Glucocorticoid (intermediate-acting)
Prednisolone
Brand names: Deltacortril, Prednesol
Adult dose
Dose: Highly indication-dependent: 5–60mg PO OD; e.g. asthma exacerbation 40mg OD x5d, PMR 15mg OD
Route: PO
Frequency: OD
Clinical pearls
- Equivalent doses: prednisolone 5mg ≈ hydrocortisone 20mg ≈ dexamethasone 0.75mg
- Doses ≥10mg/day for >3 weeks → withdrawal regimen needed; carry steroid card
Contraindications
- Systemic infection (untreated)
- Live vaccines (high-dose)
- Hypersensitivity
Side effects
- Cushingoid features
- Hyperglycaemia
- Hypertension
- Osteoporosis
- Adrenal suppression
- Mood changes
- Cataracts/glaucoma
- Peptic ulceration
- Increased infection risk
- Skin thinning
Interactions
- NSAIDs
- Live vaccines
- Anticoagulants
- CYP3A4 modulators
- Antidiabetics (often need adjustment)
Monitoring
- BP
- Glucose
- Weight
- Bone density (long-term)
- Eyes
Reference: BNF; NICE NG137; UK guidelines; https://bnf.nice.org.uk/drugs/prednisolone/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Steroid Dose Equivalence · Medications
- Maddrey Discriminant Function (Alcoholic Hepatitis) · Alcoholic Liver Disease
- Lille Model (Steroid Response in Alcoholic Hepatitis) · Alcoholic Liver Disease
- Maddrey's Discriminant Function for Alcoholic Hepatitis · Hepatology
- Lille Model for Alcoholic Hepatitis · Hepatology
- Mayo Score for Ulcerative Colitis Activity · Inflammatory Bowel Disease
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016