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Why it's used

Prednisolone is used to treat certain types of allergies, inflammatory conditions, autoimmune diseases, skin and eye diseases, and cancers. This includes asthma, multiple sclerosis, rheumatoid arthritis, nephrotic syndrome, leukemia, and lymphoma. This medicine works by blocking the response of certain inflammatory cells that cause swelling, redness and pain in the body. Prednisolone is also used to reduce the pain from certain aggressive forms of cancers such as acute leukemia and aggressive lymphomas, and to treat certain endocrinal conditions like decreased hormone production of the adrenal gland and swelling of the thyroid gland.
Corticosteroid
Prednisolone is a prescription medicine that belongs to a class of medicines called Corticosteroid. Corticosteroids are medicines that are used to provide relief for inflammation in the body. They reduce swelling, redness, itching, and certain allergic reactions. They are often used to treat severe skin problems, asthma, and arthritis. Corticosteroids can have side-effects that are very serious as they are very strong medicines.

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How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Prednisolone, ask your doctor or pharmacist. Use Prednisolone as per the instructions provided by your doctor.
Prednisolone is used with food. To prevent irritation in the stomach and intestines. Swallow the whole tablet with or without water. Do not break, chew or split the tablet.

Typical Dosage

The typical dose of Prednisolone for adults is 10-60 mg a day depending on the specific disease and its severity. This medicine is generally used for a period of 3-10 days for asthma. This medicine is not known to be addictive or habit-forming.
Prednisolone should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
If using the orally-disintegrating form of this medicine, make sure you do not consume any food or fluid 5 minutes before or after taking this medicine. Before taking the medicine out of the package, wash your hands thoroughly. Place the medicine on the tongue. Make sure you do not chew or swallow the medicine. You do not need to drink water after consuming the medicine. In certain cases, the medicine can taste slightly bitter. Also, ensure that you do not break or split the medicine.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
When used in the injection form, this medicine is given directly into muscles (intramuscular), joints (intra-articular), or around the body joints (periarticular route).

Talk to Your Doctor

Discuss with your doctor if your condition worsens. Consult with your doctor before stopping the use of Prednisolone.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. A lower dose of this medicine may be recommended to reduce the risk of side-effects. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
When stopping this medicine, some patients may experience withdrawal symptoms like an insufficient production of steroid hormones (adrenal insufficiency), and low blood pressure. You may need to taper (gradually decrease) the dose of this medicine when stopping.

Use in Children

If you are giving Prednisolone to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Avoid licorice while using Prednisolone.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Prednisolone for conditions or symptoms for which it was not prescribed. Do not give Prednisolone to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.

Storage

Follow storage instructions on the product package if available. Store Prednisolone at room temperature 20-25ºC (68-77ºF), away from moisture, and away from light. Store this medicine away from children and pets.

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How to take Prednisolone

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Prednisolone depends on the following factors:
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed
  • response to treatment

Prednisolone Dosage

Dosage for multiple sclerosis

Adult
  • Recommended: 200 mg/day for a week, followed by 80 mg/day every other day for one month
Children
  • Initial: 0.14 mg-2 mg/kg (0.06 mg-0.9 mg/lb of body weight) daily in 3-4 divided doses depending on the severity

Dosage for nephrotic syndrome

Children
  • Recommended: 60 mg/m2 bsa/day given in three divided doses for 4 weeks and 40 mg/m2 bsa/day single dose should be given on alternate days for 4 weeks

Dosage for asthma

Children
  • Recommended: 1-2 mg/kg (0.4-0.9 mg/lb of body weight) daily in single or divided doses for 3-10 day bursts

Dosage for allergic and skin disorders

Adult
  • Initial: 5-15 mg/day

Dosage for collagenosis

Adult
  • Initial: 20-30 mg/day

Dosage for rheumatoid arthritis

Adult
  • Initial: 10-15 mg/daily

Dosage for lymphoma

Adult
  • Initial: 15-60 mg/day

Dosage for blood disorders

Adult
  • Initial: 15-60 mg/day

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Orally disintegrating tablets
Strength: 10 mg, 15 mg, 30 mg
Tablet
Strength: 5 mg
Suspension for Injection
Strength: 25 mg/ml
Syrup
Strength: 15 mg/5 ml, 10 mg/3.3 ml, 7.5 mg/2.5 ml, 5 mg/1.6 ml

