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Indication:
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1. Allergy and anaphylaxis: bronchial asthma, drug hypersensitivity reactions, serum sickness, angioneurotic oedema, anaphylaxis. 2. Respiratory disease: allergic pneumonitis, asthma, occupational asthma, pulmonary aspergillosis, pulmonary fibrosis, pulmonary alveolitis, aspiration of foreign body, aspiration of stomach contents, pulmonary sarcoid, drug induced lung disease, adult respiratory distress syndrome, spasmodic croup. 3. Rheumatic disorders: rheumatoid arthritis, polymyalgia rheumatica, juvenile chronic arthritis, systemic lupus erythematosus, dermatomyositis, mixed connective tissue disease. 4. Arteritis/collagenosis: giant cell arteritis/polymyalgia rheumatica, mixed connective tissue disease, polyarteritis nodosa, polymyositis. 5. Blood disorders: haemolytic anaemia (auto-immune), leukaemia (acute and chronic lymphocytic), lymphoma, multiple myeloma, idiopathic thrombocytopenic purpura. 6. Cardiovascular disorders: post-myocardial infarction syndrome, rheumatic fever with severe carditis. 7. Endocrine disorders: primary and secondary adrenal insufficiency, congenital adrenal hyperplasia. 8. Gastro-intestinal disorders: Crohn's disease, ulcerative colitis, persistent coeliac syndrome (coeliac disease unresponsive to gluten withdrawal), auto-immune chronic active hepatitis, multisystem disease affecting liver, biliary peritonitis. 9. Infections (with appropriate chemotherapy): helminthic infestations, Herxheimer reaction, infectious mononucleosis, miliary tuberculosis, mumps orchitis (adult), tuberculous meningitis, rickettsial disease. 10. Muscular disorders: polymyositis, dermatomyositis. 11. Neurological disorders: infantile spasms, Shy-Drager syndrome, sub-acute demyelinating polyneuropathy. 12. Ocular disease: scleritis, posterior uveitis, retinal vasculitis, pseudo-tumours of the orbit, giant cell arteritis, malignant ophthalmic Graves disease. 13. Renal disorders: lupus nephritis, acute interstitial nephritis, minimal change glomerulonephritis. 14. Skin disorders: pemphigus vulgaris, bullous pemphigoid, systemic lupus erythematosus, pyoderma gangrenosum. 15. Miscellaneous: sarcoidosis, hyperpyrexia, Behçets disease, immunosuppression in organ transplantation.
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Warning & Precautions:
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Caution is necessary when oral corticosteroids, including Prednisolone, are prescribed in patients with the following conditions like-tuberculosis, hypertension, congestive heart failure, liver failure, renal insufficiency, diabetes mellitus or in those with a family history of diabetes, osteoporosis, patients with a history of severe affective disorders and particularly those with a previous history of steroid-induced psychoses, epilepsy, peptic ulceration, previous steroid myopathy.
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Drug interaction:
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Prednisolone may interact with phenobarbital, phenytoin, rifampicin, rifabutin, carbamazepine, primidone and aminoglutethimide , ketoconazole, troleandomycin, indomethacin, erythromycin, anticoagulants, amphotericin, ritonavir, methotrexate etc.
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Use in special groups:
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Use in pregnancy: Corticosteroids should only be prescribed when the benefits to the mother and child outweigh the risks. Patients with pre-eclampsia or fluid retention require close monitoring. Use in lactation: Corticosteroids should be administered to nursing mothers only if the benefits of therapy are judged to outweigh the potential risks to the infant. Use in the elderly: Treatment of elderly patients, particularly if long term, should be planned bearing in mind the more serious consequences of the common side effects of corticosteroids in old age, especially osteoporosis, diabetes, hypertension, hypokalemia, susceptibility to infection and thinning of the skin. Close clinical supervision is required to avoid life-threatening reactions.
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