doses of mg of prednisolone for a week followed by 80 mg every other day for 1 month have been shown to be effective.
Dosage range is the same for prednisone and prednisolone. Alternate Day Therapy Alternate day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning. The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids while minimizing certain undesirable effects, including pituitary-adrenal suppression, the cushingoid state, corticoid withdrawal symptoms, and growth suppression in children.
The rationale for this treatment schedule is based on two major premises: a the anti-inflammatory or therapeutic effect of corticoids persists longer than their physical presence and metabolic effects and b administration of the corticosteroid every other morning allows for re-establishment of more nearly normal hypothalamic-pituitary-adrenal HPA activity on the off-steroid day.
A brief review of the HPA physiology may be helpful in understanding this rationale. Acting primarily through the hypothalamus a fall in free cortisol stimulates the pituitary gland to produce increasing amounts of corticotropin ACTH while a rise in free cortisol inhibits ACTH secretion. Normally the HPA system is characterized by diurnal circadian rhythm. Serum levels of ACTH rise from a low point about 10 pm to a peak level about 6 am.
Increasing levels of ACTH stimulate adrenocortical activity resulting in a rise in plasma cortisol with maximal levels occurring between 2 am and 8 am. This rise in cortisol dampens ACTH production and in turn adrenocortical activity. There is a gradual fall in plasma corticoids during the day with lowest levels occurring about midnight.
The same clinical findings of hyperadrenocorticism may be noted during long-term pharmacologic dose corticoid therapy administered in conventional daily divided doses. It would appear, then, that a disturbance in the diurnal cycle with maintenance of elevated corticoid values during the night may play a significant role in the development of undesirable corticoid effects. Escape from these constantly elevated plasma levels for even short periods of time may be instrumental in protecting against undesirable pharmacologic effects.
During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex.
Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Normally the HPA system is characterized by diurnal circadian rhythm.
Serum levels of ACTH rise from a low point about 10 pm to a peak level about 6 am. Increasing levels of ACTH stimulate adrenocortical activity resulting in a rise in plasma cortisol with maximal levels occurring between 2 am and 8 am. This rise in cortisol dampens ACTH production and in turn adrenocortical activity.
There is a gradual fall in plasma corticoids during the day with lowest levels occurring about midnight. The same clinical findings of hyperadrenocorticism may be noted during long-term pharmacologic dose corticoid therapy administered in conventional daily divided doses.
It would appear, then, that a disturbance in the diurnal cycle with maintenance of elevated corticoid values during the night may play a significant role in the development of undesirable corticoid effects. Escape from these constantly elevated plasma levels for even short periods of time may be instrumental in protecting against undesirable pharmacologic effects. During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex.
Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone 10 mg as opposed to a quarter of that dose administered every 6 hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used.
Further, it has been shown that a single dose of certain corticosteroids will produce adrenocortical suppression for two or more days. Basic principles and indications for corticosteroid therapy should apply.
The benefits of alternate day therapy should not encourage the indiscriminate use of steroids. Alternate day therapy is a therapeutic technique primarily designed for patients in whom long-term pharmacologic corticoid therapy is anticipated. In less severe disease processes in which corticoid therapy is indicated, it may be possible to initiate treatment with alternate day therapy.
More severe disease states usually will require daily divided high dose therapy for initial control of the disease process. The initial suppressive dose level should be continued until satisfactory clinical response is obtained, usually four to ten days in the case of many allergic and collagen diseases.
It is important to keep the period of initial suppressive dose as brief as possible particularly when subsequent use of alternate day therapy is intended. Once control has been established, two courses are available: a change to alternate day therapy and then gradually reduce the amount of corticoid given every other day or b following control of the disease process reduce the daily dose of corticoid to the lowest effective level as rapidly as possible and then change over to an alternate-day schedule.
Theoretically, course a may be preferable. Because of the advantages of alternate day therapy, it may be desirable to try patients on this form of therapy who have been on daily corticoids for long periods of time e. Since these patients may already have a suppressed HPA axis, establishing them on alternate day therapy may be difficult and not always successful.
However, it is recommended that regular attempts be made to change them over. It may be helpful to triple or even quadruple the daily maintenance dose and administer this every other day rather than just doubling the daily dose if difficulty is encountered. Once the patient is again controlled, an attempt should be made to reduce this dose to a minimum. As indicated above, certain corticosteroids, because of their prolonged suppressive effect on adrenal activity, are not recommended for alternate day therapy e.
The maximal activity of the adrenal cortex is between 2 am and 8 am, and it is minimal between 4 pm and midnight. Exogenous corticosteroids suppress adrenocortical activity the least when given at the time of maximal activity am.
