Twice daily fractionated dose administration of prednisolone compared to standard once daily administration to patients with glomerulonephritis or with kidney transplants.

Abstract

BACKGROUND:

Pharmacokinetic half-life of prednisolone is 2-3 h, indicating short pharmacodynamic effect duration. Therefore, the fractionated twice daily administration of prednisolone might be favorable.

PATIENTS AND METHODS:

A 6-month observational study was conducted in a total of 51 patients, 35 with glomerulonephritis and 16 with kidney transplants. Low-dose and long-term prednisolone was given twice daily to 37 patients and once daily to 14 patients.

RESULTS:

The median dose (first-third quartile) for fractionated prednisolone was 2 x 1.25 mg/day (2.5-2.6) and significantly lower (p = 0.008) than the once daily standard dose of 1 x 4.0 mg/day (2.5-5.0). The number of comedications was also significantly lower in the fractionated dose group: 1.0 co-immunosuppressant (0.0-1.0) compared to 1.5 drugs (0.25-2.0) such as cyclosporine and/or mycophenolate (p = 0.017), and 0.0 antidiabetics (0.0-0.0) versus 0.0 drugs (0.0-0.75) such as gliquidone (p = 0.032). The fall in proteinuria was significant in the fractionated dose group with -0.12 g/l (-0.4-0.0) versus +0.08 g/l (-0.04-+0.24) in controls (p = 0.008).

CONCLUSION:

Twice daily fractionated administration of prednisolone allows a lower daily dose (total 2.5 mg/day), and appears to be as efficient but less diabetogenic compared to the standard once daily dosing (4.0 mg/day).

• Authors: Sebastian Oliver Decker, Frieder Keller, Jens Mayer, Sylvia Stracke
• Journal: Medizinische Klinik (Munich, Germany : 1983) (Med Klin (Munich)) Vol. 104 Issue 6 Pg. 429-33 (Jun 15 2009) ISSN: 1615-6722 [Electronic] Germany
• PMID: 19533049 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Hypoglycemic Agents
• Immunosuppressive Agents
• Prednisolone
• Calcium

Topics

• Adult
• Aged
• Calcium (blood)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Glomerulonephritis (blood, drug therapy)
• Humans
• Hypoglycemic Agents (administration & dosage, pharmacokinetics)
• Immunosuppressive Agents (administration & dosage, adverse effects, pharmacokinetics)
• Kidney Function Tests
• Kidney Transplantation
• Long-Term Care
• Male
• Metabolic Clearance Rate (physiology)
• Middle Aged
• Prednisolone (administration & dosage, adverse effects, pharmacokinetics)