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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.