2 Before you take Prednisolone tablets
Do not take Prednisolone tablets if you:
- are allergic (hypersensitive) to prednisolone or any of the other ingredients in Prednisolone tablets (see section 6). An allergic reaction may include a rash, itching, difficulty breathing or swelling of the face, lips, throat or tongue. Certain ingredients can cause allergic reactions such as Ponceau 4R and sunset yellow (azo dyes) which can cause asthma (5mg tablets only)
- have cold sores that affect the eyes
- have an untreated infection.
Check with your doctor or pharmacist before taking Prednisolone tablets if you:
- have been in contact with anyone who has chickenpox, shingles or measles. Contact your doctor immediately for advice
- have or have a family history of diabetes or glaucoma
- have brittle bones, high blood pressure, a recent heart attack, a stomach ulcer, an underactive thyroid gland or tuberculosis
- have taken prednisolone tablets (or a similar medicine) before and had muscular problems (steroid myopathy)
- have heart, kidney or liver disease
- suffer or have suffered from any mental illness
- are being treated with vaccines
have ever had severe depression or manic-depression (bipolar disorder). This includes having had depression before while taking steroid medicines like Prednisolone tablets or any of your close family has had these illnesses
Mental problems while taking Prednisolone tablets:
Mental health problems can happen while taking steroids like Prednisolone tablets (see also section 4 Possible Side Effects)
- These illnesses can be serious
- Usually they start within a few days or weeks of starting the medicine.
- They are more likely to happen at high doses.
- Most of these problems go away if the dose is lowered or the medicine is stopped. However, if problems do happen, they might need treatment.
Talk to a doctor if you (or someone taking this medicine), show any signs of mental problems. This is particularly important if you are depressed, or might be thinking about suicide. In a few cases, mental problems have happened when doses are being lowered or stopped.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription:
- antacids – do not take at the same time as the Prednisolone tablets
- diuretics (‘water tablets’)
- medicines to treat epilepsy such as carbamazepine, phenobarbital, phenytoin, primidone
- medicines for diabetes including insulin
- medicines to treat infections such as rifabutin, rifampicin, amphotericin, ketoconazole, tetracyclines
- medicines used to treat cancer such as methotrexate, etoposide
- anticoagulant drugs used to thin blood
- oral contraceptives (the ‘pill’)
- other non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin
- mifepristone (used for abortion), ciclosporin, acetazolamide, beta-2-agonists, theophylline, carbenoxolone, aminoglutethimide or carbimazole.
Driving and using machines
If you do not have enough sleep you may be less alert and patients should make sure they are not affected before driving or operating machinery.
Pregnancy and breastfeeding
Ask your doctor or pharmacist for advice before taking this medicine.
If you have been told by your doctor that you have an intolerance to some sugars, contact them before taking this medicine, as it contains lactose.
If you see another doctor or go into hospital, let them know what medicines you are taking.
3 How to take Prednisolone tablets
You will be supplied with a ‘Steroid Treatment Card’ which includes important details of your treatment. This card should be carried at all times.
Always take Prednisolone tablets exactly as your doctor has told you, especially if you are elderly. If you are not sure, check with your doctor or pharmacist.
Swallow the tablets whole, with a little water as a single dose in the morning after breakfast unless otherwise directed by the doctor. Do not chew or cut the tablets.
The usual doses are:
General conditions 5-60mg daily
Allergic and skin disorders 5-15mg daily
Blood disorders 15-60mg daily
Collagenosis 20-30mg daily
Rheumatoid arthritis 10-15mg daily
Doses will be decided for children aged 1-17 years and the elderly.
Once a dose is established, it may be changed to use the lowest effective dose depending on your response to the drug.
Differences in absorption of prednisolone may be experienced by individuals especially when switching between coated and non-coated prednisolone tablets, therefore close monitoring of your condition is recommended. Talk to your doctor if you notice worsening of your condition or if you have any concerns about your treatment.
If you are diabetic, you may find that you need to take more medication to balance the effect of Prednisolone tablets. You should discuss this with your doctor.
Your doctor should check your progress at regular visits. Also, your progress may have to be checked after you have stopped using this medicine, since some of the effects may continue.
If you forget to take Prednisolone tablets
If you forget to take a dose, take one as soon as you remember and then your next dose at the usual time. Never take two doses at the same time.
If you take more Prednisolone tablets than you should
If you (or someone else) swallow a lot of tablets at the same time, or you think a child may have swallowed any contact your nearest hospital casualty department or tell your doctor immediately.
If you stop taking Prednisolone tablets
If you stop taking the tablets suddenly you may develop muscle or joint pain, conjunctivitis, fever, weight loss, painful itchy skin lumps or runny nose. Talk to your doctor before you stop taking the tablets and follow their advice.
4 Possible side effects
Like all medicines, Prednisolone tablets can cause side effects, particularly when you first start taking it although not everybody gets them. Please tell your doctor or pharmacist if you notice any of the following effects or any effects not listed.
Stop taking Prednisolone tablets and contact your doctor straight away if the following allergic reaction happens: puffy, swollen face, tongue or body, which may cause shortness of breath, shock and collapse.
Tell your doctor straight away if the following happens:
- inflammation of the pancreas (very severe abdominal pains)
- Steroids including Prednisolone tablets can cause serious mental health problems. These are common in both adults and children. They can affect about 5 in every 100 people taking medicines like Prednisolone tablets:
- feeling depressed, including thinking about suicide
- feeling high (mania) or moods that go up and down
- feeling anxious, having problems sleeping, difficulty in thinking or being confused and losing your memory
- feeling, seeing or hearing things which do not exist. Having strange and frightening thoughts, changing how you act or having feelings of being alone.
Tell your doctor if the following occur:
Infections - lowered resistance to infections, such as a cold, existing eye infections may become worse or symptoms of a previous infection such as tuberculosis (TB) may happen more easily. This is especially important regarding chickenpox or measles.
Cushing’s Disease a hormone disorder which can cause symptoms including gaining weight very quickly, especially on the trunk and face, thinning of the skin and sweating.
Stomach and intestines – increased appetite, indigestion, a feeling of being full or bloated, very sore throat and white areas inside your mouth (oral thrush), feeling sick, weight gain, stomach ulcers.
Heart – high blood pressure.
Nervous system – unusual tiredness or weakness, nervousness, worsening of schizophrenia, increased pressure in the skull (causing painful eyes, changes in vision or a bad headache, especially behind your eyes).
Skin – reddish purple lines, thin skin, unusual bruising, acne, wounds that will not heal.
Muscle or bones – muscle weakness or wasting, pain in back, hips, ribs, arms, shoulders or legs. Osteoporosis (may be easier to fracture your bones or to tear your tendons).
Hormones - filling or rounding out of the face, periods become irregular or stop altogether, unusual increase in hair growth on body or face. Growth in infancy, childhood and adolescence may be reduced.
Kidney - urinating at night, water and salt retention.
Blood - blood clots, changes in the balance of minerals in the blood (detected by a blood test).
Eyes – cataracts, increased pressure in the eye (glaucoma), thinning of the tissues of the eye, pressure on the nerve of the eye, central serous chorioretinopathy (causing blind spots, distortion of straight lines and objects appearing smaller/further away).
Withdrawal symptoms – muscle or joint pain, conjunctivitis, fever, weight loss, runny nose and painful, itchy skin lumps.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the safety of this medicine.