| prednisone (U.S.N.L.M.) | |
|---|---|
| Dosing/ (anterior uveitis) | 10-20 mg po bid for 5 days. May be appropriate when topical steroids and cycloplegia prove inadequate.* |
| Dosing/ (intermediate and posterior uveitis) |
Posterior or panuveitis may require higher dosages (up to 30 mg po bid) for longer durations with taper. (Consider immunomodulators for longer duration therapy.) |
| Quantities | 1, 2.5, 5, 10, 20, 50mg tablets Also available as powders, syrups, and solutions. |
| Cost | 9.58 / 10 tablets /20mg |
| Class | Synthetic precursor to the glucocorticoid prednisolone. |
| Action | Inhibits action of phospholipase preventing formation of arachidonic acid and subsequent inflammatory mediators. |
| Short Term Usage | A brief (4 to 7 days) course of treatment does not require a taper and rarely elicits side effects noted below. *A brief course of systemic medication may be useful when drops fail to control anterior uveitis. Such failure, however, may signal the need to reevaluate the diagnosis or underlying disease. |
| Long Term Usage | Depending on dose and duration, side effects may include increased infection risk, weight gain/redistribution, gastrointestinal ulcers or bleeding, osteoporosis, mood alteration/de- pression/anxiety, mental confusion, insomnia, fluid retention, elevated blood pressure, elevated blood sugar, atherosclerosis, aseptic necrosis, tuberculosis reactivation, glau- coma, posterior subcapsular cataract, facial swelling, fatigue, dry mouth, acne, skin rash, and a substantial additional list of side effects and warnings which can be found on the package insert. Adrenal suppression may be expected if prednisone is taken for longer than seven days. Therefore appropriate taper is required to avoid Addison Crisis. |
| Contraindications | Prednisone tablets are contraindicated in systemic fungal infections. |
| Pediatric use | In addition to growth retardation, adverse effects assumed to be similar to adults. Used as early as 1 month for serious conditions. |
| Pregnancy | Category C. Teratogenic in many species in doses equivalent to the human dose. |
| About 50% of uveitis is idiopathic, 20% trauma, 20% systemic, and 10% local ocular such as herpes and toxoplasmosis. Mean age of onset is 30.7 years. Most uveitis cases are anterior uveitis. HLA-B27 related anterior uveitis may need topical treatment for 6 weeks or longer. Mutton fat KP's with flare is most often associated with systemic infection or autoimmune disease. |