Prednisolon Boston treats inflammatory and allergic disorders (500 tablets)

Dosage form 500 tablets
Specifications Prednisolone

Ingredient

Composition information	Content
Prednisolone	5mg

Uses

Indications

Prednisolon Boston is indicated in the following cases:

Treatment of inflammatory and allergic disorders.

Pharmacokic

Prednisolone is a glucocorticoid that has a clear anti -inflammatory, anti -allergic and immunosuppressant effect.

Basic corticosteroidal anti -inflammatory ability is shown by the mechanisms:

Inhibits leukocyte adhesion and macrophages, preventing their movement into the inflamed area. Related.

Prednisolone is easily absorbed through the gastrointestinal tract and exists in the form of active metabolites. Prednisolone's absorption ability is affected by food.

Distribution

Plasma peak concentration reaches 1-2 hours after taking the drug. Prednisolone is strongly connected to plasma proteins, although less than hydrocortisone. Prednisolone passes the placenta and a small amount is excreted through breast milk.

Metabolism

prednisolone is metabolized in the liver.

Elimination

Prednisolone is excreted in urine in the form of ester sulfate and glucuronide along with large amounts in the form of unchanged Prednisolone.

Before taking Prednisolon Boston treats inflammatory and allergic disorders (500 tablets)

How to use

oral oral medications after eating.

Should use the lowest dose effectively and in the shortest time to reduce side effects.

Dosage

adults

Initial dose: 5 - 60 mg/day, take 1 single dose in the morning, or take a daily dose. The dose may be reduced within a few days but if needed for a few weeks or months.

Maintenance dose: 2.5 - 15 mg/day. Cushing syndrome may be suffered from> 7.5 mg/day if used for a long time.

Children

Only used in specific specified cases with the minimum doses in the shortest possible time: anti -inflammatory and immunosuppressive inhibition: 0.1 - 2 mg/kg/day, divided into 1-4 times.

Level bronchial asthma

1 - 2 mg/kg/day, divided into 1-2 times (maximum 60 mg/day), for 3-10 days. Prolonged treatment: 0.25 - 2 mg/kg/day, drink once a day in the morning or daily when needed to control asthma.

Nephrotic syndrome

Start 2 mg/kg/day or 60 mg/m2/day (maximum 80 mg/day), divided into 1-3 times, until urine is no longer protein for 3 consecutive days or for 4-6 weeks. After that, the maintenance dose of 1 - 2 mg/kg or 40 mg/m2, used daily in the morning for 4 weeks. Maintain long -term if frequent recurrence: 0.5 - 1.0 mg/kg, used for daily for 3-6 months.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Management: There is no specific antidote. Symptomatic treatment is considered in this case. Need to monitor electrolytes in serum if the case occurs overdose.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Prednisolon Boston, you may experience unwanted effects (ADR).

Endocrine and metabolism: inhibit the hypothalamus - pituitary - adrenal gland, inhibit growth in the embryo stage, children and teenagers, abnormal menstrual periods, deeply, weight gain, reducing carbohydrate tolerance, blood sugar, pre -calcium loss, loss of calcium, increased appetite, hypercholesterol long).

Infection: Increasing sensitivity and severity of infection along with concealing signs and clinical symptoms: opportunistic infections, recurrent tuberculosis, candidiasis.

muscle muscle: muscle weakness, osteoporosis, fracture.

electrolyte: water and sodium retention, electrolyte disorders, potassium loss, alkaline infection, reduced potassium, edema.

Blood and lymph: hyper coagulation, leukemia.

heart and vessels: hypertension, venous thrombosis, heart muscle rupture after myocardial infarction.

Psychiatric and nervous: stimulating, excitement, depression and unstable mood, suicide thought, paranoia, hallucinations, schizophrenia, behavioral disorders, irritability, anxiety, sleep disorders. vision: Increased urology pressure, glaucoma, thorny gai, cataract, protruding eyes (long -term use). digestive: digestive disorders, stomach ulcers with perforation and hemorrhage, acute pancreatitis, nausea. Dermatology: Skin atrophy, bruising, acne, thin skin, blushing.

