Prednisolone: Brands, Price & Uses in Bangladesh

Prednisolone is a synthetic corticosteroid (glucocorticoid) used to treat a wide range of inflammatory, allergic, and autoimmune conditions. Its uses can be classified by strength of evidence as follows:

Established / Guideline-Supported Uses

• Respiratory conditions: acute exacerbations of bronchial asthma, chronic obstructive pulmonary disease (COPD) exacerbations
• Allergic states: severe allergic reactions, seasonal or perennial allergic rhinitis (severe), drug hypersensitivity reactions, angioedema
• Rheumatic disorders: rheumatoid arthritis, juvenile idiopathic arthritis, systemic lupus erythematosus, polymyalgia rheumatica, acute gouty arthritis (as adjunct)
• Dermatologic diseases: pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, severe psoriasis, severe seborrheic dermatitis
• Endocrine disorders: primary or secondary adrenocortical insufficiency (used with a mineralocorticoid where applicable), congenital adrenal hyperplasia, non-suppurative thyroiditis
• Gastrointestinal disease: to help patients through a critical period of ulcerative colitis and Crohn's disease
• Hematologic disorders: acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura in adults
• Renal disease: to induce diuresis or remission of proteinuria in nephrotic syndrome (idiopathic type or due to lupus erythematosus)
• Ophthalmic disease: severe acute and chronic allergic and inflammatory processes involving the eye
• Neurologic conditions: acute exacerbations of multiple sclerosis
• Organ transplantation: as part of immunosuppressive regimens to prevent/treat graft rejection

Adjunct Therapy

Used as adjunct/palliative therapy in certain leukemias and lymphomas, and in combination with other disease-modifying or chemotherapeutic agents in autoimmune and malignant conditions.

Off-Label Use

Prednisolone is also commonly used off-label for conditions such as sarcoidosis-related organ involvement, autoimmune hepatitis, and short-course management of severe croup or acute gout flares, based on clinical judgment and specialist guidance.

Prednisolone is not an antibiotic and has no role in treating infections themselves.

Dosage of Prednisolone is highly individualized based on the disease being treated, severity, and patient response, rather than fixed by body weight alone (except in specific pediatric indications).

Renal/Hepatic Impairment

No fixed dose adjustment is well-established, but Prednisolone should be used cautiously and at the lowest effective dose in significant hepatic impairment (reduced conversion from prednisone favors direct use of Prednisolone) and in renal impairment, with close clinical monitoring.

Tapering

After more than a few weeks of therapy, Prednisolone must not be stopped abruptly; the dose should be gradually tapered under medical supervision to allow recovery of adrenal function (see Precautions and Warnings).

Side effects of Prednisolone are generally dose- and duration-dependent.

Common

• Increased appetite, weight gain
• Insomnia, mood changes, nervousness
• Indigestion, nausea
• Fluid retention, facial puffiness ("moon face")
• Acne, increased sweating

Less Common but Serious (usually with prolonged/high-dose use)

• Adrenal suppression, Cushingoid features
• Hyperglycemia / worsening of diabetes
• Osteoporosis, increased fracture risk, avascular necrosis of bone
• Peptic ulceration, GI bleeding (especially with NSAIDs)
• Increased susceptibility to infections; masking of infection signs
• Cataracts, glaucoma, increased intraocular pressure
• Muscle weakness/myopathy
• Psychiatric effects (mood swings, psychosis, severe depression) — rare but reported
• Growth suppression in children with prolonged use