Special Instructions

Eye drops
Shake the bottle well before use and avoid touching the dropper tip against the eye. Close your eyes for 2-3 minutes after inserting an eye drop. If you have poured more than one drop in the same eye, wait for at least 5 minutes before inserting the next drop.
Eye ointment
Thoroughly wash your hands with soap and water. Avoid contact of the tip of the tube against your eye. Generally, a 1/2-inch strip of ointment is used for the effectiveness, unless directed by your doctor. Close your eyes for 1 to 2 minutes to allow the medicine to be fully absorbed.
Injection (intramuscular and intra-articular)
The dose of intra-articular injection depends upon the size of the affected joints. Not more than three joints can be treated in a day. Similarly, the dosage of intramuscular injection depends upon the severe conditions of the disease and response to this medicine.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Prednisolone?
If you have taken more than the recommended dose of Prednisolone, get medical treatment immediately. In the case of long-term intoxication, vomiting and cleaning out the contents of the stomach (gastric lavage) may help to reduce the toxic effects. Continuous steroid therapy is required to decrease overdose symptoms of Prednisolone.
Symptoms of an overdose of Prednisolone
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • abnormal enlargement of the liver
  • abnormal fat deposits
  • acne
  • decreased blood potassium level
  • decreased glucose tolerance
  • decreased resistance to infection
  • dry scaly skin
  • excessive hair growth (hypertrichosis)
  • fluid build up inside the body
  • fractures
  • headache
  • high blood pressure
  • increase in appetite
  • increased heartbeat
  • increased sweating
  • inflammation of a vein due to the blood clot formation (thrombophlebitis)
  • insufficient production of cortisol hormone (adrenal insufficiency)
  • irregular periods (accentuated menopausal symptoms)
  • low bone density (osteoporosis)
  • menstrual disorders
  • mental illness
  • pain from nerve damage (neuropathy)
  • skin coloration (pigmentation)
  • skin discoloration (ecchymosis)
  • skin marks during pregnancy (striae)
  • stomach ulcer
  • swelling of the abdomen (abdominal distention)
  • thinning of scalp hair
  • weakness
  • weight gain
If you think you have overdosed on Prednisolone, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Prednisolone

Before you use Prednisolone, tell your doctor of your medical and health history including the following:
  • a family history of diabetes
  • abnormal functioning of kidneys
  • chickenpox
  • congestive heart failure
  • epilepsy
  • glaucoma
  • high blood pressure
  • liver failure
  • measles
  • patients with blood clotting disorders
  • patients with hypothyroidism
  • recurrent episodes of heart attack
  • severe mood disorders
  • stomach ulcers
  • tuberculosis
  • weakened immune system
  • weakness in skeletal muscles
  • women with weakened and brittle bones after menstruation
Before you use Prednisolone, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Prednisolone may change intraocular pressure. Use of this medicine may increase the fluid pressure inside the eyes (intraocular pressure).
The use of this medicine may change blood pressure. Use of this medicine may lead to an increase in blood pressure.
The use of Prednisolone may change bone density. Use of this medicine leads to a decrease in bone density. Proper monitoring is required in patients who are receiving long-term corticosteroid treatment.
The use of this medicine may change sodium, and potassium levels in the blood. Use of this medicine may increase sodium and potassium levels in the blood.

Use when Pregnant

Consult with your doctor on the use of Prednisolone during pregnancy or if you are planning to become pregnant. Use of Prednisolone during the first trimester of pregnancy may increase the risk of congenital abnormalities of mouth and lips, restricted growth of the fetus in uterus and decrease in birth weight.

If Breastfeeding

Consult with your doctor on the use of Prednisolone during breastfeeding. This medicine may pass into breast milk. Hence caution should be exercised when using Prednisolone while breastfeeding, especially when using it for a long period of time.

