Short description: Steroid medication

Prednisone

Clinical data
Trade names| Deltasone, Liquid Pred, Orasone, others
AHFS/Drugs.com| Monograph
MedlinePlus| a601102
License data|

* US DailyMed: Prednisone

Pregnancy
category|

* AU: A

Routes of
administration| By mouth
ATC code|

* A07EA03 (WHO) H02AB07 (WHO)

Legal status
Legal status|

* AU: S4 (Prescription only)
* US: ℞-only

Pharmacokinetic data
Bioavailability| 70%
Metabolism| prednisolone (liver)
Elimination half-life| 3 to 4 hours in adults. 1 to 2 hours in children[1]
Excretion| Kidney
Identifiers

IUPAC name

* 17,21-dihydroxypregna-1,4-diene-3,11,20-trione

CAS Number|

* 53-03-2 Y

PubChem CID|

* 5865

IUPHAR/BPS|

* 7096

DrugBank|

* DB00635 Y

ChemSpider|

* 5656 Y

UNII|

* VB0R961HZT

KEGG|

* C07370 Y

ChEBI|

* CHEBI:8382 Y

ChEMBL|

* ChEMBL635 Y

Chemical and physical data
Formula| C21H26O5
Molar mass| 358.434 g·mol−1
3D model (JSmol)|

* Interactive image

SMILES

* 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

* 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)

Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases.[2] It is also used to treat high blood calcium due to cancer and adrenal insufficiency along with other steroids.[2] It is taken by mouth.[2]

Common side effects with long-term use include cataracts, bone loss, easy bruising, muscle weakness, and thrush.[2] Other side effects include weight gain, swelling, high blood sugar, increased risk of infection, and psychosis.[3][2] It is generally considered safe in pregnancy and low doses appear to be safe when breastfeeding.[4] After prolonged use, prednisone needs to be stopped gradually.[2]

Prednisone is a pro drug and must be converted to prednisolone by the liver before it becomes active.[5][6] Prednisolone then binds to glucocorticoid receptors, activating them and triggering changes in gene expression.[3]

Prednisone was patented in 1954 and approved for medical use in the United States in 1955.[2][7] It is on the World Health Organization's List of Essential Medicines.[8] It is available as a generic medication.[2] In 2019, it was the 27th most commonly prescribed medication in the United States, with more than 22 million prescriptions.[9][10]

## Contents

* 1 Medical uses
* 2 Side effects
* 2.1 Major
* 2.2 Minor
* 2.3 Dependency
* 2.4 Withdrawal
* 3 Pharmacology
* 3.1 Pharmacokinetics
* 3.2 Lodotra
* 4 Industry
* 5 Chemistry
* 6 History
* 7 See also
* 8 References
* 9 External links

## Medical uses

Prednisone is used for many different autoimmune diseases and inflammatory conditions, including asthma, gout, COPD, CIDP, rheumatic disorders, allergic disorders, ulcerative colitis and Crohn's disease, granulomatosis with polyangiitis, adrenocortical insufficiency, hypercalcemia due to cancer, thyroiditis, laryngitis, severe tuberculosis, hives, lipid pneumonitis, pericarditis, multiple sclerosis, nephrotic syndrome, sarcoidosis, to relieve the effects of shingles, lupus, myasthenia gravis, poison oak exposure, Ménière's disease, autoimmune hepatitis, giant-cell arteritis, the Herxheimer reaction that is common during the treatment of syphilis, Duchenne muscular dystrophy, uveitis, and as part of a drug regimen to prevent rejection after organ transplant.[11][12][13]

Prednisone has also been used in the treatment of migraine headaches and cluster headaches and for severe aphthous ulcer.[14] Prednisone is used as an antitumor drug.[15] It is important in the treatment of acute lymphoblastic leukemia, non-Hodgkin lymphomas, Hodgkin's lymphoma, multiple myeloma, and other hormone-sensitive tumors, in combination with other anticancer drugs.

Prednisone can be used in the treatment of decompensated heart failure to increase renal responsiveness to diuretics, especially in heart failure patients with refractory diuretic resistance with large doses of loop diuretics.[16][17][18][19][20][21] In terms of the mechanism of action for this purpose: prednisone, a glucocorticoid, can improve renal responsiveness to atrial natriuretic peptide by increasing the density of natriuretic peptide receptor type A in the renal inner medullary collecting duct, thereby inducing a potent diuresis.[22]

At high doses it may be used to prevent rejection following organ transplant.[2]

## Side effects

Micrograph of fatty liver, as may be seen due to long-term prednisone use. Trichrome stain.

