prednylidene

H02AB11

Forms & Strengths

Adult Dosing

Initial dose: 5 mg to 20 mg daily, divided into 2 to 4 doses
Maintenance dose: 2.5 mg to 5 mg daily
Severe conditions: Up to 40 mg daily initially, tapered as clinical response permits

Pediatric Dosing

Indications

Severe inflammatory and allergic conditions requiring systemic corticosteroid therapy
Endocrine disorders (e.g., primary or secondary adrenocortical insufficiency)
Rheumatic disorders, collagen diseases, and dermatologic conditions
Severe allergic and asthmatic states unresponsive to conventional therapy

Mechanism of Action

Synthetic glucocorticoid with potent anti-inflammatory, immunosuppressant, and antiproliferative effects
Binds to cytosolic glucocorticoid receptors, modulating gene transcription to inhibit proinflammatory mediators

Contraindications

Systemic fungal infections
Hypersensitivity to prednylidene or other corticosteroids
Administration of live or live-attenuated vaccines in patients receiving immunosuppressive doses

Adverse Reactions

Fluid retention, hypertension, and electrolyte imbalance (hypokalemia)
Increased susceptibility to infections and masking of symptoms
Osteoporosis, vertebral compression fractures, and myopathy
Hyperglycemia, weight gain, Cushingoid features, and hypothalamic-pituitary-adrenal axis suppression
Peptic ulcer disease, gastrointestinal bleeding, and mood/behavioral disturbances

Drug Interactions

CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin) decrease corticosteroid plasma concentrations
Potassium-depleting agents (e.g., thiazide or loop diuretics) increase risk of severe hypokalemia
Nonsteroidal anti-inflammatory drugs (NSAIDs) increase risk of gastrointestinal ulceration and bleeding
Antidiabetic agents: corticosteroids may elevate blood glucose, requiring dosage adjustments of insulin or oral hypoglycemics
Coumarin anticoagulants: variable effects on anticoagulant response; monitor INR closely

Curated Content: Needs Vetting Before Put to Clinical Use