In using alternate day therapy it is important, as in all therapeutic situations, to individualize and tailor the therapy to each patient. Complete control of symptoms will not be possible in all patients.
An explanation of the benefits of alternate day therapy will help the patient to understand and tolerate the possible flare-up in symptoms which may occur in the latter part of the offsteroid day. Other symptomatic therapy may be added or increased at this time if needed.
In the event of an acute flare-up of the disease process, it may be necessary to return to a full suppressive daily divided corticoid dose for control. Once control is again established alternate day therapy may be reinstituted.
Although many of the undesirable features of corticosteroid therapy can be minimized by alternate day therapy, as in any therapeutic situation, the physician must carefully weigh the benefit-risk ratio for each patient in whom corticoid therapy is being considered. Infections associated with corticosteroids and immunosuppressive therapy.
Infectious Diseases. Philadelphia: WBSaunders Company Risk of infectious complications in patients taking glucocorticoids. Rev Infect Dis 6 DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed. DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use.
Due to inconsistencies between the drug labels on DailyMed and the pill images provided by RxImage , we no longer display the RxImage pill images associated with drug labels. We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels.
Drug Label Info. Drug Label Information Updated January 12, If you are a consumer or patient please visit this version. Rx only. The structural formula is represented below: C 21 H 26 O 5 M. Prednisone tablets are indicated in the following conditions: Endocrine disorders: primary or secondary adrenocortical insufficiency hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance ; congenital adrenal hyperplasia; hypercalcemia associated with cancer; nonsuppurative thyroiditis.
Nervous system: acute exacerbations of multiple sclerosis. Usage in pregnancy Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.
General Precautions Drug-induced, secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. Drug Interactions The pharmacokinetic interactions listed below are potentially clinically important. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.
Hi there! Create an account Buy images Sell images Lightboxes Contact us. Share Alamy images with your team and customers. Find the right content for your market. Learn more about how you can collaborate with us. All images All images.
Live news. Search by image. Search for images Search for stock images, vectors and videos. Search with an image file or link to find similar images. All Creative Editorial. All Ultimate Vital Uncut Foundation. Prednisolone Stock Photos and Images See prednisolone stock video clips. Page 1 of 2. Braile is impressed on the front of the box. RM J62M19 — Prednisolone tablets isolated against white background. Loteprednol etabonate ophthalmic suspension 0. Prednisolone pills in RX prescription drug bottle.
Braille is impressed on the front of the box. Medical concepts. Prescription Prednisolone 5 mg tablets. RM 2ACNFW7 — Pack of Prednisolone tablets, a corticosteroid drug used to treat conditions such as rheumatic disorders, skin diseases, allergic states and some bloo.
Is known as a corticosteroid or steroid medication. Structural chemical formula and molecule model. Single tablet of the corticosteroid drug prednisolone. Prednisolone is prescribed for a wide range of conditions includin.
Blister pack of soluble tablets of the corticosteroid drug prednisolone. Prednisolone is prescribed for a wide range of. Pack of tablets of the corticosteroid drug prednisolone. Prednisolone is prescribed for a wide range of conditions inclu. RM B2KK71 — generic image of Prednisolone taken as a replacement for Hydrocortisone where insufficient amounts are produced naturally. The patient was taking warfarin and prednisolone.
RM 2AJNT9M — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders. RF 2KB8 — 3D image of Prednisolamate skeletal formula - molecular chemical structure of prednisolone diethylaminoacetate isolated on white background.
Skeletal formula. RF 2KBF — 3D image of Prednisolone acetate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white backgr. RF 2B21T59 — Prednisolone corticosteroid drug molecule, illustration. Structural chemical formula on the dark blue background.
Sheet of paper in a cage. Is an anti-inflammatory and pain-killing drug requiring a prescription drug. Packages of Prednisolon. Prednisolon pills in cardboard box.
Sterile eye drops in white plastic bottle packag. RM 2AJNTF3 — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders. RF 2KBJ — 3D image of Prednisolone sodium phosphate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white.
Corticosteroid drugs, including cortisone, hydrocortisone and prednison. Atoms are represented as spheres with conventional color coding: hydrogen whitecarbon greyoxygen r. A synthetic anti-inflammatory glucocorticoid derived from cortisone. RM 2ACG8ED — Arm of an elderly female patient, showing spontaneous bruising bleeding of the skin from the anti-clotting drug warfarin and oral steroid prednisolo. Pharmaceutical industry. Pharmacy or drugstore products. Healthcare and medicine.
Health budget. Pharmaceutical manufacturing. Loteprednol ophthalmic suspension and Prednisolone acetate. Sterile eye drops. RM 2AJNT46 — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders.
