Difference Between Prednisone and Prednisolone

Prednisone and prednisolone are highly effective anti-inflammatory drugs. Both of them are steroidal anti-inflammatory drugs belonging to the drug class “corticosteroids”. These drugs are used to treat many conditions related to inflammatory response and also when performing organ transplants to avoid the body rejecting the new organ.


Prednisone is a corticosteroid used to treat skin conditions, arthritis, allergy disorders etc. Since it is a steroid, careful usage is crucial since some diseases are affected and triggered by steroids. A person should not use prednisone when he/she is allergic, have a fungal infection, or when using aspirin, water pills, diabetic medication, seizure medication etc. The dosage should be monitored closely. The need varies from person to person if they suffer from serious illnesses, have surgery or special medical emergencies.

The mechanism of action of prednisone is to prevent the release of inflammatory response signaling molecules. Prednisone is actually a pro-drug; inside the liver, it is converted to prednisolone; the actual active substance. Since prednisone drops inflammatory response, immune cells do not recognize the harmful situation inside the body. Therefore, in a way prednisone is lowering immunity. People who are taking prednisone should avoid being with sick people, especially measles or chickenpox which can be fatal. Taking “live” vaccines while under prednisone may not provide the expected protection from the diseases due to the reduced immunity.

Prednisone has many side effects such as eye pain, weight gain, severe depression, convulsions, high blood pressure etc. It is essential that a patient follows doctor’s advice accurately to get the maximum benefit of the drug without experiencing complications.


Prednisolone is very similar to prednisone. It is also used for the same types of diseases. Prednisolone is also a steroid. Therefore, the limitations to be considered when taking a steroid drug apply to prednisolone in a similar manner. Prednisolone also prevents inflammatory response signaling molecules getting released. It does not have to undergo enzymatic activation as it is already active.

Prednisolone has the same side effects and effects on the immune system like prednisone. Both the drugs when used in high doses for a long time show acne breakouts, abnormal growth of facial hair, menstrual cycle fluctuations, difference in shapes and deposits of body fat, skin thinning etc. Prednisolone is the preferred drug to be prescribed when a person has a weak liver, which makes it difficult to metabolize prednisone effectively. Prednisolone or prednisone administration should not be stopped at once. The dosage should be gradually reduced with time otherwise it may harm the adrenal glands. This phenomenon is referred to as “adrenal crisis”.

Prednisone vs prednisolone 

• Prednisone is a pro-drug which is activated to prednisolone inside the liver, but prednisolone is an active drug itself.

• Prednisone cannot be prescribed to patients who have weak liver conditions, but prednisolone can be prescribed because it doesn’t have to get activated in the liver.

• Prednisone and prednisolone have steroid- cores but their functional groups and their molecular weights are different.

• Prednisone is given orally, whereas prednisolone can be given orally, injection, or topical application.

• Prednisone’s effect is less in comparison to prednisolone.