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Reduced doses are necessary in patients with hypoalbuminaemia. Corticosteroids distributed into breast milk may suppress growth and interfere with endogenous glucocorticoid production in nursing infants. Caution is necessary when oral corticosteroids, including prednisolone, are prescribed in patients with the following conditions, and frequent patient monitoring is necessary.
Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects. The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects. Caution is required in patients with systemic sclerosis because of an increased incidence of scleroderma renal crisis with hypertension and decreased urinary output observed with a daily dose of 15 mg or more prednisolone. Blood pressure and renal function (s-creatinine) should therefore be routinely checked. When renal crisis is suspected, blood pressure should be carefully controlled. Suppression of the inflammatory response and immune function increases the susceptibility to infections and their severity.
Plasma half – life is about 3 hours in adults and somewhat less in children, Its initial absorption, but not its overall bioavailability, is affected by food. Prednisolone has a biological half-life lasting several hours, making it suitable for alternate-day administration regimens. Increased toxicity if hypokalaemia occurs with corticosteroids.
Dosage reductions should not exceed 5-7.5mg daily during chronic treatment. Pharmacologically-active dose levels may lead to atrophy of the adrenal cortex, resulting in adrenal insufficiency. Serum salicylate concentrations may decrease when corticosteroids are administered concomitantly. The renal clearance of salicylates is increased by corticosteroids and steroid withdrawal may result in salicylate intoxication. Salicylates and corticosteroids should be used concurrently with caution.
Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate, intra-uterine growth retardation and effects on brain growth and development. There is no evidence that corticosteroids result in an increased incidence of congenital abnormalities, such as cleft palate/lip in man. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intra-uterine growth retardation. The use of corticosteroids, including prednisolone, during pregnancy may also result in stillbirth. Hypoadrenalism may, in theory, occur in the neonate following prenatal exposure to corticosteroids but usually resolves spontaneously following birth and is rarely clinically important.
The speed with which dose can be reduced is also dependent on risk of relapse of the disease being treated. After prolonged treatment, tapering of dose below 7.5 mg (regarded as “equivalent” to physiological levels of glucocorticoids) should be conducted particularly cautiously. Prednidale 5mg Tablets are for the treatment of inflammatory and allergic diseases, including some autoimmune diseases and some neoplastic conditions in cats and dogs. Prednidale Tablets are indicated for the treatment of inflammatory and allergic diseases, including some autoimmune diseases and some neoplastic conditions in cats and dogs. A single administration may be sufficient for some conditions such as anaphylaxis. Other conditions may require treatment for between two and three weeks.
Do not stop taking prednisolone if you're taking it for these conditions. Steroids can cause adrenal insufficiency if stopped too quickly. Signs include lethargy, lack of appetite, vomiting and diarrhoea. However the dose is reduced and withdrawn gradually to avoid this. If you reduce the dose as advised by your vet then your dog is unlikely to show signs of adrenal insufficiency but you should contact your vet immediately if he does. Gastrointestinal ulceration may be exacerbated by corticosteroids in animals given non-steroidal anti-inflammatory drugs .
Care needs to be taken to ensure that the condition being treated justifies steroid medication, to avoid unwanted side effects. In higher doses, Prednidale can be used to treat autoimmune problems and some forms of neoplasm. Steroids on the whole are a safe and effective treatment which have a broad range of uses.
If you have not experienced any side effects then I advise not to worry. If you have any concerns then it is recommended to see your local GP. Corticosteroids are not recommended for use in pregnant animals. Studies in laboratory animals have shown that administration during early pregnancy may cause foetal abnormalities. Administration during the later stages of pregnancy may cause abortion or early parturition. Do not use in pregnant animals, those suffering from diabetes mellitus, in animals with renal insufficiency or those with corneal ulceration.
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