RF 2KBR — 3D image of Prednisolone tebutate skeletal formula - molecular chemical structure of synthetic glucocorticoid corticosteroid isolated on white backgr. Topical steroid that relieves redness, swelling, itching and irritation in eczema and psori. Structural chemical formula. Education concept. RM 2ACG8EE — Wrist of the arm of an elderly female patient, showing spontaneous bruising bleeding of the skin from the anti-clotting drug warfarin and oral stero.
Health budget concept. Group of capsule pills. RF 2JK — 3D image of Difluprednate skeletal formula - molecular chemical structure of corticosteroid isolated on white background. RM 2AJNT0T — Box of Prednisolone tablets, steroid medication used to treat certain types of allergies, inflammatory conditions and autoimmune disorders. RF 2JKDM2F — 3D image of Methylprednisolone sodium succinate skeletal formula - molecular chemical structure of synthetic glucocorticoid receptor agonist isolated.
Download Confirmation Please complete the form below. The information provided will be included in your download confirmation. Download Cancel. Forgotten your password? Next page.
Drug: Prednisolone Sodium Phosphate (Orally Disintegrating); Strength: 10 mg (base); Pill Imprint: M P10; Color: White; Shape: Round. View images & details. Prednisone 5mg Tablet. Strength: 5 MG. Pill Imprint: V. Color: White. Shape: Round. DISCLAIMER: This drug information content is provided for informational. Drug: Prednisolone Sodium Phosphate (Orally Disintegrating); Strength: 10 mg (base); Pill Imprint: M P10; Color: White; Shape: Round. View images & details. prednisone 20 mg tablet This medicine is a white, round, scored, tablet imprinted with "PD02". prednisone 20 mg tablet. 1 / Thousands of new, high-quality pictures added every day. Ipswich, UK - 23 January Boxes of prednisolone 5mg steroid tablets. Editorial. As indicated above, certain corticosteroids, because of their prolonged suppressive effect on adrenal activity, are not recommended for alternate day therapy e. Dermatologic diseases: pemphigus; bullous dermatitis herpetiformis; severe erythema multiforme Stevens-Johnson syndrome ; exfoliative dermatitis; mycosis fungoides; severe psoriasis; severe seborrheic dermatitis.If you are a consumer or patient please visit this version. Prednisone Tablets, USP are available for oral administration containing 2. Each tablet contains the following inactive ingredients: lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium lauryl sulfate and sodium starch glycolate.
Prednisone Tablets, USP contain prednisone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. The chemical name for prednisone is pregna-1,4-diene-3,11,trione, 17,dihydroxy-.
The structural formula is represented below:. Prednisone is a white or almost white crystalline powder. It is slightly soluble in acetone, ethanol, ethylacetate and methanol. Naturally occurring glucocorticoids hydrocortisone and cortisone , which also have salt-Retaining properties, are used as replacement therapy in adrenocortical deficiency states.
Their synthetic analogs are primarily used for their potent anti-inflammatory effects in disorders of many organ systems. Glucocorticoids cause profound and varied metabolic effects. In addition, they modify the body's immune responses to diverse stimuli. Dermatologic Diseases Pemphigus, Bullous dermatitis herpetiformis, severe erythema multiforme stevens-Johnson syndrome , exfoliative dermatitis, mycosis fungoides, severe psoriasis, severe seborrheic dermatitis.
Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions.
Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: allergic corneal marginal ulcers, herpes zoster ophthalmicus, anterior segment inflammation, diffuse posterior uveitis and choroiditis, sympathetic ophthalmia, allergic conjunctivitis, keratitis, chorioretinitis, optic neuritis, iritis and iridocyclitis. Respiratory Diseases Symptomatic sarcoidosis, loeffler's syndrome not manageable by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, aspiration pneumonitis.
Hematologic Disorders Idiopathic thrombocytopenic purpura in adults, secondary thrombocytopenia in adults, acquired autoimmune hemolytic anemia, erythroblastopenia RBC anemia , congenital erythroid hypoplastic anemia. Neoplastic Diseases For palliative management of: leukemias and lymphomas in adults, acute leukemia of childhood.
Edematous States To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus Gastrointestinal Diseases To tide the patient over a critical period of the disease in: ulcerative colitis, regional enteritis Nervous System Acute exacerbations of multiple sclerosis Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy, trichinosis with neurologic or myocardial involvement.
Prednisone Tablets are contraindicated in systemic fungal infections and known hypersensitivity to components. Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.
Usage in pregnancy : Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.
Infants born of mothers who have received substantial doses of corticosteroids during pregnancy, should be carefully observed for signs of hypoadrenalism. Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium.
These effects are less likely to occur with the synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion. While on corticosteroid therapy patients should not be vaccinated against smallpox.