Short-term side effects, as with all glucocorticoids, include high blood glucose levels (especially in patients with diabetes mellitus or on other medications that increase blood glucose, such as tacrolimus) and mineralocorticoid effects such as fluid retention.[23] The mineralocorticoid effects of prednisone are minor, which is why it is not used in the management of adrenal insufficiency, unless a more potent mineralocorticoid is administered concomitantly.

It can also cause depression or depressive symptoms and anxiety in some individuals.[24][25]

Long-term side effects include Cushing's syndrome, steroid dementia syndrome,[26] truncal weight gain, osteoporosis, glaucoma and cataracts, diabetes mellitus type 2, and depression upon dose reduction or cessation.[27] Prednisone also results in leukocytosis.[28]

### Major

Source:[23]

* Steroid myopathy
* Increased blood sugar for individuals with diabetes
* Difficulty in regulating emotion
* Difficulty in maintaining linear thinking
* Weight gain due to increased appetite
* Immunosuppression
* Corticosteroid-induced lipodystrophy (moon face, central obesity)
* Depression, mania, psychosis, or other psychiatric symptoms
* Unusual fatigue or weakness
* Mental confusion
* Memory and attention dysfunction (steroid dementia syndrome)
* Muscle atrophy[29]
* Blurred vision
* Abdominal pain
* Peptic ulcer
* Painful hips or shoulders
* Steroid-induced osteoporosis
* Stretch marks
* Osteonecrosis – same as avascular necrosis
* Insomnia
* Severe joint pain
* Cataracts or glaucoma
* Anxiety
* Black stool
* Stomach pain or bloating
* Severe swelling
* Mouth sores or dry mouth
* Avascular necrosis
* Hepatic steatosis

### Minor

Source:[23]

* Nervousness
* Acne
* Skin rash
* Appetite gain
* Hyperactivity
* Increased thirst
* Frequent urination
* Diarrhea
* Reduced intestinal flora
* Leg pain/cramps
* Sensitive teeth
* Headache
* Induced vomiting

### Dependency

Adrenal suppression will begin to occur if prednisone is taken for longer than seven days. Eventually, this may cause the body to temporarily lose the ability to manufacture natural corticosteroids (especially cortisol), which results in dependence on prednisone. For this reason, prednisone should not be abruptly stopped if taken for more than seven days; instead, the dosage should be gradually reduced. This weaning process may be over a few days if the course of prednisone was short, but may take weeks or months[30] if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addison crisis. For those on chronic therapy, alternate-day dosing may preserve adrenal function and thereby reduce side effects.[31]

Glucocorticoids act to inhibit feedback of both the hypothalamus, decreasing corticotropin-releasing hormone (CRH), and corticotrophs in the anterior pituitary gland, decreasing the amount of adrenocorticotropic hormone (ACTH). For this reason, glucocorticoid analogue drugs such as prednisone down-regulate the natural synthesis of glucocorticoids. This mechanism leads to dependence in a short time and can be dangerous if medications are withdrawn too quickly. The body must have time to begin synthesis of CRH and ACTH and for the adrenal glands to begin functioning normally again.

Prednisone may start to result in the suppression of the hypothalamic-pituitary-adrenal (HPA) axis if used at doses 7–10 mg or higher for several weeks. This is approximately equal to the amount of endogenous cortisol produced by the body every day. As such, the HPA axis starts to become suppressed and atrophy. If this occurs the people should be tapered off prednisone slowly to give the adrenal gland enough time to regain its function and endogenous production of steroids. Supplemental doses, or "stress doses" may be required in those with HPA axis suppression who are experiencing a higher degree of stress (e.g., illness, surgery, trauma, etc.). Failing to do so in such situations could be life-threatening.

### Withdrawal

The magnitude and speed of dose reduction in corticosteroid withdrawal should be determined on a case-by-case basis, taking into consideration the underlying condition being treated, and individual patient factors such as the likelihood of relapse and the duration of corticosteroid treatment. Gradual withdrawal of systemic corticosteroids should be considered in those whose disease is unlikely to relapse and have:

* received more than 40 mg prednisone (or equivalent) daily for more than 1 week
* been given repeat doses in the evening
* received more than 3 weeks of treatment
* recently received repeated courses (particularly if taken for longer than 3 weeks)
* taken a short course within 1 year of stopping long-term therapy
* other possible causes of adrenal suppression

Systemic corticosteroids may be stopped abruptly in those whose disease is unlikely to relapse and who have received treatment for 3 weeks or less and who are not included in the patient groups described above.

