> Patients who are on prednisolone have to come off this drug prior to carrying out a Synacthen test.
> ?how long.
> Anecdotely we say about a week---but have no evidence for this.
> Does anyone have any references to this?
> Thanks
> Sharon Russell
The mean half life of prednisolone is 2.8 hours although it is
prolonged with cyclosporine and oral contraceptive therapy.
see:
Dollery (ed) Therapeutic Drugs 2nd edit 1999
Clin Pharmacol Therap 1986;39:425-9
Our recommendation is to replace the prednisolone 24 hours earlier
with dexamethasone or hydrocortisone and miss the morning dose before
the test since it is unknown what the degree of interference is due
to metabolites of prednisolone.
However, why do the test anyway? There are well established
protocols for the withdrawal of prednisolone and there are no good
data for appropriate responses during corticosteroid therapy.
Julian Barth
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Julian H Barth
Department of Chemical Pathology & Immunology
Leeds General Infirmary
Leeds LS1 3EX
tel 0113-392-3416
fax 0113-233-5672
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