Other immunization procedures should not be undertaken in patients who are on corticosteroids, especially on high dose, because of possible hazards of neurological complications and a lack of antibody response. The use of prednisone tablets in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate anti-tuberculous regimen.
If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis. Children who are on immunosuppressant drugs are more susceptible to infections than healthy children. Chickenpox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant corticosteroids.
In such children, or in adults who have not had these diseases, particular care should be taken to avoid exposure. If chickenpox develops, treatment with antiviral agents may be considered. Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations.
Also existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection: diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis: and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporine. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles and, if exposed, to obtain medical advice. The initial dosage of prednisone may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated.
In situations of less severity lower doses will generally suffice, while in selected patients higher initial doses may be required.
The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory clinical response, prednisone should be discontinued and the patient transferred to other appropriate therapy. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached.
It should be kept in mind that constant monitoring is needed in regard to drug dosage. If after long-term therapy the drug is to be stopped, it recommended that it be withdrawn gradually rather than abruptly. Multiple Sclerosis In the treatment of acute exacerbations of multiple sclerosis daily doses of mg of prednisolone for a week followed by 80 mg every other day for 1 month have been shown to be effective. Dosage range is the same for prednisone and prednisolone.
Alternate Day Therapy Alternate day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning. The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids while minimizing certain undesirable effects, including pituitary-adrenal suppression, the cushingoid state, corticoid withdrawal symptoms, and growth suppression in children.
The rationale for this treatment schedule is based on two major premises: a the anti-inflammatory or therapeutic effect of corticoids persists longer than their physical presence and metabolic effects and b administration of the corticosteroid every other morning allows for re-establishment of more nearly normal hypothalamic-pituitary-adrenal HPA activity on the off-steroid day.
A brief review of the HPA physiology may be helpful in understanding this rationale. Acting primarily through the hypothalamus a fall in free cortisol stimulates the pituitary gland to produce increasing amounts of corticotropin ACTH while a rise in free cortisol inhibits ACTH secretion. Normally the HPA system is characterized by diurnal circadian rhythm. Serum levels of ACTH rise from a low point about 10 pm to a peak level about 6 am. Increasing levels of ACTH stimulate adrenocortical activity resulting in a rise in plasma cortisol with maximal levels occurring between 2 am and 8 am.
This rise in cortisol dampens ACTH production and in turn adrenocortical activity. There is a gradual fall in plasma corticoids during the day with lowest levels occurring about midnight.
The same clinical findings of hyperadrenocorticism may be noted during long-term pharmacologic dose corticoid therapy administered in conventional daily divided doses.
It would appear, then, that a disturbance in the diurnal cycle with maintenance of elevated corticoid values during the night may play a significant role in the development of undesirable corticoid effects. Escape from these constantly elevated plasma levels for even short periods of time may be instrumental in protecting against undesirable pharmacologic effects.
During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation.
Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone 10 mg as opposed to a quarter of that dose administered every 6 hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used.
Further, it has been shown that a single dose of certain corticosteroids will produce adrenocortical suppression for two or more days. Prednisone Tablets, USP are available in the following strengths and package sizes:. DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed. DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use.
Due to inconsistencies between the drug labels on DailyMed and the pill images provided by RxImage , we no longer display the RxImage pill images associated with drug labels. We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels.
Drug Label Info. NDC National Drug Code - Each drug product is assigned this unique number which can be found on the drug's outer packaging. Drug Label Information Updated July 7, If you are a consumer or patient please visit this version. The following should be kept in mind when considering alternate day therapy: Basic principles and indications for corticosteroid therapy should apply. The benefits of alternate day therapy should not encourage the indiscriminate use of steroids.
Alternate day therapy is a therapeutic technique primarily designed for patients in whom long-term pharmacologic corticoid therapy is anticipated.
In less severe disease processes in which corticoid therapy is indicated, it may be possible to initiate treatment with alternate day therapy. More severe disease states usually will require daily divided high dose therapy for initial control of the disease process.
The initial suppressive dose level should be continued until satisfactory clinical response is obtained, usually four to ten days in the case of many allergic and collagen diseases. It is important to keep the period of initial suppressive dose as brief as possible particularly when subsequent use of alternate day therapy is intended.
Once control has been established, two courses are available: a change to alternate day therapy and then gradually reduce the amount of corticoid given every other day or b following control of the disease process reduce the daily dose of corticoid to the lowest effective level as rapidly as possible and then change over to an alternate day schedule. Theoretically, course a may be preferable. Because of the advantages of alternate day therapy, it may be desirable to try patients on this form of therapy who have been on daily corticoids for long periods of time e.
Since these patients may already have a suppressed HPA axis, establishing them on alternate day therapy may be difficult and not always successful. However, it is recommended that regular attempts be made to change them over.
No comments:
Post a Comment