Prednisolone

• Intermediate-acting systemic glucocorticoid
• Active metabolite of prednisone

Parent class:

• Corticosteroids

Binds intracellular glucocorticoid receptor → alters gene transcription → suppresses inflammatory cytokines and immune activation.

See:

• Glucocorticoid Signaling

Equivalent anti-inflammatory mechanism to Prednisone.

Prednisone = prodrug Prednisolone = active form

Prednisolone does NOT require hepatic activation.

Preferred in:

• Severe hepatic impairment
• Pediatric liquid formulations

• Asthma exacerbations
• Autoimmune disease
• Severe allergic reactions
• Inflammatory disorders

Short-term:

• Hyperglycemia
• Mood changes
• Insomnia

Long-term:

• HPA suppression
• Osteoporosis
• Cushingoid features
• Immunosuppression

• Same potency and duration as prednisone.
• Preferred in patients with significant liver disease.
• Liquid form commonly used in pediatrics.
• Taper required with prolonged therapy.