Mechanism of action
According to the specialists of this site https://pillintrip.com/medicine/lepicortinolo prednisolone is a synthetic corticosteroid classified as intermediate-acting, with little mineralocorticoid activity, and therefore with anti-inflammatory and immunosuppressive action. It exerts its mechanism of action through the inhibition of the synthesis of prostaglandins and leukotrienes, substances that mediate vascular and cellular processes of inflammation, as well as the immune response. This translates into reduced vasodilatation, decreased fluid exudate, leukocyte activity, neutrophil aggregation and degranulation, release of hydrolytic enzymes by lysosomes, production of superoxide-type free radicals and the number of blood vessels (with less fibrosis) in chronic processes. The two actions correspond to the same mechanism which consists in the inhibition of phospholipase A2 synthesis, an enzyme that releases polyunsaturated fatty acids precursors of prostaglandins and leukotrienes.
Treatment of inflammatory and autoimmune diseases in ads. and children ≥ 1 month: bronchial asthma, allergic and inflammatory disorders, rheumatoid arthritis and other collagenopathies, dermatitis and dermatosis (subacute and chronic eczema, psoriasis, pemphigus, etc.).
Mode of administration
Oral route. Milk, broth, orange juice, etc., can be used as vehicles to facilitate correct administration.
Hypersensitivity to prednisolone or other glucocorticoids; acute viral illnesses (e.g. varicella, herpes simplex or herpes zoster); latent or overt tuberculosis, as there is a risk of manifestation of tuberculosis or worsening of tuberculosis; during the pre- and post-vaccination period (approximately 8 wk before and 2 wk after vaccination) as it may increase the risk of complications due to vaccination; except for replacement and emergency therapies, should not be used in: gastric or duodenal ulcer, known psychiatric disturbances (emotional instability or psychotic tendencies), closed or open angle glaucoma, herpetic keratitis, lymphadenopathy consecutive to BCG vaccination, acute and chronic bacterial infections, systemic mycosis, poliomyelitis (with the exception of the bulboencephalic form).
Warnings and precautions
Caution in: R.I., H.I., elderly with prolonged treatment, diabetes (monitor and adjust dose), hypertension and heart failure (monitor), hypothyroid patients or patients with liver cirrhosis (monitor and reduce dose); do not abruptly discontinue treatment and consider gradual withdrawal in the case of: hypertension and heart failure (monitor), hypothyroid patients or patients with cirrhosis of the liver (monitor and reduce dose). and consider gradual withdrawal in case of: doses > 7.5 mg/day + 3 wk, repeated treatment cycles + 3 wk, doses > 40 mg/day + 1 wk, repeated evening doses, recently repeated regimens (especially if for more than 3 wk), a short regimen within 1 year of cessation of long-term treatment; assess risk/risk ratio. risk/benefit assessment for risk of intestinal perforation with peritonitis in: severe ulcerative colitis with risk of perforation, abscesses or purulent inflammation, diverticulitis, recent intestinal anastomosis; risk of new infections; may mask signs of infection making diagnosis of existing or developing infections more difficult; take necessary measures to avoid transmission of chickenpox or herpes zoster; do not vaccinate. In myasthenia gravis administer low doses at the beginning of treatment; ensure adequate potassium intake and restrict sodium intake and monitor serum potassium levels; perform ophthalmic controls; risk of osteoporosis and inhibition of bone growth in children and adolescents; evaluate risk/benefit in treatment. concomitant treatment with CYP3A inhibitors (including drugs containing cobicistat); stressful situations (infections, trauma or surgery) may require a dose increase; not recommended in pregnancy and lactation; risk of severe acute pancreatitis and increased intracranial pressure in children; reported cases of sclerodermic renal crisis in concomitant treatment with prednisone.