Prednisolone (Oral) — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Prednisolone (Oral)?
Prednisolone is an oral glucocorticoid (corticosteroid) with potent anti-inflammatory and immunosuppressive properties. This medication is funded by Pharmac for many conditions.
What is Prednisolone (Oral) Used For?
Prednisolone is used for acute asthma exacerbations, COPD exacerbations, severe allergic reactions, inflammatory conditions (rheumatoid arthritis, polymyalgia rheumatica, inflammatory bowel disease, vasculitis), organ transplantation immunosuppression, and many other immune-mediated conditions.
How Does Prednisolone (Oral) Work?
Prednisolone binds to intracellular glucocorticoid receptors, modulating gene transcription to reduce the production of pro-inflammatory cytokines, prostaglandins, and leukotrienes. It also reduces immune cell activity and vascular permeability — providing broad anti-inflammatory and immunosuppressive effects.
How to Take Prednisolone (Oral)
Dose and duration vary widely by condition. For asthma exacerbations: 40–50 mg/day for 5 days. For inflammatory conditions: tapered from high initial doses over weeks to months. Always take in the morning with food (reduces gastric irritation). Do not stop abruptly after prolonged use — taper to prevent adrenal insufficiency.
Common Side Effects of Prednisolone (Oral)
- Weight gain and fluid retention
- Increased appetite
- Mood changes (euphoria or irritability)
- Insomnia
- Increased blood glucose
- Indigestion
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Adrenal suppression (after >3 weeks use — never stop suddenly)
- Osteoporosis and fractures (with long-term use — calcium/vitamin D prophylaxis essential)
- Avascular necrosis of bone (hip, knee)
- Diabetes mellitus or worsening blood glucose control
- Hypertension
- Serious infections (immunosuppression — may mask fever)
- Cushing’s syndrome (with long-term high doses)
- Cataracts and glaucoma
- Peptic ulcers (especially with NSAIDs)
Drug Interactions
Prednisolone (Oral) may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- NSAIDs (increased peptic ulcer risk — use PPI prophylaxis)
- Live vaccines (contraindicated in immunosuppressed patients on high-dose steroids)
- Rifampicin, carbamazepine, phenytoin (reduce prednisolone levels)
- Antidiabetic medicines (blood glucose may worsen)
- Warfarin (variable effect — monitor INR)
New Zealand Prescribing Information
Prednisolone (1 mg, 5 mg, 20 mg, 25 mg tablets) is funded by Pharmac. For short courses (e.g., asthma, COPD exacerbation): take the full course and stop without tapering. For long courses (>3 weeks): dose must be tapered gradually to allow the adrenal glands to resume cortisol production. Patients on long-term steroids should carry a steroid emergency card.
Frequently Asked Questions
Do I need to taper prednisolone after a short course?
For short courses (5–7 days) for asthma or COPD exacerbation, tapering is generally not required — you can stop after the prescribed days. For longer courses (>3 weeks), the dose must be tapered gradually to prevent adrenal crisis.
Should I take a calcium and vitamin D supplement with long-term steroids?
Yes — long-term prednisolone increases the risk of osteoporosis and fractures. Calcium (1000–1200 mg/day) and vitamin D (800–1000 IU/day) supplementation is routinely recommended alongside bisphosphonate therapy for patients on long-term corticosteroid treatment.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: