Prednisolone Antacids

Prednisolone [Corticosteroid] [See Steroids and Table VI-1] Interactions T Effects W/ clarithromycin, erythromycin, estrogen, ketoconazole, OCPs, troleandomycin X effects W/ antacids, aminoglutethimide, barbiturates, cholestyramine, colestipol, phenytoin, rifampin X effects OF anticoagulants, hypoglycemics, INH, salicylates, vaccine toxoids EMS Infxns may be masked OD May cause wt gain, T hair growth, acne, HTN, peripheral edema, and sore muscles symptomatic and supportive... 

Clinically important, potentially hazardous interactions with alfuzosin, alprazolam, amphotericin B, anisindione, antacids, aprepitant, astemizole, atorvastatin, bosentan, ciclesonide, cimetidine, clorazepate, conivaptan, cyproterone, dasatinib, dexamethasone, dicumarol, didanosine, eplerenone, erythromycin, ethotoin, fentanyl, fesoterodine, fosamprenavir, fosphenytoin, grapefruit juice, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lovastatin, mephenytoin, methylprednisolone, micafungin, midazolam, nilotinib, pimozide, prednisolone, prednisone, quinidine, rifampin, rimonabant, rivaroxaban, sildenafil, silodosin, simvastatin, sirolimus, solifenacin, temsirolimus, terfenadine, tolvaptan, triazolam, vardenafil, vinblastine, vincristine, warfarin... 

It seems desirable to administer prednisone and prednisolone in conjunction with nonabsorbable antacids. This affords improvement of long-term therapy. It appears that the therapeutic indices of these two analogues, especially when used in conjunction with nonabsorbable antacids, are higher than those for the naturally occurring glucocorticoids. 

The absorption of prednisone, and probably prednisolone, can be reduced by lai e but not small doses of aluminium/magnesium hydroxide antacids. Dexamethasone absorption is reduced by magnesium trisilicate. 

Tanner AR, Caffm JA, Halliday JW, Powell LW. Concurrent administration of antacids and prednisone effect on serum levels of prednisolone. BrJ Clin Pharmacol (1979) 7,397-400. 

Lee DAH, Taylor GM, Walker JG, James VHT. The effect of concurrent administraticn of antacids on prednisolone absorption. BrJ Clin Pharmacol (1979) 8,92. ... 

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