Methylprednisolone and prednisolone

[Lasagne777]

I know you cannot take methylprednisolone and prednisolone simultaneously but can one transfer from methylprednisolone to prednisolone without any adverse effects , bearing in mind that 4mg methylprednisolone is stronger so is equal to 5mg prednisolone .? 🤔

[PMRpro Ambassador]

Yes, I did both ways, I was switched from prednisolone to methyl prednisolone at the equivalent dose because prednisolone was not available where I was living and a few months later from methyl prednisolone to prednisone because methylpred didn't agree with me at all and was ineffective.

There is no reason not to mix methyl pred and either prednisolone or prednisone - you just use the equivalents to work out how much of each you require.

[Grammy80]

I had to research prednisolone :

The key differences between prednisolone and prednisone are as follows: Prednisolone is the active form of prednisone. Once prednisone is converted to prednisolone, this active form of the drug act on the immune system to lower the body's inflammatory response.

In my five years of steroids(States) I don't believe I have ever been prescribed prednisolone. However, on at least three, maybe four occasions I have receieved IV infusions of methylprednisolone and then followed up with prednisone oral tabs, with no incident. With my recent three days of methylprednisolone infusions ~~one feels a bit 'odd' anyhow🥴. Now at 60mg per day....I'm still a tad odd, but my body is assimilating it.

Some might say I was a bit odd without it💞

[PMRpro Ambassador in reply to Grammy80]

Prednisone and prednisolone can only be given orally. If you need injections or infusions they use methyl prednisolone or hydrocortisone.

[Grammy80 in reply to PMRpro]

Thanks for the clarity!💕

[AtopicGuy in reply to PMRpro]

I'd never heard that, so I checked. This 2023 paper, specifically about prednisone, says:

"Other routes of administration include liquid, solution, syrup, tablet, delayed-release tablets, nasal, rectal, injection, and intravenous."

ncbi.nlm.nih.gov/books/NBK5...

[PMRpro Ambassador in reply to AtopicGuy]

Prednisolone is available as

"This product is available in the following dosage forms:

Tablet

Syrup

Solution

Tablet, Disintegrating"

mayoclinic.org/drugs-supple...

Prednisone may be available as i.m. injections. However, in over 15 years doing this I have never come across deep i.m. injections of prednisone. It is always Medrol that is used.

I stand to be corrected as to whether it is made or not. However, this website drugs.com/pro/prednisone.html only mentions tablets.

They also say here

drugs.com/medical-answers/d...

"The main difference between them is that methylprednisolone is available in an injectable form which makes it useful if a person’s inflammation is severe and requires reducing quickly. Injectable forms allow larger dosages to be given quickly. Some forms of methylprednisolone can also be directly injected into a joint to provide localized, relief of pain and inflammation within 24 to 36 hours."

Which clearly implies that methyl pred is available for injection - pred is not.

[AtopicGuy in reply to PMRpro]

Thank you for clarifying "Prednisone and prednisolone can only be given orally."

A vial of injectable, intramuscular prednisolone acetate in its carton.

[Lasagne777]

Yes I have Prednol 4 which is methylprednisolone tablets but just wondered when I get below 4mg methylprednisolone if I could transfer to prednisolone but you said I could and just calculate the right dosage using a convertor . Thanks to you all for your answers to my question.

[PMRpro Ambassador in reply to Lasagne777]

Yes - you would start with 5mg prednisolone and taper from there as you can get 1mg tablets. It is also possible to use 5mg tablets, cut them in half to get 2,5mg and add 1mg tablets to allow a taper in 1/2mg steps.

[Lasagne777 in reply to PMRpro]

Thanks for this .