Prednisolone/Prednisone

What is prednisone/prednisolone?

Prednisone/prednisolone (brand name: Prednis-Tab®, Deltasone®, Rayos®, Pediapred®) is a glucocorticoid used to treat many conditions in many species. Broad uses include the following: replacement therapy for Addison’s disease, an anti-inflammatory, an immune suppressant, and an antineoplastic (cancer treatment).

Prednisone and prednisolone are distinct drugs, but prednisone is quickly converted to prednisolone in the liver, so they are considered bioequivalent (equally absorbed). However, some animals, including cats and horses, are unable to complete this conversion, so prednisolone must be administered directly. 

While some products are labeled for use in some animals with certain conditions, its use in cats, dogs, horses, small mammals, birds, and reptiles to treat inflammation, immune-mediated disease, Addison’s disease, and neoplasia is often off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is prednisone/prednisolone given?

• Prednisone/prednisolone is given by mouth in the form of a tablet or liquid solution. It can also be given as an injection in the hospital.
• Measure liquid forms carefully.
• Give this medication with food.
• If your pet is on a once daily dose, give it in the morning to dogs and horses, and give it in the evening to cats, if possible.
• Do not stop this medication abruptly; taper it slowly to avoid complications.
• Do not use in pets that are undergoing allergy testing within the next month, unless otherwise advised by your veterinarian.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

• Prednisone/prednisolone may cause the following side effects:
• Increased drinking
• Increased urination
• Increased appetite

At higher doses and during long-term use, side effects may also include:

• Vomiting
• Diarrhea
• Mild behavioral changes
• Panting

Serious adverse reactions may occur. If any of the following signs develop, stop giving prednisone/prednisolone and contact your veterinarian immediately:

• Gastrointestinal ulceration (characterized by lack of appetite, black or bloody stools, bloody vomit, and high fever)
• Haircoat changes
• Pot belly
• Weight gain
• Weakness
• Liver and lipid elevations
• Aggressive behavior
• Muscle wasting
• Abnormally low energy
• Diabetes (characterized by weight loss, despite good appetite, excessive thirst and urination)

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. 

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE prednisone/prednisolone in pets that:

• Are allergic to it
• Have systemic fungal infections (unless it is used to treat Addison’s disease)
• Have viral infections
• Have ulcers
• Have tuberculosis
• Have Cushing’s disease
• Are undergoing allergy testing within the next month (unless otherwise advised by your veterinarian)

USE WITH CAUTION in pets that:

• Have diabetes
• Have heart or vascular disease
• Have other types of infections
• Have osteoporosis
• Have cataracts
• Have high blood pressure
• Have kidney disease
• Are young (this medication can stunt growth)

USE WITH EXTREME CAUTION in pets that:

• Are pregnant or lactating
• Are receiving medications that can cause ulcers

Do not stop this medication abruptly; taper it slowly to avoid complications. Do not use the prednisone form in cats and horses, or in pets with liver dysfunction, as they cannot efficiently convert prednisone to prednisolone. Use prednisolone instead.

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with prednisone/prednisolone, including:

• Anticholinesterases
• Aspirin
• Barbiturates
• Bupropion
• Cholestyramine
• Cyclophosphamide
• Cyclosporine
• Fluroquinolones
• Insulin
• Ketoconazole
• Macrolide antibiotics
• Mitotane
• Mycophenolate
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Phenobarbital
• Potassium-depleting diuretics
• Vaccines

This product may also interact with laboratory tests, such as allergy tests, as well as cholesterol, urine glucose, potassium, and thyroid levels.

Certain medications may interact with prednisone/prednisolone, so be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Monitoring recommendations will vary depending on the reason use, dosage, duration of therapy, and your pet’s health status.
• Common monitoring includes bloodwork and urinalysis, blood sugar levels, ACTH stimulation tests, weight and appetite status, signs of swelling, and serious side effects.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.

How do I store prednisone/prednisolone?

• Store the tablets at room temperature, ideally between 59°F and 86°F (15°C and 30°C).
• Store in a tight container and protect from light.
• Liquid forms of the medication should be stored according to the label on the bottle.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.