Prednisolone — Drug Monograph
Brand names: Millipred, Orapred, Prelone
Drug class: Corticosteroid
Mechanism of Action
Synthetic glucocorticoid (the active metabolite of prednisone). Binds cytoplasmic glucocorticoid receptors, modulating transcription of anti-inflammatory and immunosuppressive genes. In hematologic malignancies it induces apoptosis (lymphocytolysis) in malignant lymphoid cells. Also used for its antiemetic, anti-inflammatory, and supportive-care benefits and to reduce edema and immune-mediated reactions.
FDA Indications
- Acute lymphoblastic leukemia (ALL) and other leukemias — as a component of combination regimens
- Lymphomas (e.g., Hodgkin and non-Hodgkin lymphoma) — as a component of combination chemotherapy
- Supportive care in oncology: antiemesis, hypersensitivity/infusion reaction prophylaxis, management of edema and inflammation
Common Side Effects
- Hyperglycemia
- Increased appetite/weight gain
- Insomnia and mood changes
- Fluid retention/edema
- Dyspepsia
- Immunosuppression
Clinical Pearl
Prednisolone is the active form of prednisone (prednisone is a prodrug converted hepatically), so prednisolone is often preferred in significant hepatic impairment and in pediatrics. As the corticosteroid backbone of regimens like CHOP and pediatric ALL protocols, it contributes directly to antitumor lymphocytolysis, not just supportive care. Always taper after prolonged use.
Related Therapies & Mechanisms
- Dexamethasone (Decadron) — Corticosteroid · Lymphoma
- Methylprednisolone (Solu-Medrol) — Corticosteroid · Lymphoma
- Prednisone (Deltasone) — Corticosteroid · Lymphoma
- Acalabrutinib (Calquence) — Lymphoma