An oral corticosteroid ("steroid")
Prednisolone
The usual oral steroid in the UK, used to reduce inflammation in many conditions — from asthma flares to inflammatory arthritis.
What is Prednisolone?
Prednisolone is the most commonly used oral corticosteroid (steroid) in the UK. It is a powerful anti-inflammatory and immune-calming medicine used in a wide range of conditions, from severe asthma flares and inflammatory bowel disease to allergic reactions and autoimmune disorders.
Education and reference only. This is a plain-language guide to Prednisolone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Prednisolone is the most commonly used oral corticosteroid ("steroid") in the UK. It is a powerful anti-inflammatory and immune-calming medicine used in a wide range of conditions, including asthma and COPD flare-ups, rheumatoid arthritis and other inflammatory joint and connective-tissue diseases, allergic and skin conditions, bowel inflammation and many more. It is the active form that the related medicine prednisone is converted into in the body — which is why prednisolone is preferred in the UK, while prednisone is more common in the US. Most prescriptions are generic; brand names include Deltacortril and the modified-release Lodotra. It can be a short sharp course or a longer-term treatment.
How it works
Prednisolone is a man-made version of cortisol, a steroid hormone the body makes naturally. It switches down the activity of the immune system and the chemical signals that drive inflammation, which calms swelling, redness, pain and over-reactive immune responses across the body. Because it mimics a natural hormone, taking it for a while tells the body to make less of its own — which is why long-term treatment must be reduced gradually rather than stopped suddenly.
Company & origin
Originated / developed by: Schering Corporation (now part of Merck & Co.).
Prednisolone was developed in the mid-1950s by Arthur Nobile and colleagues at the Schering Corporation in the United States, who used microbial oxidation of hydrocortisone to create the more potent corticosteroid, introduced around 1955.
What it treats
Conditions Prednisolone is used for
Practical use
How to take Prednisolone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it in the morning, usually with or after food to reduce stomach irritation.
- Never stop it suddenly after more than a short course — it must be reduced gradually so your body can resume making its own steroid.
- If you take it for more than a short time, carry a steroid emergency card and tell any healthcare professional you take it.
- Take the full course as prescribed and do not change the amount on your own.
- Tell your doctor if you feel unwell, develop an infection, or have chickenpox or shingles contact, as the dose may need adjusting.
- Have any recommended monitoring, such as blood pressure and blood sugar, during longer courses.
Weighing it up
Advantages & disadvantages of Prednisolone
Advantages
- Rapidly and powerfully reduces inflammation in many serious conditions.
- Can be life-saving in severe flares and allergic reactions.
- Taken by mouth, which is convenient.
- Effective across a broad range of inflammatory and autoimmune diseases.
Disadvantages
- Longer use can cause weight gain, raised blood sugar, high blood pressure, thinner bones, mood changes and increased infection risk.
- Must never be stopped abruptly after prolonged use because of the risk of adrenal crisis.
- Can irritate the stomach and disturb sleep.
- Needs a steroid card and monitoring during longer courses.
Practical use
Good to know
It is best taken in the morning with or just after food, which suits the body's natural steroid rhythm and reduces stomach upset and sleep disturbance. A short course can usually be stopped straightforwardly, but after longer-term use it must NEVER be stopped abruptly — the body needs time to restart its own steroid production, and sudden withdrawal can cause a dangerous "adrenal crisis". Anyone on longer-term steroids should carry a steroid emergency card and follow "sick-day rules" — extra steroid may be needed during illness, infection or surgery. Longer-term use brings effects on bones, blood sugar, blood pressure, weight, mood, eyes and infection risk, which are monitored.
Who should not take it / use with caution
- Long-term treatment is never stopped suddenly — it must be tapered, and a steroid emergency card carried.
- Used with care in people with diabetes, high blood pressure, osteoporosis, stomach ulcers, certain eye conditions, mental-health conditions, or a current infection.
- Live vaccines are generally avoided during significant steroid treatment, and contact with chickenpox or measles should be reported by anyone who is not immune.
Monitoring
- Blood pressure, blood sugar and weight, especially on longer-term use
- Bone health, eyes and signs of infection over time
- A careful tapering plan, a steroid emergency card and sick-day rules after longer-term use
Side effects
- Increased appetite, weight gain, indigestion, raised blood sugar, fluid retention, and difficulty sleeping or mood changes.
- With longer-term use: thinning of the bones, easy bruising, a higher risk of infections, raised blood pressure, and effects on the eyes (such as cataracts).
- Sudden stopping after long-term use can cause adrenal crisis — severe weakness, dizziness and collapse — which is a medical emergency.
Key interactions
- NSAID painkillers (e.g. ibuprofen) increase the risk of stomach irritation and ulcers when combined.
- It can raise blood sugar, affecting diabetes treatment, and can lower blood potassium, especially with certain water tablets.
- Some medicines (including certain antifungals and the herbal remedy St John's wort) change its levels; tell prescribers before live vaccines or surgery.
Available as: Standard tablets, gastro-resistant tablets, a modified-release tablet (Lodotra), and soluble tablets or a liquid for those who cannot swallow tablets.
Answers
Prednisolone: frequently asked questions
Can I just stop prednisolone when I feel better?
It depends on how long you have taken it. A short course can usually be stopped as directed, but after longer-term use you must never stop suddenly — your body needs time to restart its own steroid production, and abrupt stopping can cause a dangerous adrenal crisis. Your prescriber will give you a plan to reduce it gradually.
What are "sick-day rules" and the steroid emergency card?
If you take steroids long-term, your body may not make enough of its own steroid during illness, infection or surgery, so you may need a temporary increase — these are the "sick-day rules". A steroid emergency card alerts healthcare staff that you take steroids so they can give extra in an emergency. Carry the card and ask your team what to do if you become unwell.
Why should I take it in the morning with food?
Taking prednisolone in the morning matches the body's natural steroid rhythm and is less likely to disturb your sleep. Taking it with or just after food helps protect your stomach, since steroids can cause indigestion or irritation, especially alongside anti-inflammatory painkillers.
What is the difference between prednisolone and prednisone?
They are very closely related. Prednisone is converted by the liver into prednisolone, the active form. In the UK prednisolone is used directly, while prednisone is more common in the US — for most people the effect is essentially the same.
What is the difference between prednisolone and brands like Deltacortril?
They are the same medicine — prednisolone is the generic (active-ingredient) name and Deltacortril is a brand name (Lodotra is a modified-release brand). Generic prednisolone contains the identical active ingredient.
The wider class
About Corticosteroids
Prednisolone belongs to the corticosteroids class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF: Prednisolone.
- electronic Medicines Compendium (SmPC): Prednisolone; UK health service Steroid Emergency Card guidance.
- NICE CKS: Prednisolone (steroid) tablets.
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