If trying to Conceive

Consult with your doctor on the use of Prednisolone, if you are trying to conceive.

Seizures

Prednisolone can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Prednisolone can worsen the sleepiness. Prednisolone may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may cause stomach bleeding. Regular use of tobacco or alcohol may increase the risk. Discuss with your doctor if you smoke and drink alcohol regularly. Prednisolone can increase your risk of getting infections/worsen existing infections. Reduce your chances of getting new infections by washing your hand regularly. Prevent cuts, bruises or injuries. Avoid people who may have infectious diseases. Avoid getting vaccinated. Corticosteroids may increase the risk of infection if you are suffering from chickenpox, measles and Strongyloides threadworm infestation (intestinal infection). Hence use this medicine with proper care in such patients.

Side-effects in Older Patients

Older patients may have a higher incidence of side-effects when using Prednisolone. Elderly patients may see an increased risk of high blood glucose level, high blood pressure, low potassium level in the blood, low bone density (osteoporosis), more exposure to infections, and skin thinning.

Side-effects in Children

Younger patients may have a higher incidence of side-effects with Prednisolone. Younger patients may see an increased risk of delayed growth and development.

Long-term Use

Use of this medicine for long-term may increase the risk of damage to the optic nerve (glaucoma), high blood pressure, low bone density, diabetes, low potassium levels in the blood, more exposure to infection and skin thinning particularly in elderly patients. In children, this medicine may lead to delayed growth and development.

Prednisolone Side-effects

The following side-effects may commonly occur when using Prednisolone. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
  • behavioural and mood changes
  • fluid buildup inside the body (fluid retention)
  • glucose intolerance
  • high blood pressure
  • increased appetite
  • problem with the excretion of sodium from the body (sodium retention)
  • weight gain
The following side-effects may commonly occur in older patients on the use of Prednisolone. Discuss with your doctor if any of these side-effects last for a long time or are severe:
The following side-effects may commonly occur in children when using Prednisolone. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • delay in growth and development (growth retardation)
Rarely, the use of Prednisolone may cause the following side-effects:
  • a small opaque or cloudy area on the backside of the lens (posterior subcapsular cataracts)
  • abnormal fat deposits
  • abnormally enlarged liver (hepatomegaly)
  • acne
  • bleeding in stomach and intestine
  • bluish discoloration of skin due to trauma (ecchymose)
  • decrease in carbohydrate tolerance
  • disturbed blood flow due to fat deposits in the blood vessels (fat embolism)
  • dry scalp
  • emotional instability
  • expended abdomen due to accumulated gas or fluid (abdominal distention)
  • extreme happiness (euphoria)
  • eye bulbing (exophthalmos)
  • facial puffiness
  • facial redness
  • failure of heart circulation (circulatory collapse)
  • fainting
  • feeling of discomfort
  • fluid build up in lungs
  • fracture of long bones
  • growth retardation in children
  • headache
  • heart enlargement
  • hiccups
  • improper wound healing
  • inadequate pigmentation of the skin (hyper or hypopigmentation)
  • increased liver enzyme levels in the blood
  • increased pressure inside the eye
  • increased pressure within or around the brain
  • increased sweating
  • inflammation of the pancreas (pancreatitis)
  • inflammation of veins due to the blood clot formation (thrombophlebitis)
  • insomnia
  • loss of body balance (vertigo)
  • loss of heart functioning (cardiac arrest)
  • loss of muscle mass
  • loss of sensation in foot and ankle (Charcot-like arthropathy)
  • menstrual abnormalities
  • mood changes
  • moon-like face
  • muscle weakness
  • nausea
  • negative nitrogen balance due to protein catabolism
  • nerve inflammation (neuritis)
  • pain caused by nerve damage (neuropathy)
  • palpitation
  • partial loss of function in lower body parts (paraparesis)
  • personality changes
  • red or purplish spots on the skin (petechiae)
  • sensory disorders
  • separation of tendon from body tissues (tendon rupture)
  • skin rashes
  • skin rashes with itchy and raised bumps
  • skin thinning
  • slow heart rate (bradycardia)
  • spinal compression fractures
  • stretch marks (striae)
  • suppressed reactions to skin tests
  • swelling in body parts
  • thickening of heart muscles in premature babies (hypertrophic cardiomyopathy)
  • thin fragile skin
  • thinning of scalp hair
  • tingling sensation
  • unwanted hair growth on female body (hirsutism)
  • weakened and brittle bones (osteoporosis)
  • weight gain
The following severe side-effects may also occur when using Prednisolone:
  • Neurological diseases such as painful inflammation in the spinal cord (arachnoiditis), inflammation of the brain and spinal cord (meningitis) and nerve damage (neuropathy)
  • Bleeding in stomach and intestines
  • Life-threatening allergic reaction (anaphylaxis)
  • Heart diseases such as heart attack, abnormal heartbeat, clot formation in the blood vessels (thromboembolism) and inflammation of the blood vessels (vasculitis)
Your doctor has prescribed Prednisolone because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Prednisolone.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Alterations in Endocrine Functioning

