Note: Although separate entities, prednisone is rapidly converted by the liver in vivo to prednisolone. Except for patients in frank hepatic failure, the drugs can, for all intents, be considered equivalent.
Chemistry - Prednisolone and prednisone are synthetic glucocorticoids. Prednisolone and prednisolone acetate occur as odorless, white to practically white, crystalline powders. Prednisolone is very slightly soluble in water and slightly soluble in alcohol. The acetate ester is practically insoluble in water and slightly soluble in alcohol. The sodium succinate ester is highly water soluble. Prednisolone is also known as deltahydrocortisone or metacortandralone .
Prednisone occurs as an odorless, white to practically white, crystalline powder. Prednisone is very slightly soluble in water and slightly soluble in alcohol. Prednisone is also known as deltacortisone or deltadehydrocortisone .
Storage/Stability/Compatibility - Prednisolone and prednisone tablets should be stored in well-closed containers. All prednisone and prednisolone products should be stored at temperatures less than 40°, and preferably between 15-30°C; avoid freezing liquid products. Do not autoclave. Oral liquid preparations of prednisone should be stored in tight containers.
Prednisolone sodium succinate should be stored at room temperature and protected from light (store in carton). After reconstitution, the product is recommended to be used immediately and not stored.
Little data appears to be available regarding the compatibility of prednisolone sodium succinate injection (Solu-Delta Cortef® — Upjohn) with other products. A related compound, prednisolone sodium phosphate is reportedly compatible with the following drugs/solutions: ascorbic acid injection, cephalothin sodium, cytarabine, erythromycin lactobionate, fluorouracil, heparin sodium, methicillin sodium, penicillin G potassium/sodium, tetracycline HCl and vitamin B-Complex with C. It is reportedly incompatible with: calcium gluconate/gluceptate, dimenhydrinate, metaraminol bitartrate, methotrexate sodium, prochlorperazine edisylate, polymyxin B sulfate, promazine HCl, and promethazine. Compatibility is dependent upon factors such as pH, concentration, temperature and diluents used. It is suggested to consult specialized references for more specific information (e.g., Handbook on Injectable Drugs by Trissel; see bibliography).
For adjunctive therapy of COPD:
a) Prednisolone: Initially, 600 - 800 mg IM or PO in a 450 kg horse. May be possible to decrease dose and go to alternate day dosing. Doses as low as 200 mg every other day may be effective. (Beech 1987a)
For glucocorticoid effects:
a) Prednisolone sodium succinate: 0.25 - 1 mg/kg IV, Predniso(lo)ne tablets 0.25 - 1 mg/kg PO; Prednisolone acetate: 0.25 - 1.0 mg/kg IM or 10 - 25 mg subconjunctivally. (Robinson 1987)
a) For treatment of heatstroke: 1mg / 3 kg body weight (Schmidt, 1986).
Schmidt,M.J., 1986. Proboscidea (Elephants). In: Fowler,M.E.
(Editor), Zoo and wild animal medicine. W.B. Saunders, Philadelphia,PA,
USA pp. 884-923
Dosage Forms/Preparations/Approval Status/Withdrawal Times-
A zero tolerance of residues in milk for these compounds have been established for dairy cattle. All these agents require a prescription (Rx). Known approved-veterinary products are indicated below.
Prednisolone Tablets 5 mg. 20 mg
Delta-Cortef® (Upjohn), Prednis-Tab® (Vet-A-Mix); generic (Rx). Approved for use in dogs.
Prednisolone Acetate Suspension for Injection 25 mg/ml, 50 mg/ml, 100 mg/ml
Available under several trade names and generically.
Prednisolone Sodium Succinate for Injection (Veterinary) 20 mg/ml in 50 ml vials
Solu-Delta Cortef® (Upjohn), Sterisol-20® (Anthony), generic; (Rx) Approved for dogs, cats, and horses. Refer to the package insert for more information on dosage and preparation of the solution before using.
Prednisolone Sodium Phosphate for Injection (Veterinary) 100 mg/vial, 500 mg/vial
Cortisate-20® (Schering). Approved for IV use in dogs. Refer to the package insert for more information on dosage, etc.
Prednisone Suspension for Injection (Veterinary) 10 mg/ml, 40 mg/ml; Meticorten® (Schering) Approved for dogs, cats, and horses.
Prednisolone Tablets: 5 mg Delta-Cortef® (Upjohn); generic, (Rx)
Prednisone Tablets: 1 mg, 2.5 mg, 5 mg, 10 mg, 20, mg, 50 mg (Rx)
Prednisolone Syrup: 15 mg/5 ml in 240 ml; Prelone® (Muro) (Rx)
Prednisone Oral Solution/Syrup: 1 mg/ml in 30 ml, 120 ml, 240 ml and 500 ml (Rx)
Prednisolone Acetate Injection: 25 mg/ml, 50 mg/ml in 10 & 30 ml vials; Key-Pred 25® (Hyrex) (Rx); Predalone 50® (Forest) (Rx); Predcor-50® (Hauck) (Rx); generic
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