Prednisone

Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. It is also used to treat high blood calcium due to cancer and adrenal insufficiency along with other steroids. It is taken by mouth.

Prednisone
Clinical data
Trade namesDeltasone, Liquid Pred, Orasone, others
AHFS/Drugs.comMonograph
MedlinePlusa601102
License data
Pregnancy
category
  • AU: A
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability70%
Metabolismprednisolone (liver)
Elimination half-life3 to 4 hours in adults. 1 to 2 hours in children
ExcretionKidney
Identifiers
  • 17,21-dihydroxypregna-1,4-diene-3,11,20-trione
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.147
Chemical and physical data
FormulaC21H26O5
Molar mass358.434 g·mol−1
3D model (JSmol)
  • O=C(CO)[C@@]3(O)CC[C@H]2[C@@H]4CC\C1=C\C(=O)\C=C/[C@]1(C)[C@H]4C(=O)C[C@@]23C
  • InChI=1S/C21H26O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h5,7,9,14-15,18,22,26H,3-4,6,8,10-11H2,1-2H3/t14-,15-,18+,19-,20-,21-/m0/s1 Y
  • Key:XOFYZVNMUHMLCC-ZPOLXVRWSA-N Y
 NY (what is this?)  (verify)

Common side effects may include cataracts, bone loss, easy bruising, muscle weakness, and thrush. Other side effects include weight gain, swelling, high blood sugar, increased risk of infection, and psychosis. It is generally considered safe in pregnancy and low doses appear to be safe while the user is breastfeeding. After prolonged use, prednisone must be stopped gradually.

Prednisone is a prodrug and must be converted to prednisolone by the liver before it becomes active. Prednisolone then binds to glucocorticoid receptors, activating them and triggering changes in gene expression.

Prednisone was patented in 1954 and approved for medical use in the United States in 1955. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2021, it was the 28th most commonly prescribed medication in the United States, with more than 19 million prescriptions.

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