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What is the Difference Between Prednisone and Prednisolone?

By Solomon Branch
Updated Mar 03, 2024
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The difference between prednisone and prednisolone is that one is the precursor to the other. Prednisone is activated by enzymes in the liver to turn into prednisolone. They do have similar uses but prednisolone is more readily absorbed by the body. Prednisolone is usually used when there is liver toxicity or liver failure involved.

Although they have many similarities, there are some differences between these two substances. For one, the do have a different chemical structure and molecular weight. Also, prednisone is administered only orally, whereas prednisolone can be given orally or topically or even injected if necessary. Lastly, prednisolone has a greater anti-inflammatory effect, albeit not a particularly significant one.

Prednisone and prednisolone are both synthetically produced corticosteroids that have anti-inflammatory properties. They are used for a variety of issues where chronic or acute inflammation is involved. Some common examples are Crohn’s disease, rheumatoid arthritis, severe allergies, cluster and migraine headaches and ulcerative colitis. Other examples are temporal arteritis, Bell's palsy, multiple sclerosis, vasculitis, acute lymphoblastic leukemia and autoimmune hepatitis.

Both drugs also suppress the immune system and can be administered when an organ transplant is performed to prevent the body from rejecting the implanted organ. Prednisone and prednisolone can also be used in cases of overactive adrenal glands, as in the case of congenital adrenal hyperplasia — a group of diseases in which the adrenal glands are not functioning properly. They can both also be used to help fight tumors because of their immunosuppressive abilities.

Prednisone and prednisolone have similar side effects as well. When used over the long term, they can cause such problems as Cushing’s syndrome, a disease that involves the adrenal glands; fluid retention; osteoporosis; glaucoma; cataracts; type 2 diabetes mellitu; and even depression when dosage is reduced or stopped altogether. There are numerous short-term side effects as well, such as insomnia; increased blood glucose levels, especially in people who have diabetes mellitus; decreased or blurred vision; increased thirst; cataract formation; confusion; and other psychological problems.

Both prednisone and prednisolone cause suppression of the adrenal glands, so they can cause the adrenals to stop working properly if they are used for more than seven days. If the use of prednisone or prednisolone is stopped abruptly, this can cause a severe condition known as adrenal crisis. For this reason, the dosage has to be gradually reduced over time to give the adrenals the chance to start functioning properly again.

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Discussion Comments
By strawCake — On Jul 10, 2011

@Monika - I've actually taken both prednisone and prednisolone for allergies at different times. I actually thought they were the same thing and maybe one was the generic name or something like that.

I'm kind of confused as to why my doctor would have prescribed me presnisolone instead of prednisone the last time though. I don't have any liver problems!

By Monika — On Jul 09, 2011

I've taken prednisone before for asthma and allergies. I know a little bit about it but I didn't known there were negative side effects to ending use of it!

Although, come to think of it, I think my doctor did wean me off of it slowly last time I took it. I had a really severe allergic reaction to something so my doctor prescribed prednisone to me for about a month. It came in a packet that showed me how many pills to take each day. I started off with a pretty large number of pills and then the last day I only took one.

I guess it worked because I don't remember suffering any negative effects after I stopped taking it.

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