Hypersensitivity: Anaphylaxis reaction, Stevens - Johnson syndrome, poisoned epidermal necrosis, tumor syndrome.

Sudden stopping of corticosteroids after prolonged treatment can lead to acute adrenal failure, lower blood pressure and death. "Detox syndrome" may also occur including fever, muscle pain, muscle weakness, joint pain, rhinitis, conjunctivitis, weight loss, mental change, emotional changes, nausea, vomiting, hypotension, benign intracranial hypertension, dizziness, headache and re -appear of symptoms.

Instructions on how to handle ADR

Notify the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Prednisolon Boston is contraindicated in the following cases:

Too hypersensitivity to prednisolone or any ingredient of the drug.

Systemic infection except for specific anti -infection treatment.

Acute keratitis caused by herpes simplex.

Using a virus vaccine or reducing toxicity (when using corticosteroid doses that inhibit immunosuppression). chickenpox.

Caution when used

Before treatment with glucocorticoid for a long time, must check the electrocardiogram, blood pressure, X -rong lung and spine, test glucose tolerance and evaluate the function of the hypothalamus - pituitary - adrenal gland (HPA) for all patients.

Prednisolone can cause adrenal impairment or HPA axis inhibitor, especially in children and patients taking high doses for a long time. For long -term use for many years may have adrenal atrophy after stopping treatment. Therefore, the lowest dose is effective in the shortest time to reduce side effects. Be careful and reduce the dose slowly in patients who are not at risk of recurrence and belong to one of the following patients:

Adults: use a dose greater than 40 mg/day (or equivalent) for more than 1 week.

Children: take a dose of 2 mg/kg for 1 week or a dose of 1 mg/kg for 1 month.

Patients taking continuous doses in the evening.

Patients treated for more than 3 weeks.

A short -term treatment within 1 year after long -term treatment.

Patients who have repeated treatment (especially for longer than 3 weeks).

Other causes can inhibit the adrenal glands.

Systemic corticosteroids can be stopped suddenly in patients who are not at risk of recurrence and those who have a 3 -week treatment period and do not belong to one of the above patients.

There are 2 complications that require immediately stop or decrease to the physiological dosage while being treated with corticosteroids:

Acute mental disorders due to corticosteroids when not responding to anti -psychotic drugs.

corneal ulcer caused by herpes that can permanently puncture the cornea and blindness.

While cortisteroidal treatment can be reduced quickly by physiological dose (equivalent to 7.5 mg of prednisolone daily) and then reduce the dose slowly. It is necessary to assess the condition in the process of stopping the drug to ensure the risk of recurrence does not occur.

Patients who are about to have surgery may have to use glucocorticoid supplements because of the normal response to stress that has been reduced due to the inhibition of hypothalamus - pituitary - adrenal glands.

Corticosteroid high doses can cause acute muscle disease, common in patients with neurotransmitter disorders, can be seen in the eye and/or respiratory muscles. Creatine kinase must be monitored.

Use corticosteroids can worsen the existing mental disorders.The prolonged corticosteroid use may increase secondary infections, cover acute infections (including fungal infections), prolonged or severe viral infection, or reduced response to vaccines.

Do not use the treatment of herpes simplex in the eyes, brain malaria or viral hepatitis.

Tightly monitor patients with potential tuberculosis and/or have a TB reaction. Used limited in operating tuberculosis, only used when combined with anti -tuberculosis drugs.

The prolonged corticosteroid use can cause glaucoma disease, optic nerve damage (not indicated for treatment of optic neuritis), blurred vision and market reduction, cataracts under the following bags. Used after glass surgery can slow down the incision or increase bleeding.

There has been a prolonged treatment report with corticosteroids that develops Sarcom Kaposi, consider stopping treatment.

Use cautiously in patients with thyroid disease, liver failure, kidney failure, cardiovascular disease, diabetes, glaucoma, cataract, muscle weakness, risk of osteoporosis, risk of seizures or gastrointestinal tract disease (cholecystitis, stomach ulcers, duodenal ulcers, colon ulcers). Use caution after acute myocardial infarction.

