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Prednisolone/Prednisone

By Rania Gollakner, BS, DVM, MPH

Medications

What is prednisone/prednisolone?

Prednisone/prednisolone (brand name: Prednis-Tab®, Deltasone®, Rayos®, Pediapred®) is a glucocorticoid used to treat many conditions in many species. Broad uses include the following: replacement therapy for Addison’s disease, an anti-inflammatory, an immune suppressant, and an antineoplastic (cancer treatment). Although they are distinct drugs, prednisone is quickly converted to prednisolone in the liver, so they are considered bioequivalent (equally absorbed).

While some products are labeled for use in some animals with certain conditions, its use in cats, dogs, horses, small mammals, birds, and reptiles to treat inflammation, immune-mediated disease, Addison’s disease, and neoplasia is often ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is prednisone/prednisolone given?

Prednisone/prednisolone is given by mouth in the form of a tablet or liquid solution. Give this medication with food. It can also be given as an injection in the hospital setting. Measure liquid forms carefully. If your pet is on a once daily dosing, if possible, give it in the morning to dogs and horses, and give it in the evening to cats. Do not stop this medication abruptly; taper it slowly to avoid complications.

Do not use in pets that are undergoing allergy testing within the next month, unless otherwise advised by your veterinarian.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

The most common side effects include increased drinking, increased urination, and increased appetite. At higher doses and during long-term use, side effects may also include vomiting, diarrhea, mild behavioral changes, and panting. Serious side effects include gastrointestinal ulceration characterized by a lack of appetite, black or bloody stools, bloody vomit, or high fever, as well as haircoat changes, pot belly, weight gain, weakness, liver and lipid elevations, aggressive behavior, muscle wasting, abnormally low energy, or diabetes characterized by weight loss in the face of good appetite, excessive thirst and urination.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Prednisone/prednisolone should not be used in pets that are allergic to it, or with systemic fungal infections (unless it is used to treat Addison’s disease), viral infections, ulcers, tuberculosis, or Cushing’s disease. It should be used cautiously in pets with diabetes, heart or vascular disease, other types of infections, osteoporosis, cataracts, high blood pressure, or kidney disease. Use prednisone/prednisolone cautiously in young animals as this medication can stunt growth. Extreme caution should be used when using prednisone/prednisolone in pregnant or lactating pets or in pets receiving medications that can cause ulcers.

Do not stop this medication abruptly; taper it slowly to avoid complications.

Do not use in pets that are undergoing allergy testing within the next month, unless otherwise advised by your veterinarian.

Do not use the prednisone form in cats and horses, or in pets with liver dysfunction (i.e., use prednisolone), as they cannot efficiently convert it to prednisolone.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with prednisone/prednisolone: amphotericin B, anticholinesterases, aspirin, barbiturates, bupropion, cholestyramine, cyclophosphamide, cyclosporine, digoxin, potassium-depleting diuretics, ephedrine, estrogens, fluroquinolones, insulin, ketoconazole, macrolide antibiotics, mitotane, mycophenolate, non-steroidal anti-inflammatory drugs (NSAIDs), phenobarbital, rifampin, vaccines, or warfarin.

This product may also interact with laboratory tests, such as allergy tests, as well as cholesterol, urine glucose, potassium, and thyroid levels.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Monitoring recommendations will vary depending on the reason for use, the dosage, duration of therapy, and your pet’s health status. Common monitoring includes bloodwork and urinalysis, blood sugar levels, ACTH stimulation tests, weight and appetite status, signs of swelling, and serious side effects. Your veterinarian may monitor your pet to be sure that the medication is working.

How do I store prednisone/prednisolone?

Store the tablets at room temperature ideally between 59°F and 86°F (15°C and 30°C), and not to exceed 104°F (40°C). Store in a tight container and protect from light. Liquid forms of the medication should be stored according to the label on the bottle.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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