Prednisone vs. Prednisolone for Ulcerative Colitis

Medically reviewed by Alan Carter, PharmD on June 22, 2017Written by University of Illinois-Chicago, Drug Information Group on July 7, 2016

Introduction

When it comes to ulcerative colitis, there are different options for treatment. Many different kinds of drugs are available. The treatment your doctor prescribes for you often depends on the severity of your symptoms.

Two drugs you may hear about are prednisone and prednisolone. (A third drug, methylprednisolone, is stronger than both and should not be confused with prednisolone.) Here’s the rundown on what these drugs are and how they can help treat ulcerative colitis, including how they’re alike and how they’re different.

Prednisone and prednisolone

Prednisone and prednisolone both belong to a class of drugs called glucocorticoids. Glucocorticoids reduce inflammation throughout your body. They do this by interfering with the way certain chemicals in your body cause inflammation.

These drugs can work in different parts of your body, including your colon. Your colon is the last section of your large intestine, just before your rectum. By reducing the inflammation there, these drugs help reduce the damage that colitis does to your colon.

Neither of these drugs cures colitis, but both can help control it and improve your quality of life. These drugs relieve common symptoms such as:

  • stomach cramps and pain
  • weight loss
  • diarrhea
  • fatigue

Side-by-side comparison

Prednisone and prednisolone are very similar drugs. The following table compares the similarities and differences of several features of these two drugs.

PrednisonePrednisolone
What are the brand-name versions?Deltasone, PredniSONE Intensol, RayosMillipred
Is a generic version available?yesyes
What is it used for?ulcerative colitis and other inflammatory diseasesulcerative colitis and other inflammatory diseases
Do I need a prescription?yesyes
What forms and strengths does it come in?oral tablet, delayed-release tablet, oral solution, oral solution concentrateoral tablet, oral disintegrating tablet, oral solution, oral suspension, oral syrup
What’s the typical length of treatment?short-term short-term
Is there a risk of withdrawal?yes*yes*

*Do not stop taking this drug without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as weakness, fatigue, loss of appetite, weight loss, nausea, vomiting, and diarrhea.

Cost, availability, and insurance coverage

Prednisolone and prednisone cost about the same. Both drugs come in generic and brand-name versions. Like all drugs, the generic versions usually cost less. GoodRx.com can give you an idea of the current cost of the drug your doctor prescribes.

However, not all generics are available in the same forms or strengths as the brand-name versions. Ask your healthcare provider if it’s necessary for you to take the brand-name strength or form.

Most pharmacies stock the generic versions of both prednisone and prednisolone. The brand-name versions aren’t always stocked, so call ahead before you fill your prescription if you take a brand-name version.

Most insurance plans also cover both prednisone and prednisolone. However, your insurance company may require a prior authorization from your doctor before they approve the prescription and cover the payment.

Side effects

These drugs are from the same drug class and work in a similar way. Because of this, the side effects of prednisone and prednisolone are also similar. However, they do differ in a couple of ways. Prednisone may cause your mood to change and may make you feel depressed. Prednisolone may cause convulsions.

Read more: Detailed drug information for prednisone, including side effects »

Drug interactions

The following drugs interact with both prednisolone and prednisone:

  • anti-seizure drugs such as phenobarbital and phenytoin
  • rifampin, which treats tuberculosis
  • ketoconazole, which treats fungal infections
  • aspirin
  • blood thinners such as warfarin
  • all live vaccines

Use with other medical conditions

If you also have conditions other than ulcerative colitis, make sure your doctor knows about them. Both prednisone and prednisolone can make certain existing conditions worse. These include:

  • hypothyroidism
  • cirrhosis
  • herpes simplex of the eye
  • emotional problems
  • mental illness
  • ulcers
  • kidney problems
  • high blood pressure
  • osteoporosis
  • myasthenia gravis
  • tuberculosis

Pharmacist’s advice

Prednisone and prednisolone have more similarities than differences. The biggest differences between these drugs are the other drugs they interact with. Give your doctor a complete list of the drugs and supplements that you take. This may be some of the best information you can give to your doctor to help them decide between these two drugs for treating your ulcerative colitis.

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