Prednisolona
Prednisolone
Prednisolone acetate, Prednisolone sodium phosphate
También conocido como: Pred Forte · Pred Mild · Econopred Plus · Mydrapred · PLT · Prednicare · Prednidale · Prednisolone acetate · Prednisolone sodium phosphate · Prednisolonum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoMedical management of insulinoma after stabilization of hypoglycemic crisis
- divided q12h
Contexto clínico obligatorio (3)
- Once hypoglycemic crisis stabilized
- may need to increase dose over time
- Ideal to use H2 blocker concurrently
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La prednisolona es un corticosteroide sintético potente de acción intermedia ampliamente utilizado en medicina veterinaria. En oftalmología, se considera el estándar de oro y el fármaco más eficaz para el tratamiento de la uveítis anterior.
Existen distinciones clínicas clave entre sus formulaciones:
- Prednisolona Acetato: Formulada como suspensión. Posee una actividad antiinflamatoria superior y logra una excelente penetración en el segmento anterior del ojo a través de la córnea intacta, superando a los productos de dexametasona.
- Prednisolona Fosfato Sódico: Formulada como solución. No penetra la córnea intacta tan eficazmente como la forma de acetato, pero es útil para la inflamación de la superficie ocular.
Perla Clínica: Aunque se aplique tópicamente en el ojo, la prednisolona puede absorberse sistémicamente a través del conducto nasolagrimal y los vasos conjuntivales. En animales pequeños (menos de 20 kg), la aplicación frecuente puede provocar efectos secundarios sistémicos, incluida la desestabilización de la diabetes mellitus.
Mecanismo de acción
Prednisolone exerts its effects by diffusing across cell membranes and binding to specific cytosolic glucocorticoid receptors.
The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on DNA → alters gene transcription.
Mechanistically, it induces the synthesis of lipocortin-1 (annexin-1), which inhibits the enzyme phospholipase A2. This inhibition prevents the release of arachidonic acid from membrane phospholipids, thereby potently shutting down the downstream synthesis of inflammatory mediators, including prostaglandins and leukotrienes.
Seguridad y advertencias
Contraindicaciones
- Corneal ulcers (absolute contraindication for topical use)
- Ocular viral infections (e.g., Feline Herpesvirus-1)
- Ocular fungal infections
- Use with extreme caution in patients with uncontrolled diabetes mellitus or systemic infectious diseases
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Ulcerative keratitis (topical ophthalmic use)
- Systemic fungal infections
- Concurrent NSAID administration
Efectos adversos
- Systemic absorption leading to iatrogenic hyperadrenocorticism (PU/PD/PP, panting, alopecia)
- Insulin resistance and destabilization of diabetes mellitus
- Delayed corneal healing
- Potentiation or exacerbation of ocular infections (bacterial, viral, fungal)
- Corneal degeneration or calcification (with long-term topical use)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Proteinuria and glomerular changes (dogs)
- Weight loss and muscle atrophy (catabolic effects)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome)
- Vomiting and diarrhoea
- Gastrointestinal ulceration
- Hyperglycaemia
- Decreased serum T4 values
- Impaired wound healing
- Delayed recovery from infections
- Polyuria/polydipsia (PU/PD)
- Polyphagia
- Immunosuppression
- Muscle wasting
Precauciones
Important Warning: Subconjunctival and topical steroids can be absorbed systemically. Use with extreme caution in patients with endocrinopathies (e.g., diabetes mellitus) or infectious diseases.
Even frequent topical steroid application in small animal patients under 20 kg can cause difficulties with diabetes mellitus regulation. Once the peak inflammatory response has been suppressed, consider transitioning to nonsteroidal anti-inflammatory drugs (NSAIDs) for ongoing maintenance treatment to minimize systemic steroid exposure.
Interacciones farmacológicas
Concurrent use may increase the risk of delayed corneal healing or corneal melting, though sometimes used together cautiously for severe inflammation.
Systemically absorbed prednisolone antagonizes insulin, increasing blood glucose and complicating diabetes regulation.
Increased risk of gastrointestinal ulceration if significant systemic absorption of prednisolone occurs.
