Two recently synthesized and developed steroid hormones, prednisone and prednisolone, have given promise of having all the advantages of their precursors, cortisone and hydrocortisone, while obviating many of the undesirable side-effects of the older preparations.1,2 These side-effects, which were noticeable even with the short-term use of the older preparations, included sodium and water retention, potassium depletion, moon facies, and hypertension.
Prednisone is an analogue of cortisone, whereas prednisolone is a similar analogue of hydrocortisone. They are obtained by the dehydrogenation of the carbon atoms in Positions 1 and 2 of the steroid nucleus, resulting in a double bond between C1 and C2 (Fig.).
Clinically, they appear to have from three to five times the effect of cortisone and from two to four times the effect of hydrocortisone.3,4 There appears to be little difference between the clinical effectiveness or dosage of prednisone and of prednisolone.3-5 Therefore,