Prednisolone

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

Prednisolone is the active metabolite of prednisone and is used when hepatic conversion is a concern (e.g., liver disease, pediatric patients). It is available as a liquid formulation, making it particularly useful in pediatric populations. It has the same anti-inflammatory and immunosuppressive effects as prednisone.

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Publication status

Exploratory record, not a reviewed medical publication.

See the editorial and medical-review policies for the publication gate.

This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

Prednisolone is the active metabolite of prednisone and is used when hepatic conversion is a concern (e.g., liver disease, pediatric patients). NutriStack rates the supporting evidence as strong. Common adult dosing is 5–60 mg daily (equivalent to prednisone dosing); pediatric: 0.5–2 mg/kg/day (as prescribed by your physician), though a prescriber sets the actual dose. With long-term use it can deplete calcium, vitamin d, potassium. This profile indexes 10 sources.

What it's good for

Potent anti-inflammatory and immunosuppressive effects
Does not require hepatic activation (useful in liver disease)
Liquid formulations available for pediatric dosing¹⁰
Rapid symptom relief
Well-characterized pharmacology

What to watch for

Weight gain and increased appetite
Hyperglycemia
Mood changes (agitation, insomnia, euphoria)
Systemic fungal infections^1,2
Known hypersensitivity to prednisolone^1,2

The bottom line

Evidence rating strong. Most-documented uses: potent anti-inflammatory and immunosuppressive effects, does not require hepatic activation (useful in liver disease), liquid formulations available for pediatric dosing. 10 sources indexed (2016–2025), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Binds directly to intracellular glucocorticoid receptors (unlike prednisone, it does not require hepatic activation). The glucocorticoid-receptor complex translocates to the nucleus and modulates gene transcription, suppressing pro-inflammatory cytokines (IL-1, IL-6, TNF-alpha, NF-kB) and upregulating anti-inflammatory mediators. Also stabilizes cell membranes, reduces capillary permeability, and suppresses immune cell migration and function.⁷

Class

Corticosteroid

Absorption

Fat-soluble; take with food

Dosing

Dosing & protocol.

Common range

5–60 mg daily (equivalent to prednisone dosing); pediatric: 0.5–2 mg/kg/day (as prescribed by your physician)

Recommended form

Oral solution (Orapred, Pediapred), oral tablet, or orally disintegrating tablet

Take with food to minimize GI upset. Liquid formulations can be mixed with a small amount of juice for palatability in children.

Depletions

What it depletes.

Nutrients this medication can lower over time, and what to replace.

Calcium

Significant

Glucocorticoids reduce intestinal calcium absorption, increase urinary calcium loss, and accelerate bone resorption.

Replace CalciumMonitor Serum calcium or bone density trendOnset Bone effects accumulate over weeks to months

Vitamin D

Moderate

Glucocorticoids impair activation and signaling of vitamin D, reducing calcium absorption and bone support.

Replace Vitamin D3Monitor 25-OH vitamin DOnset Bone effects accumulate over weeks to months

Potassium

Moderate

Systemic corticosteroids can promote potassium loss or shifts in susceptible patients, especially at higher doses or with other hypokalemia risks; replacement should be lab-guided.

Replace Clinician-guided potassium repletion if serum potassium is lowMonitor Serum potassium + kidney functionOnset Can develop within days to weeks

Magnesium

Moderate

Chronic corticosteroid use can increase urinary magnesium losses and worsen low magnesium status.

Replace Magnesium GlycinateMonitor Serum magnesium or RBC magnesiumOnset Usually over weeks to months

Full Prednisolone depletion and interaction guide →

Safety

Full safety detail.

Side effects

Weight gain and increased appetite
Hyperglycemia
Mood changes (agitation, insomnia, euphoria)
Fluid retention and hypertension
Osteoporosis with long-term use
Increased susceptibility to infections
Adrenal suppression
Growth retardation in children with chronic use

Contraindications

Systemic fungal infections^1,2
Known hypersensitivity to prednisolone^1,2
Live vaccine administration during immunosuppressive doses
Active untreated infections (herpes simplex keratitis, etc.)

Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

1Corticosteroids in severe alcohol-associated hepatitis. Not so fast: A systematic review of randomized controlled trialsPMIDShi MA, Pungwe P, Comer LLM et al. · Hepatology (Baltimore, Md.) · 2025
Shi MA, Pungwe P, Comer LLM et al.. Corticosteroids in severe alcohol-associated hepatitis. Not so fast: A systematic review of randomized controlled trials. Hepatology (Baltimore, Md.). 2025
2Efficacy and Safety of Systemic Corticosteroids for Urticaria: A Systematic Review and Meta-Analysis of Randomized Clinical TrialsPMIDChu X, Wang J, Ologundudu L et al. · The journal of allergy and clinical immunology. In practice · 2024
Chu X, Wang J, Ologundudu L et al.. Efficacy and Safety of Systemic Corticosteroids for Urticaria: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. The journal of allergy and clinical immunology. In practice. 2024
3Effectiveness of prednisolone in complex regional pain syndrome treatment: A systematic narrative reviewPMIDKwak SG, Choo YJ, Chang MC · Pain practice : the official journal of World Institute of Pain · 2022
Kwak SG, Choo YJ, Chang MC. Effectiveness of prednisolone in complex regional pain syndrome treatment: A systematic narrative review. Pain practice : the official journal of World Institute of Pain. 2022
4Difluprednate versus Prednisolone Acetate after Cataract Surgery: a Systematic Review and Meta-AnalysisPMIDKhalafAllah MT, Basiony A, Salama A · BMJ open · 2019
KhalafAllah MT, Basiony A, Salama A. Difluprednate versus Prednisolone Acetate after Cataract Surgery: a Systematic Review and Meta-Analysis. BMJ open. 2019

Reviews & position papers

5Alcoholic Hepatitis: A ReviewPMIDHosseini N, Shor J, Szabo G · Alcohol and alcoholism (Oxford, Oxfordshire) · 2019
Hosseini N, Shor J, Szabo G. Alcoholic Hepatitis: A Review. Alcohol and alcoholism (Oxford, Oxfordshire). 2019
6A review of prednisolone prescribing for children with acute asthma in the UKPMIDGilchrist FJ, Ahmad AN, Batchelor HK et al. · The Journal of asthma : official journal of the Association for the Care of Asthma · 2016
Gilchrist FJ, Ahmad AN, Batchelor HK et al.. A review of prednisolone prescribing for children with acute asthma in the UK. The Journal of asthma : official journal of the Association for the Care of Asthma. 2016

Reference material

FAQ

Common questions.

Quick answers about Prednisolone, drawn from the data on this page.

What is Prednisolone?

What is Prednisolone used for?

Commonly cited benefits of Prednisolone include: Potent anti-inflammatory and immunosuppressive effects; Does not require hepatic activation (useful in liver disease); Liquid formulations available for pediatric dosing; Rapid symptom relief; Well-characterized pharmacology. NutriStack rates the overall evidence as strong.

What is a typical dose of Prednisolone?

A typical adult dose of Prednisolone is 5–60 mg daily (equivalent to prednisone dosing); pediatric: 0.5–2 mg/kg/day (as prescribed by your physician). The commonly recommended form is Oral solution (Orapred, Pediapred), oral tablet, or orally disintegrating tablet. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Prednisolone?

Reported side effects include weight gain and increased appetite, hyperglycemia, mood changes (agitation, insomnia, euphoria), fluid retention and hypertension, osteoporosis with long-term use, increased susceptibility to infections. This is educational information; check with a healthcare professional before use.

How strong is the evidence for Prednisolone?

NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

Prednisolone in NutriStack.

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