Prednisol, ampoules 30mg, 1ml, 3pcs

Product description

Minimum order quantity-2 pieces

Composition

Active ingredient:  prednisone sodium phosphate (in terms of prednisone) 25 or 30 mg.

Auxiliary substances:  nicotinamide; sodium metabisulfite; disodium edetate; sodium hydroxide; water for injection

Pharmacological action

Prednisone is a synthetic glucocorticoid drug. It has anti-inflammatory, anti-allergic, immunosuppressive, anti-exudative and antipruritic effects. The immunosuppressive effect is associated with inhibition of cytokine release from lymphocytes and macrophages. Other effects are caused by the stabilization of cell membranes, reduced capillary permeability, and improved microcirculation. Prednisone has a catabolic effect, increases the level of glucose in the blood, causes the redistribution of adipose tissue. The drug inhibits the synthesis and secretion of ACTH and, secondarily, corticosteroids by the adrenal glands. When applied externally and topically, the therapeutic activity of prednisone is due to anti-inflammatory, anti-allergic and anti-exudative (due to the vasoconstrictor effect) action.

Indications

For oral and intravenous use: rheumatism; rheumatoid arthritis; dermatomyositis; nodular periarteritis; scleroderma; Ankylosing spondylitis; bronchial asthma, asthmatic status; acute and chronic allergic diseases; Addison’s disease, acute adrenal insufficiency, adrenogenital syndrome; hepatitis, hepatic coma, hypoglycemic conditions, lipoid nephrosis; agranulocytosis, various diseases of the liver. forms of leukemia, lymphogranulomatosis, thrombocytopenic purpura, hemolytic anemia; chorea minor; pemphigus, eczema, pruritus, exfoliative dermatitis, psoriasis, pruritus, seborrheic dermatitis, lupus erythematosus, erythroderma, alopecia.

For use in ophthalmology:  allergic, chronic and atypical conjunctivitis and blepharitis; corneal inflammation with intact mucosa; acute and chronic inflammation of the anterior segment of the vascular membrane, sclera and episclera; sympathetic inflammation of the eyeball; after injuries and operations with prolonged irritation of the eyeballs.

For intra-articular insertion:  chronic polyarthritis, post-traumatic arthritis, osteoarthritis of large joints, rheumatic lesions of individual joints, arthrosis.

For infiltration into tissues:  epicondylitis, tendovaginitis, bursitis, scapular periarthritis, keloids, sciatica, Dupuytren’s contracture, rheumatic and similar lesions of joints and various tissues.

Contraindications

Peptic ulcer of the stomach and duodenum, osteoporosis, Itsenko-Cushing syndrome, tendency to thromboembolism, renal failure, severe arterial hypertension, systemic mycoses, viral infections, vaccination period, active tuberculosis, glaucoma, productive symptoms in mental illnesses. Hypersensitivity to prednisone. Infiltration introduction into the lesions of the skin and tissues – with chickenpox, specific infections, mycoses, with a local reaction to vaccination. In ophthalmology-viral and bacterial eye diseases, primary glaucoma, corneal diseases with epithelial damage. In dermatology – bacterial, viral, fungal skin lesions, tuberculosis, syphilis, skin tumors.

Side effects

With short-term use of prednisone, as with other corticosteroids, side effects are rarely observed. When using prednisone for a long time, the following side effects may develop: :

Disorders of water and electrolyte metabolism:  sodium and fluid retention in the body, hypokalemia, hypokalemic alkalosis.

From the cardiovascular system:  raising Blood pressure, circulatory failure.

From the musculoskeletal system:  muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, compression fracture of the spine, aseptic necrosis of the femoral and humeral heads, pathological fractures of the long tubular bones.

From the digestive tract:  steroid ulcer with possible perforation and bleeding, pancreatitis, flatulence, ulcerative esophagitis, digestive disorders, nausea, increased appetite.

From the side of the skin:  atrophic streaks, acne, delayed wound healing, thinning of the skin, petechiae and hematomas, erythema, increased sweating, allergic dermatitis, urticaria, angioedema.

Nervous system and sensory disorders:  increased intracranial pressure with congestive nipple syndrome of the optic nerve (pseudotumor of the brain-more often in children, usually after too rapid a dose reduction, symptoms-headache, deterioration of visual acuity or double vision); convulsions, dizziness, headache, sleep disorders, posterior subcapsular cataract, increased intraocular pressure, glaucoma; exophthalmos.

