From the Guidelines
Prednisolone can cause significant side effects in children, including growth suppression, weakened bones, and adrenal suppression, and its use should be carefully monitored and managed to minimize these risks. The most common side effects of prednisolone in children include increased appetite, weight gain, mood changes (irritability, hyperactivity), sleep disturbances, and facial puffiness (moon face) 1. Short-term use may also cause stomach upset, headaches, and increased susceptibility to infections. With longer use, more serious side effects can develop, including high blood pressure, elevated blood sugar, and adrenal suppression. The risk and severity of side effects typically depend on the dose, duration of treatment, and individual factors. Higher doses and longer treatment periods increase the likelihood of experiencing side effects.
Some key points to consider when using prednisolone in children include:
- The dose and duration of treatment should be carefully managed to minimize the risk of side effects 1
- Parents should monitor their child closely while on prednisolone and report any concerning symptoms to their doctor immediately 1
- Never stop prednisolone suddenly as this can cause withdrawal symptoms; the medication typically requires gradual tapering under medical supervision 1
- Alternative treatments, such as budesonide, may be considered in some cases to minimize the risk of side effects 1
- Regular monitoring of the child's growth, bone density, and other health parameters is essential to minimize the risk of long-term side effects 1
Overall, the use of prednisolone in children requires careful consideration and management to minimize the risk of side effects and ensure the best possible outcomes. Healthcare providers should prioritize the use of the lowest effective dose for the shortest time necessary to achieve the desired therapeutic effect.
From the FDA Drug Label
The adverse effects of prednisolone in pediatric patients are similar to those in adults (see ADVERSE REACTIONS) Like adults, pediatric patients should be carefully observed with frequent measurements of blood pressure, weight, height, intraocular pressure, and clinical evaluation for the presence of infection, psychosocial disturbances, thromboembolism, peptic ulcers, cataracts, and osteoporosis Children who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity.
The side effects of prednisolone in kids are similar to those in adults and include:
- Decrease in growth velocity
- Potential effects on blood pressure, weight, and height
- Risk of infection, psychosocial disturbances, thromboembolism, peptic ulcers, cataracts, and osteoporosis It is recommended to monitor the linear growth of children treated with corticosteroids and titrate to the lowest effective dose to minimize potential growth effects 2.
From the Research
Side Effects of Prednisolone in Kids
- Growth suppression is a unique side effect of prednisolone in children, which can be helped by alternate day treatment 3
- Administration of small doses of prednisolone (10-15 mg/day) can minimize side effects on growth velocity 3
- The potency of dexamethasone and betamethasone in suppressing growth is nearly 18 times higher than that of prednisolone 3
- Short courses of oral steroids (less than two weeks) in children are very unlikely to cause long-term side effects, including those related to prednisolone 4
- Children requiring courses more than two weeks' duration warrant specialist referral and a weaning plan to reduce adrenal suppression and insufficiency 4
- Prolonged prednisolone use was associated with a sustained decrease in pulmonary severity score without adverse effects on growth measurements in preterm infants 5
- Corticosteroids, including prednisolone, can cause reduction in growth, weight gain, behavioral changes, and immunosuppression resulting in infection in children 4