During corticosteroid withdrawal, the dose may be reduced rapidly down to physiological doses (equivalent to prednisolone 7.5 mg daily) and then reduced more slowly. Assessment of the disease may be needed during withdrawal to ensure that relapse does not occur.[32]

## Pharmacology

Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties.[33][34] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone.[35]

### Pharmacokinetics

Prednisone is absorbed in the gastrointestinal tract and has a half life of 2–3 hours.[34] it has a volume of distribution of 0.4–1 L/kg.[36] The drug is cleared by hepatic metabolism using cytochrome P450 enzymes. Metabolites are excreted in the bile and urine.[36]

### Lodotra

"Lodotra" is the trade name of an oral formulation, which releases prednisone four hours after application. It is indicated for rheumatoid arthritis with morning stiffness. Taken at 10 p.m., it releases the drug at around 2 a.m.. The plasmic peak level is reached at 4 a.m., which is considered to be the optimal time for relieving morning stiffness. The drug was approved in the European Union, in January 2009.[37][38]

## Industry

Prednisone 20 mg oral tablet

The pharmaceutical industry uses prednisone tablets for the calibration of dissolution testing equipment according to the United States Pharmacopeia (USP).

## Chemistry

Prednisone is a synthetic pregnane corticosteroid and derivative of cortisone and is also known as δ1-cortisone or 1,2-dehydrocortisone or as 17α,21-dihydroxypregna-1,4-diene-3,11,20-trione.[39][40]

## History

The first isolation and structure identifications of prednisone and prednisolone were done in 1950 by Arthur Nobile.[41][42][43] The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation, by Arthur Nobile and coworkers.[44] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone.[45]

The enhanced adrenocorticoid activity of these compounds over cortisone and hydrocortisone was demonstrated in mice.[45]

Prednisone and prednisolone were introduced in 1955 by Schering and Upjohn, under the brand names Meticorten[46] and Delta-Cortef,[47] respectively. These prescription medicines are now available from a number of manufacturers as generic drugs.

