Prednisolone is a corticosteroid that suppresses inflammation and calms an overactive immune system. It treats asthma flares, croup, severe allergic reactions, arthritis, inflammatory bowel disease and many other conditions. How you stop it matters as much as how you take it.

What is Prednisolone?

The South African Medicine Price Registry lists prednisolone and its close relative methylprednisolone across several forms, all Schedule 4:

Product	Form	Contains
Adco Prednisolone	Syrup	Prednisolone 15 mg / 5 ml
Capsoid	Tablet	Prednisolone 5 mg
Medrol	Tablet	Methylprednisolone 4 mg
Solu-Medrol, Depo-Medrol	Injection	Methylprednisolone 40–125 mg

Prednisolone and prednisone are closely related and often confused. Prednisone is inactive as swallowed and is converted by the liver into prednisolone, which does the work. Prednisolone is already active, so it does not depend on liver conversion — which is why it is preferred in liver disease, and why it is the form used in children’s syrup.

For most people the two are equivalent, and doses are interchangeable milligram for milligram.

Methylprednisolone is a related steroid, slightly more potent, available as tablets and as injections — including Depo-Medrol, a long-acting injection used into joints and soft tissue.

Corticosteroids work by switching off large parts of the inflammatory response at the level of the genes involved. That breadth is both their strength and their weakness: extremely effective against inflammation of almost any cause, and affecting nearly every body system while doing it.

What is Prednisolone commonly used for?

Asthma flare-ups, usually a short course of several days. This is one of its commonest uses.
Croup in children, where a single dose of prednisolone or dexamethasone reliably reduces severity — one of the clearest short-course benefits in paediatrics.
Severe allergic reactions, drug reactions and severe hay fever.
Rheumatoid arthritis, polymyalgia rheumatica, lupus and other autoimmune conditions.
Inflammatory bowel disease flares — Crohn’s and ulcerative colitis.
Severe eczema and other skin conditions.
Nephrotic syndrome, particularly in children.
Some cancers and blood disorders, as part of treatment.
Adrenal insufficiency, replacing hormone the body cannot make.
Preventing transplant rejection.

On the “prednisolone for cough” question, which is a common search: steroids are not a treatment for an ordinary cough. They are used where a cough is driven by airway inflammation — an asthma flare, croup, or a COPD exacerbation. A cough from a cold or a chest infection does not need a steroid, and taking one will not help.

A persistent cough lasting more than three weeks needs assessment, and in South Africa should prompt a TB check — especially with weight loss, night sweats or blood in the sputum.

Two shapes of use: a short course — often three to seven days — breaks a flare and can usually be stopped without tapering. Long-term use is different: it suppresses the body’s own cortisol production, and stopping abruptly then can be dangerous.

How Prednisolone fits into this medicine category

Group	Examples	What it does
Oral corticosteroids	Prednisolone, prednisone, methylprednisolone	Powerful, broad anti-inflammatory and immune suppression
Inhaled corticosteroids	Budesonide, fluticasone	Asthma control; act locally with far fewer body-wide effects
Topical corticosteroids	Hydrocortisone, betamethasone	Skin conditions
NSAIDs	Ibuprofen, diclofenac	Milder anti-inflammatory; different risks
Simple analgesics	Paracetamol (Donapan)	Pain and fever only
Disease-modifying drugs	Methotrexate, biologics	Long-term control of autoimmune disease

Prednisolone is often the bridge — settling a flare quickly while slower treatment takes effect. See the pain, inflammation and musculoskeletal medicines hub.

What to check before using Prednisolone

Do not stop a long course suddenly. After roughly three weeks of continuous use — sometimes less — the adrenal glands reduce their own cortisol production. Stopping abruptly can cause an adrenal crisis: severe weakness, vomiting, low blood pressure and collapse. Long courses must be tapered on a plan from your doctor.

Carry a steroid card on long-term treatment, and tell any doctor, dentist or paramedic.

Tell your doctor or pharmacist if you:

Have diabetes. Prednisolone raises blood sugar substantially, and treatment often needs adjusting during the course.
Have an active infection, including TB, or have had TB. Steroids suppress immunity and can reactivate dormant infection — a real consideration in South Africa.
Have high blood pressure, heart failure, stomach ulcers, glaucoma, cataracts, osteoporosis, epilepsy or liver or kidney disease.
Have a mental health condition. Steroids commonly cause mood changes, and occasionally psychosis.
Take anti-inflammatories, blood thinners, diabetes medicines, diuretics or anti-epileptics.
Are pregnant or breastfeeding.
Have not had chickenpox or measles and are exposed — these can be severe on steroids, and you should seek advice immediately.
Are due for any vaccination — live vaccines are generally avoided at higher doses.

Practical points: take it in the morning with food, which suits the body’s cortisol rhythm and reduces stomach upset and sleeplessness; complete the course as directed; and do not adjust the dose yourself.

Possible cautions and when to ask a pharmacist or doctor

Even short courses commonly cause increased appetite, difficulty sleeping, mood changes, indigestion, fluid retention and raised blood sugar.

Longer courses add weight gain and a rounder face, thinning skin and easy bruising, muscle weakness, osteoporosis, cataracts, glaucoma, higher blood pressure and greater susceptibility to infection. These are why courses are kept as short and as low-dose as the condition allows.

Get emergency help for:

Severe weakness, vomiting, dizziness or collapse, particularly after stopping or reducing a long course — possible adrenal crisis.
Severe abdominal pain, vomiting blood, or black tarry stools.
Signs of serious infection — high fever, breathlessness, confusion. Steroids mask the usual signs, so a modest fever may matter more than it looks.
Sudden vision changes or severe eye pain.
Severe mood disturbance, confusion or hallucinations.

Contact your doctor if blood sugars rise, if you feel unusually unwell, if mood changes trouble you, if symptoms return as the dose reduces, or if you are on long-term steroids and become ill or need surgery — the dose often needs increasing temporarily during illness, which is the opposite of what most people expect.

Related medicine guides

Frequently asked questions

What is prednisolone 5 mg used for? Suppressing inflammation and immune activity — asthma flares, croup, severe allergies, arthritis, inflammatory bowel disease and skin conditions. 5 mg is the standard tablet strength; higher daily doses are made up from several tablets.

Is prednisolone used for a cough? Only where the cough is driven by airway inflammation — an asthma flare, croup or a COPD exacerbation. It does not treat a cough from a cold or chest infection.

Is it the same as prednisone? Very close. Prednisone is converted by the liver into prednisolone. Prednisolone is already active, so it is preferred in liver disease and used in children’s syrup.

Can I stop when I feel better? For a short course, follow the instructions given. For a longer course, no — stopping suddenly can be dangerous and the dose must be tapered.

Why does it keep me awake and make me hungry? Both are common steroid effects. Taking the dose in the morning helps with sleep; appetite settles once the course ends.

Will it affect my diabetes? Yes, it commonly raises blood sugar. Monitor more closely and expect your diabetes treatment may need temporary adjustment.

Why was my child given a single dose for croup? A single dose of prednisolone or dexamethasone reliably reduces croup severity. It is one of the clearest short-course steroid benefits in children.

Do I need to carry anything? On long-term treatment, yes — a steroid card, and tell any clinician treating you.

What Is Prednisolone Used For?