Children: Corticosteroids slow growth and development in children, therefore, need to be cautious and regularly monitor when using Prednisolone prolonged.

Elderly: Common side effects of systemic corticosteroids are often more serious in the elderly, especially osteoporosis, hypertension, hypokalemia, diabetes, sensitive to infections and thin skin. Clinical monitoring is needed to avoid life threats.

In the composition containing lactose may not be suitable for patients with lactose intolerance, galactosaemia disease or malcose/galactose malabsorption.

The ability to drive and operate machinery

There is no reporting document.

Pregnancy

Prednisolone passes through the placenta and can be dangerous for the fetus when used in pregnant women. Animal studies and people suggest that using corticosteroids in the first 3 months of pregnancy increases the risk of lip chipping, cleft palate, reducing pregnancy growth in the uterus and reducing weight at birth. Using corticosteroids for mothers during pregnancy can cause adrenal insects in newborns.

If Prednisolone is used during pregnancy or starting to get pregnant while taking medication, health workers must notify patients in advance the danger to the fetus. In general, using corticosteroids in pregnant women requires consideration of benefits that can be achieved compared to the risks that may occur with mother and child.

Lactation period

Prednisolone secretes breast milk with a concentration of milk in milk equal to 5-25% of serum concentration, about 0.14% of the mother's daily dose. Be careful when using Prednisolone for nursing women. Mothers taking high doses of corticosteroids for a long time can affect the growth and development of breastfed babies and affect endogenous corticosteroid production. Must consider the benefits/risks for mothers and children. If forced to use Prednisolone for breastfeeding women, the lowest dose must be used enough to achieve clinical effect.

Drug interaction

Increase effect

Prednisolone may increase the concentration/effect of: Acetylcholinininiserase inhibitors, amphotericin B, cyclosporin, strap diuretics, thiazide diuretics, natalizumab, non -steroid anti -inflammatory drugs (non -selective COX inhibitors and COX -2), habitats)

Medications that increase concentration or effect of prednisolone: antifungal drugs (Azole derivatives use systemic sugar), Aprepitant, Calci channel blockers (not belonging to dihydropyridine), cyclosporin, estrogen derivatives, fluconazole, fosaprepit, antibiotics MacRolide groups, muscle -inhibitors. polar). Quinolone, trastuzumab, ritonavir.

Reducing effects

Prednisolone may reduce the concentration/effect of: anti -diabetes drugs, calcitriol, corticorelin, isoniazid, salicylate, vaccines (inactivated), somatropine.

The concentration/effect of prednisolone may be reduced by: aminoglutethimide, antacids, barbiturates, bile acid -mounted substances, echinacea, primidone, rifampicin derivatives, phenytoin, carbamazepine.

Sympathetic nerve stimulants (Bambuterol, Salbutamol, Salmeterol, Terbutalin, ...): Increased risk of hypokalemia if used simultaneously with high doses of corticosteroids.

Using the same digitalis may increase the risk of hypotension due to hypokalemia.

Must monitor tightly when taking the same drugs also reduces potassium.

Prednisolone may cause hyperglycemia, so it is necessary to adjust the anti -diabetic dose. Avoid simultaneous use of prednisolone with nonsteroidal anti -inflammatory drugs as it can cause stomach ulcers.

Other drugs: The desired effect of hypoglycemic drugs (including insulin), anti -hypertension drugs, antagonistic diuretics by corticosteroids and worsen the risk of acetazolamide hypotension, diuretics, thiazide diuretics, carbenoxolone, theophyllline.

Interaction with alcohol/nutrition/Herbal

Alcohol: Avoid using alcohol (due to increased irritation of the stomach lining).

Food: Prednisolone affects calcium absorption. Restricting use of cafeine.

Herbal: St John's Wort can reduce Prednisolone levels.

Avoid contact with cat swiping, Echinacea (due to immunosuppressive properties).

Storage

Store in a dry place, avoid light, temperature below 30 ° C.

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