Corticosteroids can cause hormone (hypothalamic-pituitary-adrenal axis) suppression and glucocorticosteroid insufficiency after withdrawal of treatment. This type of insufficiency may continue for months after discontinuation of therapy and can cause mineralocorticoid imbalance. Mineralocorticoid supplementation should be used to overcome the effects of corticosteroid therapy.

Increased Risk of Infections

Use of corticosteroids increases the risk of infections. The body's ability to fight new infections is reduced and existing infections may get masked. These infections include tubercolosis, chickenpox, measles, threadworm infestations, amebiasis and cerebral malaria. You should discuss with your doctor if you have a history, infection or exposure to any of these or other infections.

Patients with Heart/Kidney Dysfunction

Corticosteroids can increase blood pressure, salt or water retention, and also increases potassium and calcium secretion. Potassium supplementation and dietary salt restriction may be necessary for patients with high blood pressure, congestive heart failure, or kidney insufficiency. In such patients, these agents should be used with precaution.

History of Stomach and Intestine Related Disorders

Patients with a history of stomach and intestine related health problems are at a higher risk of getting holes in the stomach or intestines. Corticosteroids also mask signs if such an injury has already occurred.

Behavioral and Mood Changes

Prednisolone can cause behavioral and mood changes including depression, mood swings, insomnia, euphoria, and other personality changes. This medicine can also worsen existing behavioral problems. Consult with your doctor if you see such behavioral changes or have existing behavioral disorders to discuss the impact of this medicine.

Risk of Osteoporosis

Children, young adults and women who are undergoing or have undergone menopause are at a higher risk. Corticosteroids decrease bone formation because of decreased absorption and increased removal of calcium in the body. This increases the risk of osteoporosis in children, young adults and women who are undergoing or have undergone menopause.

Impact on Eye Health

Long term use of this medicine increases the risk of cataracts, glaucoma, damage to the optic nerves, and infections of the eye. Monitoring of the pressure in the eyes called as intraocular pressure should be performed if this medicine is used for more than 6 weeks. Avoid the use of Prednisolone if you have an eye infection called as ocular herpes simplex.

Live or Live Attenuated Vaccines

Such patients are at increased risk of developing complications because of a lack of immunity in the body. Live vaccines against smallpox (variola infection) should not be given to patients who are receiving immunosuppressive doses of corticosteroids.

Development Problems in Children

Long term use of Prednisolone is linked to negative effects on growth and development in children. Monitor for such effects especially if using this medicine for a long time.

Use in Pregnancy

Using this medicine during pregnancy or if you become pregnant when using this medicine may cause serious health issues in the unborn child. Such effects occur if this medicine is used during the first three months of the pregnancy.

Neuromuscular Effects

Patients using high doses of this medicine are at high risk of getting diseases related to the muscles (myopathy).

Kaposi's Sarcoma

Use of Prednisolone may cause cancer in soft tissues (Kaposi's sarcoma).

