information for parents and carers

Prednisolone for nephrotic syndrome

This leaflet is for parents and carers about how to use this with a small amount of soft food such as yogurt,
medicine in children. Our information sometimes differs from jam or mashed potato. Make sure your child
that provided by the manufacturers, because their information swallows it straight away without chewing. Do
is usually aimed at adults. Please read this leaflet carefully. not crush enteric-coated tablets. These have
Keep it somewhere safe so that you can read it again. a coating to protect the stomach and need to be
swallowed whole.
Dispersible tablets: Dissolve the tablet(s) in
Do not stop giving prednisolone suddenly, as water or fruit juice. Your doctor or pharmacist
your child is likely to become unwell. will have told you how much liquid to use, and
how much to give to your child. Make sure your
Name of drug child drinks it all straight away, using a medicine
Prednisolone spoon or oral syringe. Alternatively, these can be
swallowed as normal tablets. The solution is very
Brand names: Deltacortril
bitter and a strong tasting juice mixed with the
Why is it important for my child to take this medicine? solution or ready to take straight after may help.
In nephrotic syndrome, the kidneys leak protein into the urine
When should the medicine start working?
(wee). This causes oedema (swelling of the tissues due to
Prednisolone will not work straight away. After a few weeks,
extra water), often in the face and legs. Although it is often
the protein in the urine (seen on a urine dipstick test) and any
painless, the swelling may become uncomfortable or cause
swelling will have gone. However, your child should not stop
breathlessness and can cause high blood pressure.
taking the medicine, as continuing the treatment will reduce
Prednisolone is a steroid medicine that will get rid of the
the chance that their symptoms will come back.
protein in the urine and the extra water but it needs to be
Continue to give the medicine to your child during this time.
taken over a long period of time (months).
If you are worried about whether it is helping, contact your
What is prednisolone available as? doctor.
•• Tablets: 1 mg, 5 mg, 25 mg; these contain lactose Do not stop giving prednisolone suddenly.
•• Enteric-coated tablets: 2.5 mg, 5 mg; these contain
lactose What if my child is sick (vomits)?
•• Dispersible tablets: 5 mg •• If your child is sick less than 30 minutes after having a
If you have any concerns or questions, speak with your child’s dose of prednisolone, give them the same dose again.
doctor or pharmacist. •• If your child is sick more than 30 minutes after having
a dose of prednisolone, you do not need to give them
When should I give prednisolone? another dose. Wait until the next normal dose.
•• Prednisolone is usually given once each day. This is If your child is sick again, seek advice from your GP,
usually in the morning. pharmacist or hospital. They will decide what to do based on
Give the medicine at about the same time each day so that your child’s condition and the specific medicine involved.
this becomes part of your child’s daily routine, which will help
you to remember. What if I forget to give it?
Give the missed dose when you remember during the day, as
How much should I give? long as this is at least 12 hours before the next dose is due.
Your doctor will work out the amount of prednisolone (the Never give a double dose of prednisolone.
dose) that is right for your child. The dose will be shown on
the medicine label. What if I give too much?
After your child has taken prednisolone for some months,
It can be dangerous to give too much prednisolone.
your doctor may prescribe gradually smaller doses and/or tell
you to give the medicine on alternate days. If you think you may have given your child too much
It is important that you follow your doctor’s prednisolone, contact your doctor or local NHS services
instructions about how much to give. (details at end of leaflet).
Have the medicine or packaging with you if you telephone for
How should I give it? advice.
Tablets should be swallowed with a glass of
water, milk or juice. Your child should not chew
the tablet. You can crush the tablet and mix it
Are there any possible side-effects? •• Occasionally, prednisolone causes diabetes. If your
We use medicines to make our children better, but sometimes child seems more thirsty than normal, needs to pass
they have other effects that we don’t want (side-effects). urine (wee) often, or starts wetting the bed at night,
contact your doctor.
Side-effects you must do something about
There may, sometimes, be other side-effects that are
Prednisolone can cause ulcers in the stomach. Tell
not listed above. If you notice anything unusual and are
your doctor straight away if your child has bad
concerned, contact your doctor. You can report any suspected
stomach pain or repeated vomiting (being sick).
side-effects to a UK safety scheme at
If your child develops a rash or severe/unexplained http://yellowcard.mhra.gov.uk.
bruising, contact your doctor straight away, as there
may be a problem with your child’s blood. Can other medicines be given at the same time as
If your child has eye pain or changes in their vision, prednisolone?
contact your doctor straight away. •• You can give your child medicines that contain
Other side-effects you need to know about paracetamol or ibuprofen, unless your doctor has told
you not to.
•• Your child may have stomach ache, feel sick (nausea)
or be sick (vomit) or may have indigestion (heartburn). •• Prednisolone should not be taken with some medicines
Giving the medicine with some food may help. that you get on prescription. Tell your doctor and
pharmacist about any other medicines your child is
•• Your child may have an increased appetite and gain taking before giving prednisolone.
weight while taking prednisolone. You can help by
making sure your child has plenty of physical activity, •• Check with your doctor or pharmacist before giving any
and by offering fruit and vegetables and low-calorie other medicines to your child. This includes herbal or
food, rather than food that is high in calories (e.g. cakes, complementary medicines.
biscuits, sweets, crisps).
Is there anything else I need to know about this
•• Your child may have trouble sleeping and nightmares
medicine?
and may feel depressed, or their behaviour may change
In a very few cases, children become very unwell
in other ways. Contact your doctor for advice if you are
when they stop or reduce the amount of any steroid
concerned.
medicine they are taking, including prednisolone
•• All steroid medicines, including prednisolone, may (in high doses). If you are at all worried about this,
affect the adrenal glands so that they produce less of
contact your doctor.
a hormone called cortisol when the body is stressed
(e.g. during illness or injury). This means that your child •• The use of steroids in children receives a lot of bad
press. However, use of prednisolone in nephrotic
may have more difficulty fighting off an infection, or may
syndrome provides a lot of benefit, and is unlikely to
recover less quickly from injury or after surgery.
cause any long-term harm as long as you use the
Side-effects with high doses or long courses medicine as your doctor has told you to. If you are at all
•• Prednisolone can slow growth and affect puberty. It can worried, talk to your doctor or pharmacist.
also cause growth of body hair and irregular periods If your child has been taking prednisolone for
in girls. Your doctor will check your child’s growth and longer than 3 weeks, they should not usually stop
development. If you have any concerns, talk to your taking the medicine suddenly because they will get
doctor. withdrawal symptoms: they will feel unwell, dizzy
•• Your child may be more at risk of severe infections. They and thirsty and may be sick (vomit). Your doctor will
should stay away from anyone with an infection (such give you more advice.
as chicken pox, shingles, measles) if they have not had •• If your doctor wants to stop prednisolone, they will
these illnesses or have not been vaccinated. Contact reduce the dose gradually before stoppng it completely.
your doctor for advice if they have been in contact Make sure you follow your doctor’s instructions.
with someone who has an infection, as they may need
preventative treatment
•• The doctor or pharmacist may give your child a steroid
card, which contains useful information about what to do
•• If your child is unwell and you are worried about an if your child becomes unwell. Your child should keep this
infection, contact your doctor straight away. with them at all times.
•• Your child’s skin may become thinner, and heal more •• Your child usually cannot have live vaccines while
slowly than usual. Acne (spots) may become worse on prednisolone. If your child is due to have an
or your child may develop mouth ulcers or thrush immunisation (vaccination), tell the nurse or doctor that
(candidiasis). If you are concerned, contact your doctor. they are taking prednisolone.
•• Your child may develop problems with their hip bones •• Your child may need to take an antibiotic called
or their bones may become weaker (osteoporosis). penicillin V to prevent pneumococcal infection – see the
The muscles around the hips and shoulders may also Medicines for Children website for a leaflet.
become weaker. If your child has any difficulty walking
or moving around, contact your doctor.

