PREDNISOLONE

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist MRCPCH, CCT in Paediatrics (U.K.) Fellow in Paediatric Epilepsy & Neurology (London)

 

Brand names : Tablet : Omnacortil, Wysolone Syrup : Omnacortil (5mg/5ml) and Omnacortil FORTE (15mg/5ml)

Prednisolone is a STEROID, it is used for treatment of many conditions such as for asthma, croup, kidney problems (nephrotic syndrome), Joint problems (Rheumatoid arthritis), and EPILEPSY.



Epilepsy treatment, it is usually reserved for severe forms such as Epileptic spasms, Epileptic encephalopathies (seizures are so frequent, it impairs consciousness) and in status epilepticus (meaning seizures that continues for hours/days).

Why is Prednisolone important for my child’s treatment?

Prednisolone is prescribed only in severe form of epilepsy; hence it is important for you to discuss with your doctor and start treatment. It is important that your child takes Prednisolone regularly so that they have no Seizures or fewer seizures.

Do not stop giving Prednisolone all of a sudden , as it may lead to your child having more seizures.

What is Prednisolone available as?



Prednisolone is available in the preparation of Liquid medicine, Tablets in the market.

“Generic Vs Branded Drugs”

When should Prednisolone be given?

Dose varies based on child’s weight and underlying medical problem, steroids may have to be given once or even four times a day. Please follow your doctors advise. It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss a dosage?

Tablets & liquids: The missed dosage can be given, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.

Never give a double dose of Prednisolone.

If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.

How much of the drug should be given?

Your doctor will work out the accurate amount of Prednisolone (the dose) for your child and write in the prescription.

The dose is usually high dose for 2 weeks, followed by gradual decrease over 4 weeks. Occasionally, high dose may have to be given for 3 weeks. STEROIDS SHOULD NEVER BE STOPPED ABRUPTLY.

It is mandatory to follow the instructions given by your doctor about the dosage of medication.

Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I give this medicine? “Giving Medicines”

Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.

Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby.

Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.

Could this medication have any side effects on my child? Side effects

Although medicines are given to make children feel better, sometimes, they may cause some unwanted side effects.

Side-effects that you must do something about – Common

Gastritis is a common side effect, hence usually medicine to protect stomach lining is given, to be taken on empty stomach when steroids are prescribed orally or administered into blood stream.

Increased appetite; makes your child hungrier than usual. This is usually transient; appetite normalizes once you stop steroids. Encourage your child to eat food that is low in fat and sugar, to avoid weight gain.

Weight gain: usually they put on weight due to mechanisms other than excessive intake. Their cheeks become chubby. Once again it is transient; weight normalizes in 3 – 4 weeks after you stop steroids.

Child becomes grumpy, irritable, for few weeks, and then settles.

Immune system can be suppressed; hence any routine infection can also cause serious problem. Hence, when on steroids, if child has fever, PLEASE GET YOUR CHILD CHECKED IMMEDIATELY.

CHICKEN POX AND STEROIDS:

If possible, please keep your child away from other children for brief duration of steroid therapy, If your child develops or comes in contact with anyone who has chicken pox, Take your child to hospital immediately for treatment. IT CAN GET SERIOUS DUE TO IMMUNESUPRESSION. (Generally, in well children there is no need for treatment for chicken pox, but children on steroids are an exception)

Similarly, if they come in contact with a child with measles, they will need urgent treatment.

Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Despite this long list of side effects, Prednisolone is a very effective medicine and has no long-term impact when it used for short duration as in epilepsy.

In some medical conditions, steroids are prescribed for long term (years), then the side effect profile is different, and it is not covered here.

Can other common medicines be given at the same time as Prednisolone?

Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.

Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.

Some other medicines used to treat epilepsy may affect how well Prednisolone works or may cause side effects. If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Where should I keep the medication?

Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

Make sure the medicine is out of your child’s reach.

Store the medication in the same box it was packed in.

For more information please take a look at the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home 2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi 3. British National Formulary for Children (BNFC) 4. Food and Drug Administration, USA https://www.fda.gov