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==General==
*Type: [[Corticosteroid]]
*Dosage Forms: PO (5; 5,15,25/5 mL), ophthalmic 
*Common Trade Names: Flo-Pred, Millipred, Oraped, Pedipred, Prelone, Veripred 20

==Adult Dosing==
===Corticosteroid-responsive conditions===
*5-60mg/day PO divided QD-QID

===[[Asthma]], acute===
*ED/hospital: 40-80mg/day PO divided QD-bid, cont. until peak flow = 70% predicted
*Outpatient burst treatment: 40-60mg/day PO divided QD-bid x 3-10 days

===[[Asthma]], severe persistent===
*7.5-60mg PO QD-qod

===[[Adrenal insufficiency]]===
*4-5mg/m<sup>2</sup> PO QD

===[[Multiple sclerosis]], acute exacerbation===
*200mg PO QD x 1 wk, then 80mg PO qod x 1 mo

===[[Alcoholic hepatitis]], acute===
*40mg PO QD

==Pediatric Dosing==
===Corticosteroid-responsive conditions===
*0.14-2mg/kg/day PO divided QD-QID

===[[Asthma]], acute===
*ED/hospital: 1-2mg/kg/day PO divided QD-bid
*Max: 60mg/day, cont. until peak flow = 70% predicted
*Outpatient burst treatment: 1-2mg/kg/day PO divided QD-bid x 3-10 days
*Max: 60mg/day

===[[Asthma]], severe persistent===
*0.25-2mg/kg PO QD-qod
*Max 60mg/day

===[[Adrenal insufficiency]]===
*4-5mg/m^2 PO QD

===[[Nephrotic syndrome]]===
*60mg/m^2/day PO divided tid x 4 wk, then 40mg/m^2 PO qod x 4 wk

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation: Probably Safe
*Renal Dosing
**Adult: no adjustment
**Pediatric: no adjustment
*Hepatic Dosing
**Adult: not defined
**Pediatric: not defined

==Contraindications==
*Allergy to class/drug
*systemic fungal infection
*active or recent varicella infection
*active or recent measles infection
*avoid abrupt withdrawal (high dose or long-term use)
*caution if active infection
*caution if [[TB]] infection
*caution if ocular HSV
*caution if immunosuppressed
*caution if hypertension
*caution if CHF
*caution if diabetes mellitus
*caution if seizure disorder
*caution if PUD
*caution if ulcerative colitis
*caution if diverticulitis
*caution if recent intestinal anastomosis
*caution if psychiatric disorder
*caution if hypothyroidism
*caution if osteoporosis
*caution if myasthenia gravis
*caution if renal impairment, severe
*caution if hepatic impairment, severe
*caution if thromboembolic disorder
*caution if coagulation disorder
*caution in elderly patients

==Adverse Reactions==
===Serious===
*adrenal insufficiency
*Cushing syndrome
*immunosuppression
*infection
*[[hypertension]]
*[[CHF]]
*[[diabetes mellitus]]
*steroid psychosis
*GI perforation/ulcer
*osteopenia/osteoporosis
*hypokalemic alkalosis
*steroid myopathy
*tendon rupture
*pseudotumor cerebri
*ICP increase
*[[seizures]]
*glaucoma
*cataracts
*[[pancreatitis]]
*growth suppression (long-term use, pediatric patients)
*exophthalmos
*[[anaphylaxis]]
*withdrawal symptoms if abrupt discontinuation (high dose or long-term use)

===Common===
*sodium and fluid retention
*diaphoresis
*[[headache]]
*[[vertigo]]
*insomnia
*nervousness
*mood swings
*edema
*muscle weakness
*BP elevation
*glucose intolerance
*petechiae/ecchymosis
*facial erythema
*menstrual irregularities
*[[hypokalemia]]
*IOP increase
*impaired wound healing (long-term use)
*Cushing syndrome
*skin pigmentation abnormality
*hirsutism
*[[urticaria]]

==Pharmacology==
*Half-life: 18-36h
*Metabolism: liver, CYP450: 3A4 substrate
*Excretion: urine
*Mechanism of Action: exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects

==See Also==

==References==
<references/>
[[Category:Pharmacology]]