II. Indications

  1. Acute Asthma Exacerbation
  2. Anti-inflammatory and Immunosuppresive Agent
  3. Multiple Sclerosis
  4. Bell's Palsy

III. Contraindications

  1. Severe liver disease
    1. Use Prednisolone instead (does not require first-pass metabolism for activation)

IV. Mechanism

  1. See Systemic Corticosteroid
  2. Prednisone is a prodrug, activated by first pass metabolism in the liver to Prednisolone
    1. Prednisone and Prednisolone have identical dosing and activity
  3. Intermediate activity duration (longer than Hydrocortisone, shorter than Dexamethasone)
  4. Intermediate Glucocorticoid (5 fold more than Hydrocortisone) activity
  5. Low mineralcorticoid activity (half that of Hydrocortisone)

V. Adverse Effects

VI. Safety

  1. See Systemic Corticosteroid
  2. Pregnancy Category C
  3. Considered safe in Lactation

VII. Medications

  1. Prednisone (Deltasone) Tablets: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
  2. Prednisone Solution: 5 mg/5 ml
  3. Prednisone Concentrated Solution (Intensol): 5 mg/ml
  4. Prednisone Delayed Release Tablets (Rayos): 1 mg, 2 mg, 5 mg

VIII. Dosing: Adults

  1. See specific conditions for dosing protocols
  2. Prednisone dosing is equivalent to Prednisolone dosing
  3. Dosing: 5 to 60 mg orally daily (dosing and course depending on indication)

IX. Pharmacokinetics

  1. Requires first pass metabolism through the liver, but has 1:1 bioavailablity in most cases
    1. Consider Prednisolone instead in severe liver disease
  2. Medium potency
  3. Medium anti-inflammatory potency
  4. Has Mineralocorticoid Activity
  5. Medium Half-Life (~36 hours)

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Related Studies

Cost: Medications

prednisone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PREDNISONE 1 MG TABLET Generic $0.06 each
PREDNISONE 10 MG TAB DOSE PACK Generic $0.55 each
PREDNISONE 10 MG TABLET Generic $0.06 each
PREDNISONE 2.5 MG TABLET Generic $0.08 each
PREDNISONE 20 MG TABLET Generic $0.10 each
PREDNISONE 5 MG TAB DOSE PACK Generic $0.41 each
PREDNISONE 5 MG TABLET Generic $0.05 each
PREDNISONE 5 MG/5 ML SOLUTION Generic $0.51 per ml
PREDNISONE 50 MG TABLET Generic $0.24 each
rayos (on 5/18/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
RAYOS DR 5 MG TABLET $88.11 each

Ontology: Prednisone (C0032952)

Definition (NCI_NCI-GLOSS) A drug used to lessen inflammation and lower the body's immune response. It is used with other drugs to treat leukemia and lymphoma and other types of cancer. It is also used alone or with other drugs to prevent or treat many other conditions. These include conditions related to cancer, such as anemia (a low level of red blood cells), allergic reactions, and loss of appetite. Prednisone is a type of therapeutic glucocorticoid.
Definition (NCI) A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations.
Definition (MSH) A synthetic anti-inflammatory glucocorticoid derived from CORTISONE. It is biologically inert and converted to PREDNISOLONE in the liver.
Definition (CSP) synthetic anti-inflammatory glucocorticoid derived from cortisone; biologically inert and converted to prednisolone in the liver.
Definition (PDQ) A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cells populations. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42487&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42487&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C770" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110)
MSH D011241
SnomedCT 116602009, 10312003
LNC LP18109-6, MTHU003245
English Dehydrocortisone, delta-Cortisone, Pregna-1,4-diene-3,11,20-trione, 17,21-dihydroxy-, 17,21-Dihydroxypregna-1,4-diene-3,11,20-trione, Deltadehydrocortisone, 1;2-Dehydrocortisone, Delta(1)-Cortisone, Deltacortisone, Prednisonum, Metacortandracin, prednisone, prednisone (medication), PREDNISONE, 1,2-Dehydrocortisone, Prednisone [Chemical/Ingredient], Delta 1-Cortisone, predniSONE, .delta.1-Cortisone, 1, 2-Dehydrocortisone, Deltacortisone preparation, Deltadehydrocortisone preparation, Prednisone preparation, Prednisone (substance), Prednisone preparation (product), PRD, Prednisone, Prednisone preparation (substance), PRED, PredniSONE
Swedish Prednison
Czech prednison
Finnish Prednisoni
Russian PREDNIZON, DEL'TA-KORTIZON, DEGIDROKORTIZON, ДЕГИДРОКОРТИЗОН, ДЕЛЬТА-КОРТИЗОН, ПРЕДНИЗОН
Spanish deltacortisona, prednisona (producto), preparado con prednisona (producto), preparado con deltacortisona, deltadehidrocortisona, preparado con deltadehidrocortisona, preparado con prednisona, prednisona (sustancia), prednisona, preparado de deltacortisona, preparado de deltadehidrocortisona, preparado de prednisona (producto), preparado de prednisona (sustancia), preparado de prednisona, delta Cortisona, Deshidrocortisona, Prednisona
Italian Deidrocortisone, delta-Cortisone, Prednisone
Croatian PREDNIZON
Polish Prednizon, Encorton
Japanese デヒドロコルチゾン, プレドニソン, プレドニゾン
French Prednisone
German Dehydrocortison, Prednison, Delta-Cortison
Portuguese delta-Cortisona, Desidrocortisona, Prednisona