Vetdrugs 2.0Prednisolone acetate is a poorly water-soluble ester of prednisolone supplied in suspension formulations. Ophthalmic preparations are used for local ocular inflammation, especially anterior uveitis, while selected injectable preparations provide systemic or local glucocorticoid effects. The intended role depends on the formulation, since ophthalmic and injectable suspensions have different delivery characteristics.
Group
Glucocorticoid suspension
Mechanism of Action
Prednisolone released from the ester activates intracellular glucocorticoid receptors and modifies transcription of inflammatory and immune-response genes. Reduced mediator production and inflammatory-cell activity decrease vascular leakage, edema and tissue inflammation. The acetate ester supports corneal penetration in ophthalmic suspensions, allowing activity within the anterior eye. Suspension characteristics also influence the persistence of injectable preparations.
Dose Rates
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation | 100–200 mg/animal | IM | Prednisolone acetate suspension specifically named. | |
| Glucocorticoid effects | 0.25–1 mg/kg | IM | Acetate suspension explicitly identified. |
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Ketosis | Reference only | IM | Reported regimen gives 100-200 mg total IM for ketosis, but the formulation is not explicitly identified in this cattle regimen. Confirm acetate basis before calculation. |
Indications
- Topical treatment of selected noninfectious anterior uveitis and postoperative anterior-segment inflammation with an ophthalmic preparation.
- Treatment of selected inflammatory or immune-mediated disorders with an appropriate systemic injectable preparation.
- Local treatment of selected noninfectious synovial or other focal inflammatory disease with a formulation intended for that use.
- Historical adjunctive treatment of selected bovine ketosis cases with a corresponding injectable product.
Contraindications
- Do not administer acetate suspension intravenously.
- Use caution with infection, GI ulcer risk, diabetes, renal or cardiac disease and pregnancy.
Interactions
- NSAIDs increase gastrointestinal injury.
Adverse effects
- HPA suppression, polyuria/polydipsia, appetite and metabolic changes, infection, impaired healing and GI ulceration.
Toxicity
Acute glucocorticoid excess may cause GI or metabolic signs; repeated exposure carries greater risks of infection, adrenal suppression, hyperglycemia and impaired healing.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Prednisolone acetate suspension 10 mg/mL Suspension: never IV. | Injection | 10 mg / mL | IM |
| Prednisolone acetate suspension 25 mg/mL Suspension: never IV. | Injection | 25 mg / mL | IM |
| Prednisolone acetate suspension 50 mg/mL Suspension: never IV. | Injection | 50 mg / mL | IM |
| Prednisolone acetate ophthalmic suspension 0.12% Sterile ophthalmic suspension only; not the IM suspension. | Other | 1.2 mg / mL | TOPICAL |
| Prednisolone acetate ophthalmic suspension 0.125% Sterile ophthalmic suspension only; not the IM suspension. | Other | 1.25 mg / mL | TOPICAL |
| Prednisolone acetate ophthalmic suspension 1% Sterile ophthalmic suspension only; not the IM suspension. | Other | 10 mg / mL | TOPICAL |
Monitoring and Administration
Monitor glucose, liver and renal indices, infection and adrenal suppression. Oral free prednisolone and injectable acetate suspension have different formulation and route requirements.
Acetate is water-insoluble; protect from light and do not freeze.
Prednisolone acetate subconjunctival amount 10-25 mg is described as a local ocular procedure; it is not an IM or IV dose. Oral free-prednisolone and prednisone regimens remain outside this acetate record.
For anterior uveitis, sterile ophthalmic acetate suspension penetrates the anterior segment better than phosphate. Mild/moderate cases may begin four applications daily; severe disease may require hourly topical treatment with reassessment at 24 hours. Amount per application is not specified. Shake suspensions and exclude corneal ulceration or infection before ocular steroid use.
Frequent ocular steroids can affect diabetic regulation, especially in smaller patients. Topical therapy does not adequately treat posterior-segment inflammation; subconjunctival doses can be systemically absorbed.