Last update: June 13, 2021

Prednisone

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Prednisone is a biologically inert corticosteroid that is metabolized in the liver to its active form, prednisolone, with primarily glucocorticoid effects.
Oral and ophthalmic administration.

It is excreted in breast milk in clinically insignificant amount (Ryu 2018, Berlin 1979, Katz 1975) and no problems reported in breastfed infants whose mothers were treated at a daily dose as high as 10 mg for a long time period (Constantinescu 2014, Correia 2010, Moretti 2003, Muñoz 2001, Nyberg 1998, Ito 1993). At a daily dose of 60 mg no harm effects on breastfed infants have been reported (Correia 2010).

On long term treatments or in high doses some authors recommend to wait for 4 hours until the next nurse to minimize the transfer of drug to breast milk (Sammaritano 2020 & 2014, Götestam 2016, van der Woude 2015 & 2010, Durst 2015, Huang 2014, Bae 2012, Habal 2012, Van Assche 2010, Heetun 2007).

At high doses, intra-articular treatment with other steroid drugs (Methylprednisolone, Triamcinolone) have transiently affected milk production (Babwah 2013, McGuire 2012).
Steroids administered before delivery may delay initiation of phase II of Lactogenesis ("milk come in") and decrease milk production in the first postpartum week (Henderson 2008).

Steroid drugs are commonly used for Pediatric treatment with no side effects when infrequently used and for short-time periods.

Several medical societies, experts and expert consensus, consider the use of prednisone/prednisolone to be safe during breastfeeding (LactMed, Hale, Nguyen 2016, Götestam 2016, Flint 2016, Noviani 2016, Shah 2016, McConnell 2016, Bordini 2016, Huang 2016 & 2014, Briggs 2015, Schaefer 2015, van der Woude 2015 & 2010, Durst 2015, Yarur 2013, Bae 2012, Habal 2012, Jain 2011, Van Assche 2010, Mottet 2009, Heetun 2007, N.Asthma 2004, Janssen 2000, Goldsmith 1989, Needs 1985).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Ophthalmic administration is fully compatible with breastfeeding.


See below the information of this related product:

Alternatives

We do not have alternatives for Prednisone since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Prednisone is also known as


Prednisone in other languages or writings:

Groups

Prednisone belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Prednisone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 92 %
Molecular weight 358 daltons
Protein Binding 70 %
VD 0,4 - 1 l/Kg
pKa 12,58 -
Tmax 1 - 2 hours
T1/2 3 hours
M/P ratio 0,25 - 0,5 -
Theoretical Dose 0,02 - 0,09 mg/Kg/d
Relative Dose 2 - 4,5 %
Relat.Ped.Dose 2 - 4,5 %

References

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  2. Ryu RJ, Easterling TR, Caritis SN, Venkataramanan R, Umans JG, Ahmed MS, Clark S, Kantrowitz-Gordon I, Hays K, Bennett B, Honaker MT, Thummel KE, Shen DD, Hebert MF. Prednisone Pharmacokinetics During Pregnancy and Lactation. J Clin Pharmacol. 2018 Sep;58(9):1223-1232. Abstract
  3. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. Huang VW, Chang HJ, Kroeker KI, Goodman KJ, Hegadoren KM, Dieleman LA, Fedorak RN. Management of Inflammatory Bowel Disease during Pregnancy and Breastfeeding Varies Widely: A Need for Further Education. Can J Gastroenterol Hepatol. 2016;2016:6193275. Epub 2016 Sep 20. Abstract Full text (link to original source) Full text (in our servers)
  5. Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. Abstract Full text (link to original source) Full text (in our servers)
  6. Flint J, Panchal S, Hurrell A, van de Venne M, Gayed M, Schreiber K, Arthanari S, Cunningham J, Flanders L, Moore L, Crossley A, Purushotham N, Desai A, Piper M, Nisar M, Khamashta M, Williams D, Gordon C, Giles I; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 2016 Sep;55(9):1693-7. Abstract Full text (link to original source) Full text (in our servers)
  7. McConnell RA, Mahadevan U. Pregnancy and the Patient with Inflammatory Bowel Disease: Fertility, Treatment, Delivery, and Complications. Gastroenterol Clin North Am. 2016 Abstract
  8. Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016 Aug;25(9):973-9. Abstract
  9. Nguyen GC, Seow CH, Maxwell C, Huang V, Leung Y, Jones J, Leontiadis GI, Tse F, Mahadevan U, van der Woude CJ; IBD in Pregnancy Consensus Group. The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy. Gastroenterology. 2016 Mar;150(3):734-757.e1. Abstract Full text (link to original source) Full text (in our servers)
  10. Shah S, Verma P. Overview of Pregnancy in Renal Transplant Patients. Int J Nephrol. 2016;2016:4539342. Abstract
  11. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
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  14. van der Woude CJ, Ardizzone S, Bengtson MB, Fiorino G, Fraser G, Katsanos K, Kolacek S, Juillerat P, Mulders AG, Pedersen N, Selinger C, Sebastian S, Sturm A, Zelinkova Z, Magro F; European Crohn’s and Colitis Organization. The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. J Crohns Colitis. 2015 Feb;9(2):107-24. Review. Abstract Full text (link to original source) Full text (in our servers)
  15. Huang VW, Habal FM. From conception to delivery: managing the pregnant inflammatory bowel disease patient. World J Gastroenterol. 2014 Abstract Full text (link to original source) Full text (in our servers)
  16. Constantinescu S, Pai A, Coscia LA, Davison JM, Moritz MJ, Armenti VT. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1163-73. Abstract
  17. Sammaritano LR, Bermas BL. Rheumatoid arthritis medications and lactation. Curr Opin Rheumatol. 2014 Abstract
  18. Yarur A, Kane SV. Update on pregnancy and breastfeeding in the era of biologics. Dig Liver Dis. 2013 Oct;45(10):787-94. Abstract Full text (link to original source) Full text (in our servers)
  19. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Dec;19(4):248-50. Abstract
  20. Bae YS, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo B Jr, Kimball AB; National Psoriasis Foundation. Review of treatment options for psoriasis in pregnant or lactating women: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2012 Abstract
  21. Habal FM, Huang VW. Review article: a decision-making algorithm for the management of pregnancy in the inflammatory bowel disease patient. Aliment Pharmacol Ther. 2012 Abstract Full text (link to original source) Full text (in our servers)
  22. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Mar;20(1):32-4. Review. Abstract
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  25. van der Woude CJ, Kolacek S, Dotan I, Oresland T, Vermeire S, Munkholm P, Mahadevan U, Mackillop L, Dignass A; European Crohn's Colitis Organisation (ECCO). European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis. 2010 Abstract Full text (link to original source) Full text (in our servers)
  26. Correia LM, Bonilha DQ, Ramos JD, Ambrogini O, Miszputen SJ. Inflammatory bowel disease and pregnancy: report of two cases treated with infliximab and a review of the literature. Eur J Gastroenterol Hepatol. 2010 Abstract
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  29. Heetun ZS, Byrnes C, Neary P, O'Morain C. Review article: Reproduction in the patient with inflammatory bowel disease. Aliment Pharmacol Ther. 2007 Abstract Full text (link to original source) Full text (in our servers)
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  40. Katz FH, Duncan BR. Letter: Entry of prednisone into human milk. N Engl J Med. 1975 Nov 27;293(22):1154. No abstract available. Abstract
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