Predni-POS 1 % Eye Drops

Indications

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Rheumatoid arthritis
• Systemic lupus erythematosus
• Dermatitis
• Allergic reactions
• Certain types of cancer
• Adrenal insufficiency
• Ulcerative colitis

Dosage

Children: Paediatric dosing of prednisolone is dependent on the condition being treated and the child's weight.

Adults: Dosing of prednisolone varies based on the specific condition being treated. It is essential to refer to clinical guidelines or the BNF for specific adult dosing recommendations.

Mechanism of action

Prednisolone exerts its effects by binding to the glucocorticoid receptor, leading to the regulation of gene expression. This results in the inhibition of pro-inflammatory cytokines and chemokines, as well as the suppression of the immune system's response. The drug also influences metabolic processes, such as glucose metabolism and protein synthesis.

Pharmacodynamics

The pharmacodynamic effects of prednisolone include reduced inflammation, decreased immune response, and altered metabolism. Its anti-inflammatory action is achieved through the inhibition of the synthesis of inflammatory mediators such as prostaglandins and leukotrienes. Additionally, it has effects on carbohydrate, protein, and fat metabolism, which can lead to increased blood glucose levels and potential weight gain with prolonged use.

Pharmacokinetics

Prednisolone is well absorbed after oral administration, with peak plasma concentrations occurring within 1 to 2 hours. It has a high volume of distribution and is extensively bound to plasma proteins. The drug undergoes hepatic metabolism, primarily through the cytochrome P450 system, resulting in active metabolites. The elimination half-life varies, typically ranging from 3 to 4 hours, but can be prolonged in patients with liver impairment. Prednisolone is excreted mainly in urine, both as unchanged drug and metabolites.

Contra-indications

• Systemic fungal infections
• Hypersensitivity to prednisolone or any excipients in the formulation
• Active tuberculosis (unless under adequate treatment)

Adverse effects

• Increased risk of infections
• Hyperglycemia
• Hypertension
• Osteoporosis
• Weight gain
• Mood changes
• Gastrointestinal disturbances
• Adrenal suppression
• Cushing's syndrome
• Skin changes (e.g., thinning of skin, acne)

Interactions

• Non-steroidal anti-inflammatory drugs (NSAIDs) may increase the risk of gastrointestinal side effects
• Anticoagulants may have altered effects
• Antidiabetic agents may have reduced efficacy
• Live vaccines may be less effective
• CYP3A4 inducers or inhibitors may alter prednisolone metabolism

Precautions

• Use with caution in patients with a history of peptic ulcer disease
• Monitor for signs of infection
• Gradual withdrawal is necessary after prolonged therapy
• Use with caution in patients with diabetes or hypertension

Pregnancy

Prednisolone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It may cause adverse effects on fetal development.

Breast-feeding

Prednisolone is excreted in breast milk, and caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Oral solution
• Injection (intravenous, intramuscular)
• Topical formulations (cream, ointment)