Drug/Small Molecule:

prednisone

Overview

Generic Names:	Dehydrocortisone; PRD; Prednisona [INN-Spanish]; Prednisonum [INN-Latin]
IUPAC Name:	(8S,9S,10R,13S,14S,17R)-17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-6,7,8,9,12,14,15,16-octahydrocyclopenta[a]phenanthrene-3,11-dione
Trade Names:	Adasone; Ancortone; Apo-prednisone; Betapar; Bicortone; Cartancyl; Colisone; Cortan; Cortancyl; Cortidelt; Cotone; Dacorten; Dacortin; Decortancyl; Decortin; Decortisyl; Dekortin; Delcortin; Dellacort; Dellacort A; Delta Cortelan; Delta E; Delta-cortelan; Delta-cortisone; Delta-cortone; Delta-dome; Deltacortene; Deltacortisone; Deltacortone; Deltasone; Deltison; Deltisona; Deltisone; Deltra; Di-Adreson; Diadreson; Econosone; Encorton; Encortone; Enkorton; Fernisone; Fiasone; Hostacortin; In-Sone; Incocortyl; Juvason; Lisacort; Me-Korti; Metacortandracin; Meticorten; Nisona; Nizon; Novoprednisone; Nurison; Orasone; Origen Prednisone; Panafcort; Panasol; Paracort; Parmenison; Pehacort; Precort; Predeltin; Prednicen-M; Prednicorm; Prednicort; Prednicot; Prednidib; Prednilonga; Prednison; Prednisone Intensol; Prednitone; Prednizon; Prednovister; Presone; Pronison; Rectodelt; Retrocortine; Servisone; Sone; Sterapred; Supercortil; Ultracorten; Ultracortene; Winpred; Wojtab; Zenadrid
Brand Mixtures:	Cortab (Biotin + Chlorpheniramine Maleate + D-Pantothenic Acid + Inositol + Nicotinic Acid + Prednisone + Pyridoxine Hydrochloride + Thiamine Mononitrate + Vitamin a + Vitamin B2 + Vitamin D + Vitamin E (Dl-Alpha Tocopheryl Acetate)); Metreton Tab (Chlorpheniramine Maleate + Prednisone + Vitamin C); Predniderm Tab (Inositol + Pheniramine Maleate + Phosphatidyl Choline + Prednisone + Vitamin a + Vitamin D2 + Vitamin E); Sterolin Liq (Biotin + Fatty Acids Unsaturated + Inositol + Nicotinic Acid + Pheniramine Maleate + Phosphatidyl Choline + Prednisone + Vitamin a Palmitate + Vitamin B2 + Vitamin D2 + Vitamin E)
PharmGKB Accession Id:	PA451100

Description

A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [PubChem]

Indication

For the treatment of drug-induced allergic reactions, perennial or seasonal allergic rhinitis, serum sickness, giant cell arteritis acute rheumatic or nonrheumatic carditis, systemic dermatomyositis, systemic lupus erythematosus, atopic dermatitis, contact dermatitis, exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe (Stevens-Johnson syndrome) erythema multiforme, mycosis fungoides, pemphigus, severe psoriasis, acute adrenocortical insufficiency, Addison's disease, secondary adrenocortical insufficiency, congenital adrenal hyperplasia, hypercalcemia associated with neoplasms, nonsuppurative thyroiditis, ulceratice colitis, Crohn's disease, acquired hemolytic anemia, congenital hypoplastic anemia, erythroblastopenia, adult secondary thrombocytopenia, adult idiopathic thrombocytopenia purpura, acute or subacute bursitis, epicondylitis, acute nonspecific tenosynovitis, acute or chronic lymphocytic leukemia, Hodgkin's or non-Hodgkin's lynphomas, Waldenstrom's macroglobulinemia, primary brain tumors (adjunct), nephrotic syndrome, tuberculous meningitis, multiple sclerosis, myasthenia gravis. cerebral edema, chorioretinitis, diffuse posterior choroiditis, aleergic conjunctivitis, Herpes zoster ophthalmicus, anterior segment inflammation, iridocyclitis, iritis, keratitis, optoc neuritis, sympathetic ophthalmia, corneal marginal allergic ulcers, symptomatic sarcoidosis, Loeffler's syndrome not manageable by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy and aspiration pneumonitis.

ATC Therapeutic Categories

• A07EA:Corticosteroids acting locally
• H02AB:Glucocorticoids

Pharmacology and Interactions

Mechanism Of Action

Prednisone is a glucocorticoid agonist. It is first metabolized in the liver to its active form, prednisolone. Prednisolone crosses cell membranes and binds with high affinity to specific cytoplasmic receptors. The result includes inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, suppression of humoral immune responses, and reduction in edema or scar tissue. The antiinflammatory actions of corticosteroids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.

Pharmacology

Prednisone, the most commonly-prescribed corticosteroid, is used to treat allograft rejection, asthma, systemic lupus erythematosus, and many other inflammatory states. Prednisone has very little mineralocorticoid activity.

Food Interactions

Avoid alcohol. Avoid taking with grapefruit juice. Take with food to reduce irritation.

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic.

Protein Binding

Extensively bound to plasma proteins.

Absorption

Readily absorbed from the gastrointestinal tract.

Half Life

2 to 3 hours

Chemical Properties

Chemical Formula:

C₂₁H₂₆O₅

SMILES Code:

C[C@]12CC(=O)[C@H]3[C@H]([C@@H]1CC[C@@]2(C(=O)CO)O)CCC4=CC(=O)C=C[C@]34C

(Format: OpenEye Isomeric)

Molecular Weight ( average / monoisotopic )

358.4281 / 358.178

Curated Information

The following genes are in curated knowledge about this drug.

Non-Curated Information

A list of non-curated publications that mention this drug along with other genes is available.

Metabolizing Enzymes

• CYP3A4

Drug Targets

• NR3C1
• ANXA1

PharmGKB Curated Pathways

• Glucocorticoid and Inflammatory genes Pathway (PD)
• Glucocorticoid and Inflammatory genes Pathway (Regulation)

BioCarta Pathways†

• chromatin remodeling by hswi/snf atp-dependent complexes - (BioCarta via Pathway Interaction Database)
• corticosteroids and cardioprotection - (BioCarta via Pathway Interaction Database)

Non-Curated Information

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Curated Information

The following diseases are in curated knowledge about this drug.

	Disease	Relationship	Evidence
	Arthritis, Rheumatoid	PD	Publications
	Precursor Cell Lymphoblastic Leukemia-Lymphoma	CO PD PK    GN	Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Curated Phenotype Datasets

These datasets are sorted alphabetically by title.

1. Pharmacogenetic Risk Factors for Osteonecrosis of the Hip Among Children With Leukemia

   • 
   • 
   • 
   • 
   • CO

   Submitted by Mary Relling, PharmD involving ABCB1, CYP3A4, CYP3A5, GSTM1, GSTP1, GSTT1, MTHFR, NR3C1, SLC19A1, TPMT, TYMS, UGT1A1, VDR, dexamethasone, methotrexate, prednisone, , Osteonecrosis and Precursor Cell Lymphoblastic Leukemia-Lymphoma
2. Tacrolimus dosing and Steroid Weaning in pediatric heart transplant patients

   • 
   • 
   • 
   • 
   • CO
   • PK

   Submitted by Burckart GJ involving ABCB1, CYP3A4, CYP3A5, glucocorticoids, prednisone, tacrolimus, and Organ Transplantation

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

1. Genetic predictors of glucocorticoid-induced hypertension in children with acute lymphoblastic leukemia
2. Genome-wide copy number profiling reveals molecular evolution from diagnosis to relapse in childhood acute lymphoblastic leukemia
3. Osteonecrosis in Children with Acute Lymphoblastic Leukemia: A Report from the Children's Oncology Group
4. Pharmacogenetics of Minimal Residual Disease Response in Children with B-Precursor Acute Lymphoblastic Leukemia (ALL): A Report from the Children's Oncology Group
5. Physicochemical determinants of human renal clearance
6. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.