systemic anti-inflammatory
Intermediate-acting glucocorticoid. Widely used for its potent anti-inflammatory and immunosuppressive effects. Converted to active Prednisolone in the liver.
- Mechanism: Glucocorticoid agonist (minimal mineralocorticoid activity). Inhibits inflammatory cytokines and lymphocyte proliferation.
- Dosing:
- Graves’ Orbitopathy: 0.3–0.5 mg/kg (mild prophylaxis) or high dose protocols.
- Thyroiditis (Painful): 40 mg daily taper.
- Amiodarone Thyrotoxicosis (Type 2): 30–40 mg daily taper.
- PK: Half-life: 12–36 hours.
indications
- graves’ disease Orbitopathy:** Active moderate-to-severe disease (IV Methylprednisolone preferred) or prophylaxis with RAI.
- Destructive Thyroiditis: If NSAIDs fail (De Quervain’s) or drug-induced (Amiodarone).
- Autoimmune/Inflammatory Conditions: COPD, Asthma, Vasculitis, etc.
adverse effects
- Short-term: Hyperglycaemia, Insomnia, Mood changes (Psychosis), Gastritis.
- Long-term: Adrenal suppression (must taper), Osteoporosis, Weight gain, Cataracts.
related pages: Hydrocortisone, Graves’ Disease, Thyroiditis