Endocrine status:  secondary adrenal and hypothalamic-pituitary insufficiency (especially during stressful situations, such as illness, trauma, surgery); Cushing’s syndrome; growth suppression in children; menstrual disorders; decreased tolerance to carbohydrates; manifestation of latent diabetes mellitus and increased need for insulin or oral antidiabetic drugs in patients with diabetes mellitus, hirsutism.

From the side of metabolism:  negative nitrogen balance as a result of protein catabolism, hyperglycemia, glucosuria.

Mental disorders:  symptoms that mimic schizophrenia, mania, or delirium syndrome (most often appear during the first two weeks of treatment). Women and patients with lupus erythematosus are most susceptible to mental disorders.

Other services:  anaphylactic and hypersensitivity reactions, obliterating endarteritis, weight gain, masking the symptoms of infectious diseases, syncope.

Interaction

Cardiac glycosides: increased risk of cardiac arrhythmias and glycoside toxicity associated with hypokalemia. Antihistamines weaken the effect of prednisone. Barbiturates, antiepileptic drugs (phenytoin, carbamazepine), rifampicin, glutetimide accelerate the metabolism of corticosteroids (by inducing microsomal enzymes), weaken their effect. Amphotericin B, carbonic anhydrase inhibitors: hypokalemia, left ventricular myocardial hypertrophy, circulatory failure. Paracetamol: hypernatremia, peripheral edema, increased calcium excretion, risk of hypocalcemia and osteoporosis. Increased risk of paracetamol hepatotoxicity. Anabolic steroids, androgens: increased risk of developing peripheral edema, acne; use cautiously, especially in cases of liver and heart disease. Holinoblokiruyushchy drugs (mainly, atropine — – increase in intraocular pressure. Anticoagulants (coumarin derivatives, indandion, heparin), streptokinase, urokinase: reduced, and in some patients increased effectiveness; dose should be determined based on PV; increased risk of ulceration and bleeding from the gastrointestinal tract. Oral contraceptives containing estrogens: increased concentration of globulins binding glucocorticosteroids in the blood serum, slower metabolism, increased T1 / 2, increased effect of prednisone. Tricyclic antidepressants may increase the psychiatric disorders associated with taking prednisone. They should not be used to treat these disorders. Antithyroid drugs, thyroid hormones — changes in the function of the thyroid gland (it is possible to adjust the dose of these drugs or stop taking them). Diuretics: weakening of the action of diuretics (potassium-sparing), hypokalemia. Oral antidiabetic drugs, insulin: weakening of the hypoglycemic effect, an increase in the concentration of glucose in the blood. It is possible to adjust the dose of antidiabetic drugs. Ephedrine can accelerate the metabolism of corticosteroids (dose adjustment of prednisone is possible). Laxatives: weakening of the effect, hypokalemia. Isoniazid: a decrease in the concentration of isoniazid in blood plasma, mainly in individuals with rapid acetylation (dose adjustment is possible). Mexiletine: accelerates the metabolism of mexiletine and reduces its concentration in the blood serum. Immunosuppressive drugs: increased risk of infection, lymphoma, and other lymphoproliferative diseases. Drugs that block neuromuscular conduction (depolarizing muscle relaxants): hypocalcemia associated with prednisone use may increase synapse blockage, leading to an increase in the duration of neuromuscular blockage. Medications and foods containing sodium: peripheral edema, arterial hypertension (it may be necessary to reduce the intake of sodium with food and medications with a high sodium content; sometimes the use of corticosteroids requires additional sodium use). NSAIDs, acetylsalicylic acid, alcohol: weakening of the effect, increased risk of peptic ulcer disease and bleeding from the gastrointestinal tract. Vaccines containing live viruses: during the use of immunosuppressive doses of corticosteroids, viral replication and the development of viral diseases are possible; reduced antibody production (simultaneous use is not recommended). Folic acid: increased need for this medication. Other vaccines: increased risk of neurological complications and decreased antibody production.

How to take it, the course of use and dosage

In/in (jet, then drip) or in / m. The dose of Prednisone and the duration of treatment is determined by the doctor individually, depending on the indications and severity of the disease.