## See also

* Chloroprednisone

## References

1. ↑ "Clinical pharmacokinetics of prednisone and prednisolone". Clinical Pharmacokinetics 4 (2): 111–28. 1979. doi:10.2165/00003088-197904020-00004. PMID 378499.
2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 "Prednisone Monograph for Professionals". AHFS. https://www.drugs.com/monograph/prednisone.html.
3. ↑ 3.0 3.1 Brunton, Laurence (2017). Goodman & Gilman's the pharmacological basis of therapeutics (13 ed.). McGraw-Hill Education. pp. 739, 746, 1237. ISBN 978-1-25-958473-2.
4. ↑ "Prednisone Use During Pregnancy". https://www.drugs.com/pregnancy/prednisone.html.
5. ↑ "Product Information Panafcort (prednisone) Panafcortelone (prednisolone)" (PDF). St Leonards, Australia: Aspen Pharmacare Australia Pty Ltd. 11 July 2017. pp. 1–2. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-06868-3&d=2018063016114622483.
6. ↑ "Delayed-release prednisone - a new approach to an old therapy". Expert Opinion on Pharmacotherapy 14 (8): 1097–106. June 2013. doi:10.1517/14656566.2013.782001. PMID 23594208.
7. ↑ Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 485. ISBN 9783527607495. https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA485.
8. ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. WHO/MHP/HPS/EML/2021.02.
9. ↑ "The Top 300 of 2019". https://clincalc.com/DrugStats/Top300Drugs.aspx.
10. ↑ "Prednisone - Drug Usage Statistics". https://clincalc.com/DrugStats/Drugs/Prednisone.
11. ↑ Autoimmune Hepatitis~treatment at eMedicine
12. ↑ "Corticosteroids". LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 30 May 2014. NBK548400. https://www.ncbi.nlm.nih.gov/books/NBK548400/. Retrieved 19 March 2020.
13. ↑ "Prednisone". The American Society of Health-System Pharmacists. https://www.drugs.com/monograph/prednisone.html.
14. ↑ Wackym, P. Ashley; Snow, James B. (2017). Ballenger's Otorhinolaryngology: Head and Neck Surgery. PMPH USA. p. 1185. ISBN 9781607951773. https://books.google.com/books?id=CFwrAwAAQBAJ&pg=PA1185.
15. ↑ "Antineoplastic Agents, Hormonal". Medical Subject Headings.. U.S. National Library of Medicine. 2009. https://www.nlm.nih.gov/cgi/mesh/2009/MB_cgi?mode=&term=Antineoplastic+Agents,+Hormonal.
16. ↑ "Application of the newer corticosteroids to augment diuresis in congestive heart failure". The American Journal of Cardiology 1 (4): 488–96. April 1958. doi:10.1016/0002-9149(58)90120-6. PMID 13520608.
17. ↑ "Reversal of intractable cardiac edema with prednisone". New York State Journal of Medicine 59 (4): 625–33. February 1959. PMID 13632954.
18. ↑ "Prednisone adding to usual care treatment for refractory decompensated congestive heart failure". International Heart Journal 49 (5): 587–95. September 2008. doi:10.1536/ihj.49.587. PMID 18971570.
19. ↑ "Potent diuretic effects of prednisone in heart failure patients with refractory diuretic resistance". The Canadian Journal of Cardiology 23 (11): 865–8. September 2007. doi:10.1016/s0828-282x(07)70840-1. PMID 17876376.
20. ↑ "Potent potentiating diuretic effects of prednisone in congestive heart failure". Journal of Cardiovascular Pharmacology 48 (4): 173–6. October 2006. doi:10.1097/01.fjc.0000245242.57088.5b. PMID 17086096.
21. ↑ "The glucocorticoid in acute decompensated heart failure: Dr Jekyll or Mr Hyde?". The American Journal of Emergency Medicine 30 (3): 517.e5–10. March 2012. doi:10.1016/j.ajem.2011.01.023. PMID 21406321.
22. ↑ "Glucocorticoids improve renal responsiveness to atrial natriuretic peptide by up-regulating natriuretic peptide receptor-A expression in the renal inner medullary collecting duct in decompensated heart failure". The Journal of Pharmacology and Experimental Therapeutics 339 (1): 203–9. October 2011. doi:10.1124/jpet.111.184796. PMID 21737535. https://semanticscholar.org/paper/32fc63479e418ef4557ece350696d2d6d528df4f.
23. ↑ 23.0 23.1 23.2 "Prednisone and other corticosteroids: Balance the risks and benefits". Mayo Clinic. http://www.mayoclinic.org/steroids/art-20045692?pg=2.
24. ↑ "Prednisone Information". Drugs.com. https://www.drugs.com/prednisone.html.
25. ↑ "Prednisone". MedlinePlus Drug Information. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601102.html#side-effects.
26. ↑ "The "steroid dementia syndrome": a possible model of human glucocorticoid neurotoxicity". Neurocase 13 (3): 189–200. June 2007. doi:10.1080/13554790701475468. PMID 17786779.
27. ↑ "Steroids". Australian Department of Health & Human Services. April 2016. https://www.betterhealth.vic.gov.au/health/healthyliving/steroids.
28. ↑ Miller, Neil R.; Walsh, Frank Burton; Hoyt, William Fletcher (2005). Walsh and Hoyt's Clinical Neuro-ophthalmology. Lippincott Williams & Wilkins. p. 1062. ISBN 9780781748117. https://books.google.com/books?id=9RA2ZOPRuhgC&pg=PA1062.
29. ↑ "Mechanisms of muscle atrophy induced by glucocorticoids". Hormone Research 72 (Suppl. 1): 36–41. November 2009. doi:10.1159/000229762. PMID 19940494.
30. ↑ "Steroid Drug Withdrawal Symptoms, Treatment & Prognosis". MedicineNet. https://www.medicinenet.com/steroid_withdrawal/article.htm.
31. ↑ "Therapeutic and Adverse Effects of Glucocorticoids". U.S. Pharmacist Continuing Education Program. http://www.uspharmacist.com/NewLook/CE/glucocort/lesson.htm.
32. ↑ Iliopoulou, Amalia; Abbas, Afroze; Murray, Robert (19 May 2013). "How to manage withdrawal of glucocorticoid therapy". Prescriber 24 (10): 23–29. doi:10.1002/psb.1060.
33. ↑ "Basic and clinical pharmacology of glucocorticosteroids". Anesthesia Progress 60 (1): 25–31; quiz 32. Spring 2013. doi:10.2344/0003-3006-60.1.25. PMID 23506281.
34. ↑ 34.0 34.1 "Prednisone". https://www.drugbank.ca/drugs/DB00635.
35. ↑ "Prednisone". MedlinePlus. NIH U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a601102.html.
36. ↑ 36.0 36.1 "Pharmacology and pharmacogenetics of prednisone and prednisolone in patients with nephrotic syndrome". Pediatric Nephrology 34 (3): 389–403. March 2019. doi:10.1007/s00467-018-3929-z. PMID 29549463.
37. ↑ Wan, Yuet (8 January 2009). "Delayed-release prednisone (Lodotra™) approved in EU for treatment of rheumatoid arthritis". http://www.nelm.nhs.uk/en/NeLM-Area/News/2009
January/08/Delayed-release-prednisone-Lodotra-approved-in-EU-for-treatment-of-rheumatoid-arthritis/. Retrieved 22 November 2009.
38. ↑ Buttgereit, F.; Doering, G.; Schaeffler, A.; Witte, S.; Sierakowski, S.; Gromnica-Ihle, E.; Jeka, S.; Krueger, K. et al. (2008). "Efficacy of modified-release versus standard prednisone to reduce duration of morning stiffness of the joints in rheumatoid arthritis (CAPRA-1): A double-blind, randomised controlled trial". Lancet 371 (9608): 205–214. doi:10.1016/S0140-6736(08)60132-4. PMID 18207016.
39. ↑ The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. 14 November 2014. pp. 1013–. ISBN 978-1-4757-2085-3. https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA1013.
40. ↑ Index Nominum 2000: International Drug Directory. Taylor & Francis. January 2000. pp. 871–. ISBN 978-3-88763-075-1. https://books.google.com/books?id=5GpcTQD_L2oC&pg=PA871.
41. ↑ "The secret of success: Arthur Nobile's discovery of the steroids prednisone and prednisolone in the 1950s revolutionised the treatment of arthritis". Chemistry in Britain 34 (1): 46. 1998. OCLC 106716069.
42. ↑ "Inventor Profile: Arthur Nobile". National Inventors Hall of Fame. http://www.invent.org/hall_of_fame/355.html.
43. ↑ "Arthur Nobile". New Jersey Inventors Hall of Fame. http://www.stevens.edu/njinvent/2000/inductees_2000/nobile.html.
44. ↑ Merck Index (14th ed.). Merck & Co. Inc. 2006. p. 1327. ISBN 978-0-911910-00-1.
45. ↑ 45.0 45.1 "New antiarthritic steroids". Science 121 (3136): 176. February 1955. doi:10.1126/science.121.3136.176. PMID 13225767. Bibcode: 1955Sci...121..176H.
46. ↑ "Meticorten: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=009766.
47. ↑ "Delta-Cortef: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=009987.

