High-Concentration Liquid Prednisolone Formula: Filling a Therapeutic Niche in Severe Acute Attacks of Urticaria and Angioedema.

Background/aims: According to current guidelines, the emergency kit for patients with severe urticaria and/or angioedema should include a corticosteroid with a prednisolone-equivalent of 50-100 mg. Since severe dysphagia may occur in anaphylaxis, liquid corticosteroids are advantageous. Presently, only liquid preparations with less than 100 mg prednisolone equivalent are available worldwide.

Methods: We prepared a highly concentrated liquid prednisolone formula for oral administration (1 or 5 mg prednisolone per ml). We observed efficacy and safety of 100 mg or >250 mg liquid oral prednisolone in comparison to intravenous administration (250 mg prednisolone) in 53 patients with urticaria and/or angioedema.

Results: The symptom control achieved with oral administration was comparable to that obtained with intravenous therapy, with remission of at least 50% of the symptoms in less than 30 min. No side effects occurred during the treatment period.

Conclusion: The liquid prednisolone formula is an additional therapeutic rescue medication in dermatological emergency medicine, filling a therapeutic niche for patients who need high-concentration liquid prednisolone. It is suitable for self-administration emergency kits in children and adults, in accordance with current guidelines.