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💊 Medication Guide
Corticosteroid (Glucocorticoid)

Prednisolone (Steroid)

A powerful anti-inflammatory — benefits, risks, and how to use it safely

Prednisolone is a synthetic glucocorticoid steroid with potent anti-inflammatory and immunosuppressive effects. It is used across almost every medical specialty — from asthma to rheumatoid arthritis to organ transplant. It is also one of the most misused drugs in Nigeria: sold without prescription, used for weight gain, and applied as topical steroids for skin lightening. Understanding its proper use and serious risks is essential.

Known as: PrednisoloneDeltacortrilSolupredPred
📋 Patient Information Guide. This page explains how this medication works in plain language. It does not replace your doctor's advice. Always take medication as prescribed and discuss any concerns with your doctor or pharmacist.

What It Is Used For

✓ Severe asthma exacerbation
✓ Rheumatoid arthritis and other inflammatory joint conditions
✓ Inflammatory bowel disease (Crohn's, ulcerative colitis)
✓ Organ transplant immunosuppression
✓ Nephrotic syndrome
✓ Severe allergic reactions
✓ Autoimmune conditions (lupus, vasculitis)
✓ Some cancers (lymphoma, myeloma)

How It Works

Prednisolone binds to glucocorticoid receptors in cells and suppresses the production of pro-inflammatory cytokines and mediators. It also suppresses the immune system by reducing lymphocyte function. This powerful effect is therapeutic in autoimmune and inflammatory conditions — but causes the same suppression of normal immune defence against infection.

Dosing — Typical Guidance

Asthma exacerbation
40–50 mg daily for 5 days. Short course — no need to taper.
Inflammatory conditions
Variable: 5–60 mg daily. Long-term doses above 7.5 mg daily carry significant side effect risk.
Tapering
After more than 2 weeks of steroids — dose must be reduced gradually to prevent adrenal crisis.
Alternate-day dosing
Used to minimise side effects in long-term treatment — take the full dose every other day.
🍽️ Food & Timing: With food or milk to reduce stomach upset. Take in the morning (mimics cortisol's natural diurnal peak — reduces sleep disruption).
⏰ Missed a dose? Take as soon as remembered on the same day. Do not double dose. If on long-term steroids and miss a dose during illness, take the dose and consider sick-day rules (doubling the dose during illness — discuss with doctor).
⚠️ Important Safety Note: Never stop prednisolone abruptly after more than 2–3 weeks of use — this can cause adrenal crisis. Carry a steroid card or medical alert if on long-term steroids. Vaccinations with live vaccines (e.g., yellow fever) are contraindicated during steroid use.

Side Effects

Common
Weight gain, moon face, increased appetite
Steroid-induced fat redistribution. Reduce diet during treatment.
Common
Mood changes — euphoria or depression
Can be significant. Report to doctor. Do not use recreationally.
Common
Insomnia
Take in the morning. Avoid afternoon/evening doses.
Common
Blood sugar elevation
Monitor glucose, especially in diabetics. May cause steroid-induced diabetes.
Serious
Osteoporosis (long-term use)
Take calcium + vitamin D. Bisphosphonate if on steroids for more than 3 months.
Serious
Immune suppression and infection
Increased risk of tuberculosis, fungal infections, and varicella (chickenpox). Report any fever promptly.
Serious
Adrenal suppression (with abrupt stop)
Never stop abruptly after prolonged use — taper under medical guidance.
Serious
Cataract and glaucoma
With long-term use — annual eye check.

Who Should Avoid This Medication

Who Should Not Take This (or Use With Caution)

Drug Interactions to Know

Medication / SubstanceWhy It Matters
NSAIDs (ibuprofen, aspirin)Increased risk of peptic ulceration — add a PPI (omeprazole) if combined.
Antidiabetic medicationsSteroids raise blood glucose — insulin/metformin doses may need increasing.
Live vaccinesAbsolutely contraindicated during significant steroid doses — can cause serious infection.
Rifampicin (TB drug)Reduces prednisolone levels by 45% — dose increase may be needed during TB treatment.

Monitoring While on This Medication

Blood pressure and weight
Weekly when starting high doses.
Blood glucose
In diabetics and those at risk — fasting glucose at 1 week, then regularly.
Bone density (DEXA scan)
If on steroids longer than 3 months — baseline and annually.
Eye pressure (intraocular)
Annual check for glaucoma if on long-term steroids.

Frequently Asked Questions

Is prednisolone the same as the steroids athletes misuse?
No — prednisolone is a glucocorticoid (anti-inflammatory steroid), not an anabolic steroid (muscle-building) like testosterone or nandrolone. They are chemically related but have completely different effects. Athletes misuse anabolic steroids; prednisolone is misused in Nigeria mainly for weight gain and skin lightening — both very harmful applications.
Can steroids be used for weight gain?
Prednisolone does cause weight gain — a well-known side effect. Using it specifically for this purpose is medically unjustifiable and dangerous. Short-term use causes moon face and fluid retention; prolonged use causes diabetes, osteoporosis, infections, adrenal suppression, and potential death. This is not a supplement — it is a potent drug with serious risks.
Why must steroids be tapered?
Prednisolone suppresses the adrenal glands — which normally produce cortisol. After prolonged use, the adrenals atrophy and cannot produce cortisol when needed (e.g., during illness or stress). Abrupt stopping leaves the body without cortisol — causing adrenal crisis: low blood pressure, confusion, and potentially fatal collapse. Tapering gives the adrenals time to recover.
Can steroid eye drops cause glaucoma?
Yes — topical steroids (eye drops and even skin creams applied near the eyes) can raise intraocular pressure and cause steroid-induced glaucoma. Many cases of glaucoma in Nigeria are caused by inappropriate use of steroid eye drops for 'red eye'. Always use steroid eye drops under ophthalmology supervision.
Is it safe to take prednisolone for 5 days for asthma?
Yes — short courses of prednisolone (5–7 days) for asthma exacerbation are safe and effective. Short courses do not cause significant adrenal suppression and do not require tapering. They are a cornerstone of asthma exacerbation treatment and should not be withheld due to steroid concerns.

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