## External links

* "Prednisone". Drug Information Portal. U.S. National Library of Medicine. https://druginfo.nlm.nih.gov/drugportal/name/prednisone.
* The National Center for Biotechnology Information: Prednisone
* National Inventors Hall of Fame induction of Arthur Nobile

* v
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Glucocorticoids and antiglucocorticoids (H02)

Glucocorticoids|

| Natural|

* Cortisone
* Cortisone acetate
* Cortodoxone (cortexolone, 11-deoxycortisol)
* Desoxycortone (deoxycortone, cortexone, 11-deoxycorticosterone)
* Desoxycortone esters
* Hydrocortisone (cortisol)#
* Hydrocortisone esters
* Prebediolone acetate
* Pregnenolone
* Pregnenolone acetate
* Pregnenolone succinate

|

Synthetic|

* Cortisol-like and related (16-unsubstituted): Chloroprednisone
* Cloprednol
* Difluprednate
* Fludrocortisone
* Flugestone acetate (flurogestone acetate)
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* Methylprednisolone
* Methylprednisolone esters
* Prednicarbate
* Prednisolone#
* Prednisone
* Tixocortol
* Tixocortol pivalate

* Methasones and related (16-substituted): Alclometasone
* Beclometasone
* Beclometasone esters
* Betamethasone#
* Betamethasone esters
* Clobetasol
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* Ulobetasol (halobetasol)

* Cyclic ketals (16,17-cyclized): Amcinonide
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* Flunisolide
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* Fluocinonide
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* Triamcinolone acetonide
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Antiglucocorticoids|

* Antagonists: Aglepristone
* Ketoconazole
* Mifepristone
* Ulipristal acetate

Synthesis modifiers|

* Acetoxolone
* Aminoglutethimide
* Carbenoxolone
* Enoxolone
* Ketoconazole
* Metyrapone
* Mitotane
* Trilostane

* #WHO-EM
* ‡Withdrawn from market
* Clinical trials:
* †Phase III
* §Never to phase III

See also
Glucocorticoid receptor modulators
Mineralocorticoids and antimineralocorticoids
List of corticosteroids

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Antidiarrheals, intestinal anti-inflammatory and anti-infective agents (A07)

Rehydration|

* Oral rehydration therapy

Intestinal anti-infectives|

* Antibiotics
* Amphotericin B
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* Kanamycin
* Natamycin
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* Sulfonamides
* Phthalylsulfathiazole
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* Sulfaguanidine

* Nitrofuran
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* Nifurzide

* Imidazole
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* Arsenical
* Acetarsol

* Oxyquinoline
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Intestinal adsorbents|

* Charcoal
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* Diosmectite

Antipropulsives (opioids)|

* Opium tincture (laudanum)
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* Camphorated opium tincture (paregoric)

