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The drug is taken orally, washed down with a small amount of water.
The dose and duration of treatment is selected by the doctor individually, depending on the indications and severity of the disease. The selection of the dose and duration of treatment is determined depending on the individual response to therapy.
The entire daily dose of the drug is recommended to be taken once or twice a daily dose – every other day, taking into account the circadian rhythm of endogenous secretion of GCS in the interval from 6 to 8 hours in the morning. The daily dose of Prednisolone should be taken after a meal (breakfast). A high daily dose can be distributed in 2-4 doses, while a large dose should be taken in the morning.
In acute conditions and as replacement therapy, adults are prescribed at an initial dose of 20-30 mg / day, the maintenance dose is 5-10 mg / day. If necessary, the initial dose can be 15-100 mg / day, supporting 5-15 mg / day.
For children from 3 years and older, the initial dose is 1-2 mg / kg of body weight per day in 4-6 doses, the maintenance dose is 0.3-0.6 mg / kg / day.
When receiving a therapeutic effect, the dose is gradually reduced by 5 mg, then 2.5 mg at intervals of 3-5 days, canceling later receptions first.
With prolonged use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped suddenly. The withdrawal of the maintenance dose is carried out the slower, the longer the glucocorticoid therapy has been used.
In case of stressful effects (infection, allergic reaction, trauma, surgery, nervous stress), in order to avoid exacerbation of the underlying disease, the dose of prednisone should be temporarily increased (1.5-3, and in severe cases – 5-10 times).
The frequency of development and severity of side effects depend on the duration of use, the amount of the dose used and the possibility of observing the circadian rhythm of prescribing prednisone.
Infectious and parasitic diseases: opportunistic infection, masking of clinical symptoms of infections, candidiasis esophagitis.
On the part of the immune system: skin rash, itching, anaphylactic shock.
From the endocrine system: decreased glucose tolerance, “steroid” diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (moon-shaped face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae), hirsutism, delayed sexual development in children, increased need for insulin or oral hypoglycemic drugs in patients with diabetes mellitus diabetes.
From the side of metabolism and nutrition: increased excretion of calcium ions, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating, increased or decreased appetite.
Disorders caused by mineralocorticoid activity: fluid retention and sodium ions in the body (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
Mental disorders: suicidal thoughts, inappropriate behavior, irritability, confusion, mood swings, delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, nervousness or anxiety, insomnia.
From the nervous system: amnesia, increased intracranial pressure, pseudotumor of the cerebellum, headache, seizures, cognitive disorders, epidural lipomatosis.
From the side of the organ of vision: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral infectious eye diseases, trophic corneal changes, exophthalmos, central serous chorioretinopathy, glaucoma.
On the part of the organ of hearing and labyrinthine disorders: vertigo, vertigo.
From the cardiovascular system: arrhythmia, bradycardia (up to cardiac arrest); development (in predisposed patients) or progression of chronic heart failure, ECG changes characteristic of hypokalemia, thrombosis. In acute and subacute myocardial infarction, it is possible to spread the focus of necrosis, slow down the formation of scar tissue, which can lead to rupture of the heart muscle. Increased blood pressure, hypercoagulation, thromboembolism (including pulmonary embolism), telangiectasia.
From the digestive system: nausea, vomiting, pancreatitis, “steroid” ulcers of the stomach and duodenum, erosive esophagitis, gastrointestinal bleeding and perforation of the gastrointestinal wall, digestive disorders, flatulence, hiccups.
From the liver and biliary tract: increased activity of hepatic transaminases and alkaline phosphatase.
From the skin and subcutaneous tissues: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, acne, striae, a tendency to develop pyoderma and candidiasis.
From the musculoskeletal system: slowing of growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (pathological bone fractures, aseptic necrosis of the head of the humerus and femur), muscle tendon rupture, “steroid” myopathy, decreased muscle mass (atrophy).
General disorders and disorders at the injection site: malaise.
Other: increased susceptibility to infections, exacerbation of infections (the appearance of this undesirable reaction is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, “withdrawal of GCS” syndrome, frequent urination at night, urolithiasis.
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