First 4 weeks: 60 mg/m²/day or 2 mg/kg/day PO divided q8hr until urine is protein free for 3 consecutive days; not to exceed 28 days; dose not to exceed 80 mg/day Subsequent 4 weeks: 40 mg/m² or 1-1.5 mg/kg PO every other day; not to exceed 80 mg/day Maintenance in frequent relapses: 0.5-1 mg/kg/dose PO every other day for 3-6 months Treatment may have to be individualized Acne Adrenal suppression Delayed wound healing Diabetes mellitus GI perforation Glucose intolerance Hepatomegaly Hypokalemic alkalosis Increased transaminases Insomnia Menstrual irregularity Myopathy Neuritis Osteoporosis Peptic ulcer Perianal pruritus Pituitary adrenal axis suppression Pseudotumor cerebri (on withdrawal) Psychosis Seizure Ulcerative esophagitis Urticaria Vertigo Weight gain Documented hypersensitivity Systemic fungal infection, varicella, superficial herpes simplex keratitis Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term ( Use with caution in cirrhosis, diabetes, ocular herpes simplex, hypertension, diverticulitis, following myocardial infarction, thyroid disease, seizure disorders, hypothyroidism, myasthenia gravis, hepatic impairment, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy Thromboembolic disorders or myopathy may occur Delayed wound healing is possible Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored) Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy Parenteral forms (prednisolone sodium phosphate) have been discontinued Suppression of hypothalamic-pituitary-adrenal axis may occur particularly in patients receiving high doses for prolonged periods or in young children; discontinuation of therapy should be done through slow taper Posterior subcapular cataract formation associated with prolonged use of corticosteroids Prolonged use of corticosteroids may increase risk of secondary infections Increase in intraocular pressure associated with prolonged use of corticosteroids Long-term use associated with fluid retention and hypertension Development of Kaposi's sarcoma associated with prolonged corticosteroid use Acute myopathy associated with high dose of corticosteroids Corticosteroid use may cause psychiatric disturbances If product is used for 10 days or longer, intraocular pressure should be routinely monitored even though it may be difficult in children and uncooperative patients; steroids should be used with caution in the presence of glaucoma. Intraocular pressure should be checked frequently Steroids after cataract surgery may delay healing and increase incidence of bleb formation Use of ocular steroids may prolong course and may exacerbate severity of many viral infections of the eye (including herpes simplex) Prednisolone shown to be teratogenic in mice when given in doses 1-10 times human dose; dexamethasone, hydrocortisone, and prednisolone were ocularly applied to both eyes of pregnant mice five times per day on days 10 through 13 of gestation; a significant increase in the incidence of cleft palate observed in fetuses of treated mice; there are no adequate well-controlled studies in pregnant women; prednisolone should be used during pregnancy only if potential benefit justifies potential risk to fetus Not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk; systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects Because of potential for serious adverse reactions in nursing infants from prednisolone, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother Glucocorticosteroid; elicits mild mineralocorticoid activity and moderate anti-inflammatory effects; controls or prevents inflammation by controlling rate of protein synthesis, suppressing migration of polymorphonuclear leukocytes (PMNs) and fibroblasts, reversing capillary permeability, and stabilizing lysosomes at cellular level The above information is provided for general informational and educational purposes only. 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