* crosses BBB: Diphenoxylate (Diphenoxylate/atropine)
* Difenoxin

* does not cross BBB: Eluxadoline
* Loperamide#

Intestinal anti-inflammatory agents|

* corticosteroids acting locally
* Prednisolone#
* Hydrocortisone
* Prednisone
* Betamethasone#
* Tixocortol
* Budesonide
* Beclometasone

* antiallergic agents, excluding corticosteroids
* Cromoglicic acid

* Aminosalicylates
* Sulfasalazine
* Mesalazine
* Olsalazine
* Balsalazide

Antidiarrheal micro-organisms|

* Saccharomyces boulardii

Other antidiarrheals|

* Albumin tannate
* Ceratonia
* Crofelemer
* Octreotide
* Racecadotril

* #WHO-EM
* ‡Withdrawn from market
* Clinical trials:
* †Phase III
* §Never to phase III

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Appetite stimulants (A15)

Exogenous|

* Amitriptyline
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* Dexamethasone
* Dronabinol/Tetrahydrocannabinol (Cannabis)
* Medroxyprogesterone acetate
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* Olanzapine
* Omega-3 fatty acid
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* Sugars
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Endogenous|

* ACTH/Corticotropin
* Adiponectin
* Agouti-related peptide
* Anandamide
* Cortisol/Hydrocortisone
* Cortisone
* Ghrelin
* Melanin-concentrating hormone
* Melatonin
* Neuropeptide Y
* Orexin/Hypocretin

* v
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Glucocorticoid receptor modulators

GR|

| Agonists|

* Cortisol-like and related (16-unsubstituted): 3α,5α-Tetrahydrocorticosterone
* 5α-Dihydrocorticosterone
* 9α-Fluorocortisone (alfluorone)
* 11-Dehydrocorticosterone (11-oxocorticosterone, 17-deoxycortisone)
* 11-Dehydrocorticosterone acetate
* 11-Deoxycorticosterone (desoxycortone, deoxycortone, desoxycorticosterone)
* Desoxycortone esters
* 11-Deoxycortisol (cortodoxone, cortexolone)
* Cortifen (cortiphen, kortifen)
* Cortodoxone acetate
* 21-Deoxycortisol
* Δ7-Prednisolone
* Δ7-Prednisolone 21-acetate
* Amebucort
* Chloroprednisone
* Chloroprednisone acetate
* Cloprednol
* Cloprednol acetate
* Corticosterone
* Corticosterone acetate
* Corticosterone benzoate
* Cortisol (hydrocortisone)
* Benzodrocortisone (hydrocortisone benzoate)
* Hydrocortamate (hydrocortisone diethylaminoacetate)
* Hydrocortisone esters
* Cortisone
* Cortisone acetate
* Deprodone
* Deprodone propionate
* Dichlorisone
* Dichlorisone acetate
* Dichlorisone diacetate
* Difluprednate
* Endrisone (endrysone)
* Etiprednol
* Etiprednol dicloacetate (etiprednol dichloroacetate)
* Fludrocortisone (fludrocortone)
* Fludrocortisone acetate
* Fluorometholone
* Fluorometholone acetate
* Fluperolone
* Fluperolone acetate
* Fluprednisolone
* Fluprednisolone esters
* Halopredone
* Halopredone acetate (halopredone diacetate)
* Isoflupredone (9α-fluoroprednisolone)
* Isoflupredone acetate
* Loteprednol
* Mazipredone (depersolone)
* Medrysone
* Methylprednisolone
* Methylprednisolone esters
* Prebediolone
* Prebediolone acetate
* Prednisolone
* Prednazate
* Prednazoline
* Prednicarbate (prednisolone ethylcarbonate propionate)
* Prednimustine
* Prednisolamate (prednisolone diethylaminoacetate)
* Prednisolone esters
* Prednisone
* Prednisone esters
* Pregnenolone
* Pregnenolone acetate
* Pregnenolone succinate (pregnenolone hemisuccinate)
* Resocortol
* Tipredane
* Tixocortol
* Butixocort (tixocortol butyrate)
* Butixocort propionate
* Tixocortol pivalate

