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Prednisone or prednisolone ?

Posted , 11 users are following.

Dave-California
Dave-California

I have been reading Kate Gilbert’s book “PMR and GCA: a survival guide. As many of you who have read it and discussed on the forum before, this is a really excellent help for those of us who just started or who have been long suffering with these diseases.

One thing that I noted was that throughout the book she refers to our ‘famous’ corticosteroid as ‘Prednisolone’ – there was not one mention of Prednisone. I initially thought that this was a typo but apparently not.

I checked into it and read that the difference between prednisone and prednisolone is that one is the precursor to the other. Prednisone is activated by enzymes in the liver to turn into prednisolone. Apparently they do have similar uses but prednisolone is more readily absorbed by the body and is used when there is liver toxicity or liver failure involved.

This indeed surprised me as my rheumatologist has never mentioned or prescribed anything other than Prednisone.

It seems from researching the two names that they have many similarities, but there are differences. The chemical structure and molecular weight are different and prednisone is administered only orally, whereas prednisolone can be given orally, topically or injected.

Anyway, this has surprised me and I am now wondering if there is any information that all my “friends” on this forum can share with those of us who have not heard of this before.

And many thanks to you all for your constant helping and sharing with all of us who are ‘laden’ with PMR.

David

4 likes, 31 replies

31 Replies

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  • judytal
    judytal Dave-California

    Posted

    Hi David,  book sounds interesting. I'll google it.  Also my GP explained the difference to me...I'm taking predinsolone...  

      We need to ask questions ....they may not like it but we MUST.  Dr's are not infallible ... I sent the article to the Rheum. And he called and thanked me and apologized...however I will not return to him.  I lost my trust in his decisions...

    take care

  • Mrs.Mac-Canada
    Mrs.Mac-Canada Dave-California

    Posted

    Hi David,

    Thank you for bringing this to the attention of those of us that didn't know the difference.  I thought prednisolone was just what they called it "on the other side of the pond" as Eileen calls it (I live in Canada). I also wasn't aware of the differences between Medrol and Lodotra and prednisone either so thank you for that Eileen.

    For anyone that is already taking other meds or does have liver issues this could be quite important I think.  Will definitely check with my Rhuemy when I seem him next month.

    Diana🌸

  • judytal
    judytal Dave-California

    Posted

    As I have been reading the many and different postings regarding Meds and differing treatment approaches it seems a lot is based on physicians personal / clinical experiences ...granted we are all different and our bodies are different and respond differently we (patients) need to be involved in our treatment ..  I realize there is a great deal of trust in physicians but we need to ask questions. Ie WHY this med/ why this approach, why .  Reading and staying informed...

      You can report in the U.S. Adverse reactions etc to the FDA. I believe there is still the mentality that the doctors are "gods". Yes there are a few who are true human beings, thank god for them.  

    Ok, all going to have some breakfast!!

  • judytal
    judytal Dave-California

    Posted

    Why did you start taking Ratos ?
    • Dave-California
      Dave-California judytal

      Posted

      I had just gone through a first ‘flare’ and my pain levels zoomed up and so did my ESR blood tests – up to 60 level.

      So my rheumatologist recommended stepping back up to 20 mg of pred and starting a very slow taper including a weekly methotrexate dose (25 mg). I did this and pain levels dropped, but not to a “Happy” level. She thought that a delayed release pred may work, as my absorption rate may not be quite normal. So I started a 1 month trial of Delayed Release Prednisone (Rayos).

      Well – then read on with the ‘story’ I sent to Eileen yesterday to see what happened.

      David

  • paul33361
    paul33361 Dave-California

    Posted

    Dave, took me a little bit of searching the net, but came across your article. A belated thanks. Never knew there was a difference before you have pointed this out. I am Downunder and have been taking Prednisone 50mg reducing to 32.5 mg daily. My lier is inflamed and full of toxins due to the trigger that set the whole thing off, but now I am going to questio my Rheumatologist and find out why Prednisne, and not Prednisolone if it it easier for the liver. Once again, thanks and regards from downunder.
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