What is Prednisolone?
Prednisolone is a synthetic glucocorticoid medication used to treat various inflammatory and autoimmune conditions [1, 2]. It reduces inflammation throughout the body by interfering with how certain chemicals cause inflammation [3].
Prednisolone is similar to prednisone, another commonly prescribed corticosteroid. The liver converts prednisone into the active metabolite, prednisolone [4]. Prednisolone suppresses cytokine gene expression, inhibits the differentiation and proliferation of activated lymphocytes, decreases the production of adhesion molecules, increases apoptosis of lymphocytes, and decreases collagen deposition in the liver [4].
Prednisolone is available in various forms, including tablets, eye drops, and topical formulations. Some common brand names for prednisolone eye drops include AK-Pred, Pred Forte, and Pred Mild [1, 2]. Prednisolone eye drops are used to treat eye inflammation and related conditions.
Uses and Benefits of Prednisolone
Prednisolone is used to treat:
- asthma,
- severe allergies like hay fever and allergic skin reactions,
- various forms of arthritis (rheumatoid arthritis, osteoporosis, gout),
- inflammatory bowel diseases like ulcerative colitis,
- flare-ups of multiple sclerosis,
- lupus,
- certain blood disorders,
- and some cancers [5].
Prednisolone works by reducing activity in the immune system. It stops the immune system from producing chemicals that cause inflammation. This anti-inflammatory effect helps treat the many conditions prednisolone is [5].
In a survey of rheumatoid arthritis patients, 31.2% reported current prednisolone use, and 53.7% reported previous use, showing it is a commonly used treatment. Current users believed prednisolone was necessary for managing [6].
For autoimmune hepatitis, prednisolone suppresses cytokine production, inhibits lymphocyte activation, decreases inflammation, and reduces collagen deposition in the liver. It remains a mainstay of treatment for this condition [4].
A study found that adding 5 mg of prednisolone daily for two years was an effective treatment for elderly rheumatoid arthritis patients without substantial adverse event risks [7].
Side effects of Prednisolone
Prednisolone can cause a range of side effects. These side effects can be mild or severe and may occur immediately or develop over time.
Common side effects:
Common side effects include:
- headache,
- nausea,
- changes in mood,
- difficulty sleeping,
- thinning skin,
- slowed healing of cuts and bruises,
- acne,
- and changes in how fat spreads around the body [8].
Other side effects include increased appetite, sweating, and irregular or absent menstrual periods [8].
Severe side effects:
In some cases, prednisolone can cause serious side effects. These include:
- sore throat,
- fever,
- chills,
- cough, or other signs of infection,
- seizures,
- muscle weakness,
- vision problems,
- depression,
- loss of contact with reality,
- sudden weight gain,
- stomach swelling, and difficulty breathing or swallowing [8].
Prednisolone may also cause changes in blood sugar levels, weight gain, nausea, vomiting, and diarrhoea, mood or behavioural changes, insomnia, increased risk of infection due to immunosuppression, osteoporosis, and eye changes, such as glaucoma or cataracts [9].
Rare side effects:
In rare cases, prednisolone can cause severe allergic reactions, including skin rash, itchiness, flushing, or swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include tongue, mouth, or throat swelling, which can cause trouble breathing [5].
Side effects of long-term use:
Long-term use of prednisolone can lead to more severe side effects, such as high blood pressure, low potassium levels, raised risk of infection, weakened bones and osteoporosis, ulcers in the stomach or upper part of the small intestine, high blood sugar levels and type 2 diabetes, eye problems, such as glaucoma and cataracts, adrenal insufficiency, mental health conditions such as personality changes, depression, or psychosis (loss of touch with reality), and slowed growth in children [5].
Side effects in children:
In children, prednisolone may slow growth and development. Your child's doctor will oversee their growth while your child is using prednisolone [8].
Risk of Osteoporosis:
Prednisolone may increase the risk that you will develop osteoporosis. Talk to your doctor about the dangers of taking prednisolone and about things that you can do to decrease the chance that you will develop osteoporosis [8].
What are some natural alternatives to Prednisolone?
Some natural compounds have shown promise as alternatives, although more research is needed to confirm their efficacy and safety compared to prednisolone.
Curcumin, berberine chloride, and epigallocatechin gallate are natural products that have shown promising anti-inflammatory effects in in vitro assays, making them potential alternatives to prednisolone [10].
Escin, ginsenosides, and glycyrrhizic acid are compounds derived from natural plant sources that have been reported to exert anti-inflammatory activity by interacting with the glucocorticoid receptor, similar to glucocorticoids, without the risk of side effects such as osteoporosis.
However, it's important to note that while these natural alternatives show promise, more comprehensive studies are needed to confirm their efficacy and safety. Always consult with a healthcare provider before starting any new treatment regimen.