* Methasones and related (16-substituted): 16α-Methyl-11-oxoprednisolone
* Alclometasone
* Alclometasone dipropionate
* Amelometasone
* Beclometasone (beclomethasone)
* Beclometasone esters
* Betamethasone (betametasone)
* Betamethasone esters
* Cortobenzolone (betamethasone salicylate)
* Ciclometasone (ciclomethasone, cyclomethasone)
* Clobetasol
* Clobetasol propionate
* Clobetasone
* Clobetasone butyrate
* Clocortolone
* Clocortolone esters
* Cloticasone
* Cloticasone propionate
* Cormetasone (cormethasone)
* Cormetasone acetate
* Descinolone
* Desoximetasone (desoxymethasone)
* Dexamethasone (dexametasone)
* Dexamethasone esters
* Diflorasone
* Diflorasone diacetate
* Diflucortolone
* Diflucortolone pivalate
* Diflucortolone valerate
* Dimesone
* Dimesone acetate
* Doxibetasol (doxybetasol)
* Fluclorolone
* Flumetasone (flumethasone)
* Flumetasone acetate
* Flumetasone pivalate
* Fluocinolone
* Fluocortin
* Fluocortin butyl (fluocortin butylate)
* Fluocortolone
* Fluocortolone esters
* Fluprednidene (fluprednylidene)
* Fluprednidene acetate
* Fluticasone
* Fluticasone furoate
* Fluticasone propionate
* Halocortolone
* Halometasone
* Icometasone
* Icometasone enbutate (icometasone butyrate acetate)
* Isoprednidene
* Locicortolone (locicortone)
* Locicortolone dicibate (locicortone dicibate)
* Meclorisone
* Meclorisone dibutyrate
* Meprednisone (methylprednisone)
* Meprednisone acetate
* Meprednisone hydrogen succinate (methylprednisone hemisuccinate)
* Mometasone
* Mometasone furoate
* Paramethasone
* Paramethasone acetate
* Paramethasone disodium phosphate
* Paramethasone phosphate
* Prednylidene
* Prednylidene diethylaminoacetate
* Rimexolone
* Ticabesone
* Ticabesone propionate
* Timobesone
* Timobesone acetate
* Triamcinolone
* Triamcinolone diacetate
* Ulobetasol (halobetasol)
* Ulobetasol propionate
* Vamorolone

* Cyclic ketals (16,17-cyclized): Acrocinonide (triamcinolone acroleinide)
* Amcinafal (triamcinolone pentanonide)
* Amcinafide (triamcinolone acetophenide)
* Amcinonide (triamcinolone acetate cyclopentanonide)
* Budesonide
* Ciclesonide
* Cicortonide
* Deflazacort (azacort)
* Descinolone acetonide
* Desonide (hydroxyprednisolone acetonide)
* Desonide disodium phosphate
* Desonide pivalate
* Dexbudesonide
* Drocinonide
* Drocinonide phosphate
* Fluazacort
* Fluclorolone acetonide (flucloronide)
* Fludroxycortide (flurandrenolone, flurandrenolide)
* Flumoxonide
* Flunisolide
* Flunisolide acetate
* Fluocinolone acetonide
* Ciprocinonide (fluocinolone acetonide cyclopropylcarboxylate)
* Fluocinonide (fluocinolide, fluocinolone acetonide acetate)
* Procinonide (fluocinolone acetonide propionate)
* Formocortal
* Halcinonide
* Itrocinonide
* Rofleponide
* Rofleponide palmitate
* Tralonide
* Triamcinolone acetonide
* Flupamesone (triamcinolone acetonide metembonate)
* Triamcinolone acetonide esters
* Triamcinolone aminobenzal benzamidoisobutyrate (TBI-PAB)
* Triclonide

* Others/atypical (other expanded steroid ring systems, homosteroids, and non-pregnane steroids): Cortisuzol
* Cortivazol
* Domoprednate
* Naflocort
* Nicocortonide
* Nicocortonide acetate
* Nivacortol (nivazol)
* Oxisopred
* RU-26988
* RU-28362

* Non-corticosteroids with some glucocorticoid activity: 15β-Hydroxycyproterone acetate
* 17α-Hydroxyprogesterone
* Bromoketoprogesterone
* Chlormadinone acetate
* Cyproterone
* Cyproterone acetate
* Danazol
* Delmadinone acetate
* Desogestrel
* DU-41165
* Etonogestrel
* Flugestone
* Flugestone acetate (flurogestone acetate)
* Fluoromedroxyprogesterone acetate
* Fluoxymesterone
* Gestodene
* Medrogestone
* Medroxyprogesterone acetate
* Megestrol acetate
* Metribolone
* Norgestomet
* Osaterone acetate
* Progesterone
* Promegestone
* RU-2309
* Quingestrone
* Segesterone acetate (nestorone)
* Tetrahydrogestrinone

* Nonsteroidal glucocorticoids: AZD-5423
* GSK-9027

|

Mixed
(SEGRMs)|

* Dagrocorat
* Fosdagrocorat
* Mapracorat

Antagonists|

* 7α-Hydroxy-DHEA
* 17α-Methylprogesterone
* Aglepristone
* Asoprisnil
* Asoprisnil ecamate
* C108297
* C113176
* CORT-108297
* Cyproterone acetate
* Exicorilant (CORT-125281)
* Guggulsterone
* Ketoconazole
* Lilopristone
* LLY-2707
* Metapristone (RU-42633)
* Miconazole
* Mifepristone (RU-486)
* Miricorilant (CORT-118335)
* Onapristone
* ORG-34116
* ORG-34517 (SCH-900636)
* ORG-34850
* Pregnenolone 16α-carbonitrile
* Relacorilant (CORT-125134)
* RTI 3021–012
* RTI 3021–022
* Telapristone
* Tibolone
* Toripristone
* Ulipristal acetate

