[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Corticosteroids (glucocorticoids)](https://durgical.com/en/pharmacology/classes/corticosteroids/) › Prednisolone

[Pharmacology](https://durgical.com/en/pharmacology/) · [Corticosteroids (glucocorticoids)](https://durgical.com/en/pharmacology/classes/corticosteroids/)

# Prednisolone

The active form of prednisone. It does not need liver activation and comes as liquids for children and as eye drops.

Updated 2026-11-01

- Class: [Corticosteroids (glucocorticoids)](https://durgical.com/en/pharmacology/classes/corticosteroids/)
- Receptor: Glucocorticoid receptor (GR), a nuclear receptor
- ATC code: H02AB06
- WHO Model List of Essential Medicines

◎**Glucocorticoid receptor (GR), a nuclear receptor**Prednisolone

ⓘ The figure shows cortisol (hydrocortisone) in the ligand-binding pocket of the human glucocorticoid receptor; prednisolone, which differs from cortisol by one double bond, binds the same pocket.

**Target in 3D:** Glucocorticoid receptor (GR), a nuclear receptor. PDB structure 4P6X (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4P6X) · Drag to rotate · pinch to zoom

## Mechanism of action

Prednisolone binds the glucocorticoid receptor directly. The complex enters the nucleus, switches on anti-inflammatory genes and represses NF-κB and AP-1, so cytokines, prostaglandins and immune cell activity fall. Because it is already active, it is a good choice in liver disease and in children, where it is often given as an oral solution.

- Prednisolone binds the glucocorticoid receptor without needing activation
- The drug-receptor complex moves into the nucleus
- It switches on anti-inflammatory genes and represses NF-κB and AP-1
- Fewer cytokines, prostaglandins and immune cells reach the tissue

## Pharmacokinetics

**Absorption**
Well absorbed by mouth; tablets, dispersible tablets, solutions and eye drops exist

**Metabolism**
Already active; metabolised in the liver and excreted in the urine as conjugates

**Half-life**
Intermediate-acting glucocorticoid

## Indications

- Asthma exacerbations, especially in children (oral solution) [Asthma →](https://durgical.com/en/conditions/asthma/)
- Rheumatic and autoimmune diseases [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- Multiple sclerosis exacerbations [Multiple sclerosis →](https://durgical.com/en/conditions/multiple-sclerosis/)
- Eye inflammation such as uveitis (eye drops) [Uveitis →](https://durgical.com/en/conditions/uveitis/)
- Prevention of transplant rejection, with other drugs

## Adverse effects

### Common

- Mood changes and insomnia
- Increased appetite and fat redistribution
- Thin, fragile skin and slow healing
- Hyperglycaemia
- Acne

### Serious (rare, important)

- Infections, which the drug can also mask
- Adrenal suppression: adrenal insufficiency if stopped abruptly after prolonged use
- Osteoporosis and fractures with long use
- Peptic ulcer and gastrointestinal bleeding, especially with NSAIDs
- Posterior subcapsular cataract and glaucoma
- Psychiatric reactions (euphoria, depression, psychosis)
- Slowed growth in children

## Contraindications

- Systemic fungal infections
- Hypersensitivity to the product
- Live or live attenuated vaccines during immunosuppressive doses

## Key interactions

**CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, barbiturates)**
Faster clearance and a weaker corticosteroid effect

**Strong CYP3A4 inhibitors (ketoconazole)**
Higher corticosteroid levels and more side effects

**Aspirin and other NSAIDs**
Higher risk of gastrointestinal ulcer and bleeding

**Potassium-depleting drugs (loop or thiazide diuretics, amphotericin B)**
Hypokalaemia; with digoxin, more risk of arrhythmia

**Warfarin**
The anticoagulant response changes; INR is checked more often

## What is monitored

- Blood glucose
- Blood pressure and weight
- Potassium
- Signs of infection
- Eye pressure and bone density with long use

## Administration and safety

- Oral forms are given with food; liquids are measured with the device supplied, not a kitchen spoon
- Eye drops do not replace the oral drug; each form has its own order
- Long courses are tapered, not stopped suddenly

## Nursing care

- Check glucose, especially in people with diabetes; corticosteroids raise it
- Watch for infection: fever and other signs may be blunted
- Watch mood and sleep; report agitation, depression or confusion
- Teach that a long course is not stopped suddenly; it is tapered under medical supervision
- In children on long courses, measure height and weight to watch growth

## Pregnancy and breastfeeding

Used in pregnancy when the benefit justifies it; newborns of mothers on substantial doses are watched for adrenal insufficiency.

## Memory aid

PrednisoLONE is the one already «on»: no liver needed, so it suits children's syrups and liver disease.

## Test yourself

Think of the answer, then tap the question to see it.

## Why might prednisolone be chosen over prednisone in severe liver disease?

Prednisolone is already active; prednisone needs hepatic conversion, which may be reduced when the liver fails.

## Which eye complications are linked to long-term corticosteroids?

Posterior subcapsular cataract and raised eye pressure (glaucoma); herpes infections of the eye can also worsen.

## What is checked regularly in a child on a long course of prednisolone?

Growth (height and weight), blood pressure, glucose and signs of infection.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/prednisolone/)

## Related drugs

- [Prednisone](https://durgical.com/en/pharmacology/prednisone/)
- [Methylprednisolone](https://durgical.com/en/pharmacology/methylprednisolone/)
- [Hydrocortisone](https://durgical.com/en/pharmacology/hydrocortisone/)

## Related conditions

- [Asthma](https://durgical.com/en/conditions/asthma/)
- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Multiple sclerosis](https://durgical.com/en/conditions/multiple-sclerosis/)
- [Uveitis](https://durgical.com/en/conditions/uveitis/)

[← Back to the class: Corticosteroids (glucocorticoids)](https://durgical.com/en/pharmacology/classes/corticosteroids/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Prednisolone: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a615042.html) (MedlinePlus (U.S. National Library of Medicine), 2015); [DailyMed - PREDNISOLONE SODIUM PHOSPHATE solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=96de9cad-2fb7-4947-87ae-4db57563a83a) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H02AB06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/prednisolone/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/prednisolone/