The pharmacokinetic interactions listed below are potentially clinically important. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity. Corticosteroids may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia. The effect of corticosteroids on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulants when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.
Prednisolone 5 mg tablets contain a potent steroid and are to be used under the direct supervision of a veterinarian. All precautions and contraindications for adrenocortical hormones must be observed. Warning signs of cortisone overdosage may not be present. In certain cases, where large doses are required, the patient must be closely observed for side effects such as polyuria and polydipsia. When side effects occur, it may be necessary to reduce the dosage or discontinue therapy. Continuous large doses of Prednisolone 5 mg tablets may result in some depression of adrenocortical function and may produce adrenal atrophy. If long-term therapy is to be terminated, gradual withdrawal is recommended. The possible action of Prednisolone 5 mg tablets in delaying healing should also be considered.
The anti-inflammatory effect of prednisolone lasts for between 12 and 36 hours and that is the underlying idea of alternate day therapy (ADT)where you take double the dose one day and nothing the next. If you are amongst the lucky people for whom the antiinflammatory effect lasts longer you can change to ADT with no problems on the second day and this allows your body to have a day without the suppressive effect. On the other hand, if you start to get stiff and sore again after the 12 hours, you might feel that taking an evening dose is helpful and this is often used for rheumatoid arthritis patients as steroids are sometimes used together with other medications for them. Whilst many people are terrified of taking steroids, in fact there are a lot of drugs out there for rheumatic disease/arthritis with even worse potential side-effects and which require far closer monitoring than steroids do.