Increased risk of gastrointestinal ulceration
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Enhanced metabolism of corticosteroids
Enhanced metabolism of corticosteroids
Decreased metabolism of corticosteroids
Synergistic immunosuppression; may alter pharmacokinetics
Monitorización
- Resolution of clinical signs of uveitis (aqueous flare, miosis, pain, photophobia)
- Intraocular pressure (IOP) to monitor for secondary glaucoma
- Fluorescein staining (to ensure no corneal ulceration develops)
- Blood glucose and water intake/urine output in diabetic or small patients
- Clinical response to therapy
- Haematocrit (in cases of IMHA)
- Blood glucose (risk of hyperglycaemia)
- Serum T4 values (may be decreased)
- Renal parameters and urinalysis (proteinuria in dogs)
- Signs of GI ulceration (vomiting, melaena)
- Haematology at each visit (including 4 and 8 weeks after cessation of therapy)
- PCV (Packed Cell Volume)
- Liver parameters (especially if combined with azathioprine)
- Clinical signs of anaemia or GI bleeding
Farmacocinética
Vida media
Absorción
Prednisolone acetate is highly lipophilic and readily penetrates the intact corneal epithelium to reach therapeutic concentrations in the aqueous humor. Systemic absorption occurs via drainage through the nasolacrimal duct into the nasal mucosa and GI tract.
Distribución
Distributes widely into ocular tissues (anterior segment). Systemically absorbed drug distributes throughout total body water and binds to plasma proteins (transcortin and albumin).
Metabolismo
Systemically absorbed prednisolone is metabolized primarily in the liver.
Eliminación
Excreted primarily by the kidneys as conjugated metabolites.
Sobredosis
Acute overdose from topical ophthalmic application is highly unlikely to cause severe toxicity. However, chronic overdosage or overly frequent application (especially in small patients <20 kg) can lead to systemic absorption resulting in iatrogenic hyperadrenocorticism (Cushing's syndrome), adrenal suppression, and destabilization of blood glucose in diabetic patients. If a corneal ulcer is present, overuse can lead to rapid corneal melting and perforation.
Productos disponibles
Formulaciones
- Ophthalmic suspension (0.12%, 0.125%, 1%)
- Ophthalmic solution (0.125%, 1%)
- Ophthalmic drops combined with atropine
- Ophthalmic suspension: 0.5%, 1% (5 ml, 10 ml bottles)
- Topical preparations (dermatological, otic, ophthalmic)
- Injectable solution: prednisolone sodium succinate 10 mg/ml
- Injectable suspension: 7.5 mg/ml (plus 2.5 mg/ml dexamethasone)
- Oral tablets: 1 mg, 5 mg, 25 mg
- Oral compound: PLT (contains cinchophen)
- Oral suspension
Veterinario
- PLT (compound with cinchophen)
- Prednicare
- Prednidale
Etiquetado para humanos
- Prednisolone Acetate Drops: 0.12% Suspension (Pred Mild®)
- Prednisolone Acetate Drops: 0.125% Suspension (Econopred®)
- Prednisolone Acetate Drops: 1% Suspension (Econopred Plus®, Pred Forte®, generic)
- Prednisolone Sodium Phosphate Drops: 0.125% & 1% Solution (various)
- Prednisolone (0.25%) and Atropine (1%) Drops (Mydrapred®)
- Pred-forte (ophthalmic suspension 0.5%, 1%)
- Prednisolone tablets
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store at room temperature (15°-25°C / 59°-77°F). Protect from freezing. Keep the bottle tightly closed when not in use. Suspensions must be stored upright.
Información para el cliente
Paso Crucial: Si está utilizando la suspensión de acetato (p. ej., Pred Forte), DEBE agitar el frasco vigorosamente antes de cada uso. El medicamento se asienta en el fondo y, si no se agita, solo estará aplicando agua en el ojo.
- Administración: Lávese las manos antes de usar. No permita que la punta del gotero toque el ojo, los párpados o cualquier otra superficie de su mascota para evitar la contaminación.
- Espaciado: Si está aplicando varios tipos de gotas para los ojos, espere al menos de 5 a 10 minutos entre cada medicamento.
- Vigile las úlceras: Los esteroides retrasan la cicatrización. Si el ojo de su mascota se pone más rojo, nublado, o si comienza a entrecerrar los ojos o frotarse el ojo, suspenda el medicamento y comuníquese con su veterinario de inmediato. Esto podría indicar un rasguño o úlcera corneal.
- Signos sistémicos: Incluso las gotas para los ojos pueden absorberse en el cuerpo. Monitoree a su mascota por si presenta aumento de sed, aumento de la micción o aumento del apetito, e informe a su veterinario.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.