Despite having been on Prednisolone for nearly two years in my present bout of PMR, and for a previous 2 years some 10 years ago, I have only just become aware of the existence of Prednisone and the difference between it and Prednisolone.
What confuses me is the apparent use of the abbreviation "Pred"for both, especially in the context of dose levels. Is there a convention that I haven't yet become aware of?
There is no real difference between prednisone and prednisolone - prednisone is processed in the liver to form prednisolone which is the active form and the dosage is a simple 1 to 1 relationship. In the UK it is almost always prednisolone, in the USA it is equally almost always prednisone. Methyl prednisolone or Medrol may be used in the USA and very occasionally in the UK in tablet form, it is usually the version used in injections. In Europe all three may be used depending on local preferences.
We refer to it as pred since that covers both and saves a lot of typing when it write it as often in a day as some of us! I do write out methyl pred - it is different in that it is stronger.
Thanks for the clarification.
I think PMRPro has done a brilliant join explaining prednisone and prednisolone. Prednisolone is the active form of prednisone. Once prednisone is converted to prednisolone by the liver, they are effectively the same. The other thing is that in UK there is a coated version that should protect against stomach problems. Due to the coating there is a ‘delayed release’.
As PMRPro says, the conversion of (inactive) prednisone into the active form prednisolone takes place in the liver (not the kidneys). Prednisolone is eventually broken down, and it is these metabolites that are excreted in the urine.
What's the point of prednisone? It is kinder on the stomach, but less kind on the liver.
Glad I'm not the only one! Thanks to all responders.
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