Prednisolone and prednisone are two synthetic corticoid drugs , namely glucocorticoids, widely used clinically and intimately. So related that one is a precursor of the other. Of the two substances, the active form is prednisolone. For prednisone to exert its action, it must first be transformed into prednisolone, a process that takes place in the liver. It is said then that prednisone is a prodrug and that prednisolone is its active metabolite .
Chemically they have only a tiny difference. The formula of prednisone is C 21 H 26 O 5 , has a molecular mass of 358.428 g / mol and structurally has three ketone groups (is a trione) and two hydroxyl groups. Its systematic name according to IUPAC is 17,21-dihydroxypregna-1,4-diene-3,11,20-trione.
The formula for prednisolone is C 21 H 28 O 5 , has a molecular mass of 360.444 g / mol and structurally has two ketone groups (is a dione) and three hydroxyl groups. Its systematic name according to IUPAC is (11?) -11,17,21-trihydroxypregna-1,4-diene-3,20-dione (see attached images).
Since prednisone is the precursor of prednisolone, which is the active substance, both have the same activity, same side effects and are used for the same purposes . The difference between the two is due to the need for metabolism of prednisone in the liver, which may limit its use in some circumstances. In patients with hepatic impairment caution is advised and in severe cases of hepatic failure the administration of prednisone may be contraindicated.
The need for hepatic metabolism also makes prednisolone the choice for administration routes other than oral. For example, for intramuscular and intravenous administration prednisolone is preferably used. For local and local routes, prednisolone is always used as the need for hepatic metabolism makes local action impossible; for example, dermal, ophthalmic or nasal route.
The idiosyncrasy of each patient may cause it to respond very differently to prednisolone, as with any other drug, but this fact may be more notable with prednisone due precisely to the need for a metabolic process to transform it into the form active.
As corticosteroids, prednisone and prednisolone have a potent anti-inflammatory action and are therefore used in the treatment of a wide variety of diseases that occur with both chronic inflammation and acute inflammation. Some examples may be rheumatoid arthritis, severe allergic reactions or Crohn’s disease.
They also have immunosuppressive activity , which may be an adverse effect, but it is also an effect used to treat some diseases, especially in some types of cancer and some autoimmune diseases. For example, they are used in lymphoblastic leukemia and autoimmune hepatitis. The immunosuppressive effect in organ transplants is also used to reduce the risk of rejection.
The side effects of both drugs are equally very similar and can become very serious, especially in prolonged treatments. Like the rest of corticosteroids, the detection of these drugs in athletes is considered doping.
- Prednisone in PubChem. CID 5865.
- Prednisolone in PubChem. CID 5755.
- Kelly Young (January 24, 2013). Prednisone Versus Prednisolone: ??the Same for Everyone? .