Others|

* Antisense oligonucleotides: IONIS-GCCRRx (ISIS-426115)

See also
Receptor/signaling modulators
Glucocorticoids and antiglucocorticoids
Mineralocorticoid receptor modulators
List of corticosteroids

* v
* t
* e

Mineralocorticoid receptor modulators

MR|

| Agonists|

* 11-Dehydrocorticosterone (11-oxocorticosterone, 17-deoxycortisone)
* 11-Dehydrocorticosterone acetate
* 11-Deoxycorticosterone (desoxycortone, deoxycortone, desoxycorticosterone)
* Desoxycortone esters
* 11-Deoxycortisol (cortodoxone, cortexolone)
* Cortifen (cortiphen, kortifen)
* Cortodoxone acetate
* 11β-Hydroxyprogesterone
* 16α,18-Dihydroxy-11-deoxycorticosterone
* 17α-Hydroxyaldosterone
* 18-Hydroxy-11-deoxycorticosterone
* 19-Norprogesterone
* Aldosterone
* Corticosterone
* Corticosterone acetate
* Corticosterone benzoate
* Cortisol (hydrocortisone)
* Benzodrocortisone (hydrocortisone benzoate)
* Hydrocortamate (hydrocortisone diethylaminoacetate)
* Hydrocortisone esters
* Cortisone
* Cortisone acetate
* Fludrocortisone (fludrocortone)
* Fludrocortisone acetate
* Mometasone
* Mometasone furoate
* Prednisolone
* Prednazate
* Prednazoline
* Prednicarbate (prednisolone ethylcarbonate propionate)
* Prednimustine
* Prednisolamate (prednisolone diethylaminoacetate)
* Prednisolone esters
* Prednisone
* Prednisone esters

|

Antagonists|

* Steroidal: 6β-Hydroxy-7α-thiomethylspironolactone
* 7α-Acetylthio-17α-hydroxyprogesterone
* 7α-Thiomethylspironolactone (SC-26519)
* 7α-Thioprogesterone (SC-8365)
* 7α-Thiospironolactone (SC-24813)
* 16α-Hydroxyprogesterone
* 17α-Hydroxyprogesterone (hydroxyprogesterone)
* 18-Deoxyaldosterone
* 18,19-Dinorprogesterone
* Canrenoate potassium (potassium canrenoate)
* Canrenoic acid (canrenoate)
* Canrenone (canrenoate y-lactone)
* Dicirenone
* Dimethisterone
* Drospirenone
* Dydrogesterone
* Eplerenone
* Gestodene
* Guggulsterone
* Hydroxyprogesterone caproate
* Medrogestone
* Mespirenone
* Metribolone
* Mexrenoate potassium
* Mexrenoic acid (mexrenoate)
* Mexrenone
* Oxprenoic acid (oxprenoate)
* Oxprenoate potassium (RU-28318)
* Pregnenolone
* Progesterone
* Prorenoate potassium
* Prorenoic acid (prorenoate)
* Prorenone
* RO-14-9012
* RU-26752
* SC-5233 (spirolactone)
* SC-8109
* SC-11927 (CS-1)
* SC-19886
* SC-27169
* Spirorenone
* Spironolactone
* Spiroxasone
* Tibolone
* Trimegestone
* ZK-91587
* ZK-97894

* Nonsteroidal: Amlodipine
* Apararenone
* Benidipine
* BR-4628
* Esaxerenone
* Felodipine
* Finerenone
* Miricorilant (CORT-118335)
* Nifedipine
* Nimodipine
* Nitrendipine
* PF-03882845
* SM-368229

See also
Receptor/signaling modulators
Mineralocorticoids and antimineralocorticoids
Glucocorticoid receptor modulators
List of corticosteroids

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Original source: https://en.wikipedia.orghttps://handwiki.org/wiki/ Prednisone. Read more

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Retrieved from "https://handwiki.orghttps://handwiki.org/wiki/index.php?title=Chemistry:Prednisone&oldid=2527396"
*[US]: United States
*[AU]: Australia
*[CID]: Compound ID
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*[GR]: Glucocorticoid receptor
*[SEGRMs]: Selective glucocorticoid receptor agonists
*[MR]: Mineralocorticoid receptor