In acute adrenal insufficiency, a single dose of the drug is 100-200 mg, daily 300-400 mg.

For severe allergic reactions Prednisone is administered in a daily dose of 100-200 mg for 3-16 days.

In bronchial asthma, the drug is administered depending on the severity of the disease and the effectiveness of complex treatment from 75 to 675 mg per course of treatment from 3 to 16 days; in severe cases, the dose can be increased to 1400 mg per course of treatment or more with a gradual decrease in the dose.

With asthmatic status Prednisone is administered at a dose of 500-1200 mg per day, then reduced to 300 mg per day and switched to maintenance doses.

With a thyrotoxic crisis,100 mg of the drug is administered in a daily dose of 200-300 mg; if necessary, the daily dose can be increased to 1000 mg. The duration of use depends on the therapeutic effect, usually up to 6 days.

For shock resistant to standard therapy, Prednisone is usually administered in a jet stream at the beginning of therapy, after which it is switched to drip use. If blood pressure does not rise within 10-20 minutes, repeat the jet injection of the drug. After removal from the shock state, drip use is continued until blood pressure stabilizes. A single dose is 50-150 mg (in severe cases-up to 400 mg). The drug is re-administered after 3-4 hours. The daily dose may be 300-1200 mg (with subsequent dose reduction).

In acute hepatic-renal insufficiency (in acute poisoning, in the postoperative and postpartum periods), Prednisone is administered at 25-75 mg per day; if indicated, the daily dose can be increased to 300-1500 mg per day or higher.

For rheumatoid arthritis and systemic lupus erythematosus Prednisone is administered in addition to the systemic intake of the drug at a dose of 75-125 mg per day for no more than 7-10 days.

In acute hepatitis Prednisone is administered at 75-100 mg per day for 7-10 days.

For poisoning with cauterizing fluids with burns of the digestive tract and upper respiratory tract Prednisone is prescribed at a dose of 75-400 mg per day for 3-18 days.

If intravenous use is not possible, Prednisone is administered intravenously in the same doses. After stopping the acute condition, Prednisone tablets are prescribed inside, followed by a gradual decrease in the dose.

With prolonged use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped abruptly!

Overdose

The risk of overdose increases with prolonged use of prednisone, especially in large doses.

Symptoms: raising Blood pressure, peripheral edema, increased undesirable effects described above.

Treatment: You should temporarily stop taking the drug or reduce the dose.

Special instructions

The effectiveness of antacids in preventing ulceration, bleeding from the digestive tract, or intestinal perforation has not been confirmed. With long-term treatment, it may be necessary to limit sodium and increase the potassium content, as well as increase the protein content in food. Prednisone is contraindicated in patients with systemic fungal infections due to the risk of increased infection. The drug can in some cases be used for fungal infections treated with amphotericin B to reduce its side effects, but in these cases it can cause circulatory failure and left ventricular hypertrophy of the heart, as well as severe hypokalemia. Taking the drug with a meal can reduce side effects from the gastrointestinal tract. In the case of steroid myopathy, if prednisone therapy cannot be discontinued, replacing it with another corticosteroid may alleviate the symptoms. The risk of developing osteoporosis associated with prolonged use of corticosteroids can be reduced by taking calcium and vitamin D or, if the patient’s condition allows, by performing appropriate physical exercises. Acetylsalicylic acid or other NSAIDs may be prescribed to mitigate some of the symptoms of corticosteroid withdrawal (without suppressing the hypothalamic-pituitary-adrenal system). If psychosis or depression occurs, reduce the dose or discontinue the drug if possible. If necessary, phenothiazines or lithium compounds can be used.

Product form

solution for injection

Storage conditions

At temperatures below 25 °C.

Shelf life

3 years

Active ingredient

Prednisone

Conditions of release from pharmacies

By prescription

Dosage form

solution for injection and infusion

Purpose

For adults as prescribed by a doctor, for children as prescribed by a doctor

Indications

Allergy, Dermatitis, Rheumatoid Arthritis, Psoriasis, Dermatosis, Hepatitis, Neurodermatitis, Seborrhea, Bronchial Asthma, Osteoarthritis and Arthritis, Eczema, Urticaria