Pharmacokinetics of prednisolone in children with nephrosis.

Abstract

The pharmacokinetics of prednisolone given intravenously were studied in 11 children with relapsed steroid responsive nephrotic syndrome, and four control subjects. The clearance of both total and unbound drug was decreased in these children and the unbound fraction of the drug in plasma was significantly correlated with the degree of hypoalbuminaemia. We conclude that changes in the clearance of prednisolone and altered protein binding might account for some of the variability in both therapeutic responses and the incidence of toxicity in patients treated with standard dosage regimens.

Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease

“…Although pulse steroid therapy involves single administrations of the same amount of steroids administered over 1 month in standard treatment, it has been suggested that the reason why it has fewer side effects relative to the amount used is that the serum pharmacokinetics of methylprednisolone in pulse steroid therapy are different from those of prednisolone, which is administrated orally and intravenously in standard treatment. In other words, as reported by Vree et al [17], although the half-life of the prednisolone that is administrated orally and intravenously in standard treatment is 2.7–3.7 h [13,14,15,16], the half-life of methylprednisolone used in pulse steroid therapy is shortened to 1.4 h [17]. In sum, there is a possibility that the fact that the half-life of methylprednisolone in pulse steroid therapy is half of that of the prednisolone of standard treatment contributes to the reduction of side effects.…”

Simultaneous determination of prednisolone, prednisone, cortisol, and cortisone in plasma by GC–MS: Estimating unbound prednisolone concentration in patients with nephrotic syndrome during oral prednisolone therapy

“…Miller et al [29] studied the relationship between percentage of unbound prednisolone (y) and plasma albumin concentration (x) and proposed a linear equation of y = −17.5x + 92. It should be noted that the Miller's equation does not take into consideration of the fact that the unbound fraction of prednisolone varies with the total prednisolone concentration as discussed above.…”

Pulse steroids as induction therapy for children with ulcerative colitis

“…The serum pharmacokinetics of methylprednisolone in pulse steroid therapy seemed to be different from that of orally administrated prednisolone. The half‐life of orally and intravenously given prednisolone in the standard way has been reported to be 2.7–3.7 h independent from their doses in the previous studies 20–23 . In contrast, that of methylprednisolone was 1.4 h according to Vree's inspiring trial 24 .…”

“…The half-life of orally and intravenously given prednisolone in the standard way has been reported to be 2.7-3.7 h independent from their doses in the previous studies. [20][21][22][23] In contrast, that of methylprednisolone was 1.4 h according to Vree's inspiring trial. 24 Thus the half-life of methylprednisolone was twofold quicker than prednisolone, which might reduce side-effects.…”