Page 2 of 3
General advice about medicines Who to contact for more information
•• Try to give medicines at about the same times each day, Your doctor, pharmacist or nurse will be able to give you more
to help you remember. information about prednisolone and about other medicines
•• If you are not sure a medicine is working, contact your used to treat nephrotic syndrome.
doctor but continue to give the medicine as usual in You can also get useful information from:
the meantime. Do not give extra doses, as you may do England: NHS 111
harm. Tel 111 - www.nhs.uk
•• Only give this medicine to your child. Never give it to
anyone else, even if their condition appears to be the Scotland: NHS 24
same, as this could do harm. Tel 111 - www.nhs24.scot
If you think someone else may have taken the
medicine by accident, contact your doctor straight Wales: NHS Direct
away. Tel 111 - www.111.wales.nhs.uk
•• Make sure that you always have enough medicine.
Northern Ireland: NI Direct
Order a new prescription at least 2 weeks before you
www.nidirect.gov.uk
will run out.
•• Make sure that the medicine you have at home has infoKID: Information for parents and carers about
not reached the ‘best before’ or ‘use by’ date on the children’s kidney conditions
packaging. Give old medicines to your pharmacist to www.infoKID.org.uk
dispose of.
Nephrotic Syndrome in Children Support Group
Where should I keep this medicine? 01823 652 886 - www.nephrotic.co.uk
•• Keep the medicine in a cupboard, away from heat and
direct sunlight. It does not need to be kept in the fridge. British Kidney Patient Association
•• Make sure that children cannot see or reach the 01420 541 424 - www.britishkidney-pa.co.uk
medicine.
National Kidney Federation
•• Keep the medicine in the container it came in.
0845 601 02 09 - www.kidney.org.uk

www.medicinesforchildren.org.uk

Version 1, November 2013. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: November 2016
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us
through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is
important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may
not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the
contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading
this leaflet.