In such patients, corticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia.Corticosteroids may exacerbate systemic fungal infections and therefore should not be used in the presence of such infections unless they are needed to control drug reactions.Corticosteroids may activate latent amebiasis. Human studies suggest a small but inconsistent increased risk of orofacial clefts with use of corticosteroids during the first trimester of pregnancy. Growth and development of pediatric patients on prolonged corticosteroid therapy should be carefully monitored.Prednisolone can cause fetal harm when administered to a pregnant woman. Losses of bone mineral density appear to be greatest early on in the course of treatment and may recover over time after steroid withdrawal or use of lower doses (i.e., ≤5 mg/day). Prednisolone has slight mineralocorticoid activity, whereby entry of sodium into cells and loss of intracellular potassium is stimulated. Select one or more newsletters to continue. However, the incidence of corticosteroid-induced side effects may be increased in geriatric patients and appear to be dose-related. These agents should be used with caution in patients with hypertension, congestive heart failure, or renal insufficiency.Literature reports suggest an association between use of corticosteroids and left ventricular free wall rupture after a recent myocardial infarction; therefore, therapy with corticosteroids should be used with caution in these patients.There is an increased risk of gastrointestinal (GI) perforation in patients with certain GI disorders. Prednisolone can stimulate secretion of various components of gastric juice. If after long term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.It is further recommended that short course, or "burst" therapy, be continued until a child achieves a peak expiratory flow rate of 80% of his or her personal best or symptoms resolve. If this drug is used during pregnancy, or if the patient becomes pregnant while using this drug, advise the patient about the potential harm to the fetus. The degree to which the dose, route and duration of corticosteroid administration correlates with the specific risks of infection is not well characterized, however, with increasing doses of corticosteroids, the rate of occurrence of infectious complications increases.Corticosteroids may mask some signs of infection and may reduce resistance to new infections.Chickenpox and measles can have a more serious or even fatal course in non-immune children or adults on corticosteroids. If a patient is exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If it is almost time for the next dose, the missed dose should be skipped and the medicine taken at the next regularly scheduled time. The blister pack should then be peeled open, and the orally disintegrating tablet placed on the tongue, where tablets may be swallowed whole as any conventional tablet, or allowed to dissolve in the mouth, with or without the assistance of water. Inform patients to take Orapred exactly as prescribed, follow the instructions on the prescription label, and not stop taking Orapred without first checking with their health-care providers, as there may be a need for gradual dose reduction.Patients should discuss with their physician if they have had recent or ongoing infections or if they have recently received a vaccine.Warn patients who are on immunosuppressant doses of corticosteroids to avoid exposure to chickenpox or measles. Appropriate diagnostic studies should be performed in patients with known or suspected peptic ulcer disease and in patients at risk for reactivation of latent tuberculosis infections.For the purpose of comparison, one 10 mg Orapred ODT tablet (13.4 mg prednisolone sodium phosphate) is equivalent to the following milligram dosage of the various glucocorticoids:Orapred ODT is contraindicated in patients who are hypersensitive to corticosteroids such as prednisolone or any components of this product.

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