Overview
Prednisolone is a widely prescribed synthetic intermediate-acting corticosteroid with potent anti-inflammatory and immunosuppressive effects. It is frequently used to manage exacerbations of asthma, rheumatoid arthritis, inflammatory bowel disease, and various severe allergic reactions.

Mechanism of Action
It exerts its effects by binding to intracellular glucocorticoid receptors, modifying gene transcription to inhibit the synthesis of inflammatory mediators. It has approximately four times the anti-inflammatory potency of hydrocortisone and exhibits only minimal mineralocorticoid activity.

Dosage and Administration
Oral dosage varies widely based on the disease severity and patient response, typically ranging from 5 mg to 60 mg daily. It is usually taken as a single morning dose to mimic natural cortisol rhythms. Prolonged therapy must be tapered gradually to avoid adrenal insufficiency.

Side Effects
Short-term use may cause insomnia, indigestion, and mood alterations. Long-term administration carries significant risks, including osteoporosis, Cushingoid appearance (moon face, weight gain), cataracts, glaucoma, hyperglycemia, hypertension, and an increased risk of serious infections.

Contraindications
Systemic administration is contraindicated in patients with untreated systemic infections, particularly systemic fungal infections. Caution is advised in patients with osteoporosis, a history of peptic ulcers, diabetes, hypertension, and psychiatric disorders.

Pregnancy and Lactation
It may be used during pregnancy if the maternal benefits outweigh the fetal risks. Prednisolone is extensively metabolized by the placenta, minimizing fetal exposure compared to some other steroids. It is excreted in breast milk in small amounts, but is generally compatible with breastfeeding.