Interactions with Prednisolone

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Prednisolone. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Antidiabetic Agents

Your doctor's guidelines may need to be followed while taking this medicine along with antidiabetic agents, which are used to lower the blood glucose levels. In the case of diabetes, corticosteroids may increase the blood sugar level in the body. Dose adjustment is required in patients receiving anti-diabetic drugs.

CYP3A4 Inducers

Prednisolone interacts with CYP3A4 inducers (barbiturates, phenytoin, rifampin), which are used to treat certain diseases such as anxiety, depression, seizures, and tuberculosis. This combination may reduce the therapeutic effectiveness of corticosteroids by increasing the rate of metabolism. The dose of Prednisolone should be increased while using both drugs in combination.

Immunosuppressants

There may be an interaction of Prednisolone with cyclosporine, which is used to prevent organ rejection. The combined use of this medicine with Prednisolone may increase the effect of both drugs and may cause seizures. Proper adjustment of dose is required while using both the drugs in combination.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Prednisolone may interact with non-steroidal anti-inflammatory drugs (aspirin, salicylates), which are used to reduce pain, fever, and inflammation. The combined use of this medicine with corticosteroids may increase the risk of side effects related to stomach and intestine. This medicine should be used with precaution in patients with a rare blood disorder (hypoprothrombinemia).

Anticoagulants

Special instructions need to be followed while taking this medicine along with warfarin and other coumarins, which are used to prevent blood clot formation. The combined use of corticosteroids and warfarin usually prevents the response of warfarin. Coagulation parameters (prothrombin time) should be monitored to maintain the desired anticoagulant effect.

Potassium-Depleting Agents

Your doctor's guidelines may need to be followed while taking this medicine along with potassium-depleting agents (e.g., diuretics, amphotericin B), which are used to treat high blood pressure and fungal infections. The combined use of these medicines may increase the risk of low potassium level in the blood. Also, amphotericin B with corticosteroids may cause heart enlargement and heart failure.

Anticholinesterase Agents

Prednisolone interacts with anticholinesterase agents, which are used to treat neurodegenerative conditions such as dementia, Parkinson's disease, and Alzheimer's disease. The combined use of anticholinesterase agents and corticosteroids may cause severe weakness in the skeletal muscles. Anticholinesterase agents should be discontinued at least 24 hours before receiving corticosteroid treatment.

Toxoids and Vaccines

Special instructions need to be followed while taking this medicine along with toxoids and live or inactivated vaccines, which are used to treat certain viral infections like mumps, chickenpox, and measles. Long-term use of corticosteroids may decrease the response to toxoids and live or inactivated vaccines. Live vaccines should not be given to patients with the weakened immune system.

CYP3A4 Inhibitors

There may be an interaction of Prednisolone with ketoconazole, macrolide antibiotics, which are used to treat certain conditions like fungal, respiratory, Helicobacter pylori, sexually transmitted, and mycobacterial infections. Ketoconazole lowers the metabolism and may result in an increased risk of side effects of this medicine. The dosage of corticosteroids with such drugs should be reduced to avoid the potential side effects.

Cardiac Glycosides

Prednisolone may interact with digitalis, which is used to treat heart diseases such as heart failure and palpitation. This medicine may increase the risk of heart palpitation due to low levels of potassium in the blood.

Antitubercular Drugs

Prednisolone may interact with isoniazid, which is used for the treatment of tuberculosis. Prednisolone may decrease the levels of isoniazid in the blood.

Aromatase Inhibitors

Your doctor's guidelines may need to be followed while taking this medicine along with aminoglutethimide, which is used to treat certain diseases like seizures, breast cancer, prostate cancer, and Cushing syndrome. This combination may reduce the therapeutic effectiveness of corticosteroids by increasing the rate of metabolism. The dose of Prednisolone should be increased while using both drugs in combination.

Oral Contraceptives

Special instructions need to be followed while taking this medicine along with estrogens (oral contraceptives), which are used to reduce menopausal symptoms and prevents the pregnancy. This medicine may increase the effect of corticosteroids by decreasing its metabolism in the liver. Dosage adjustment may be required if estrogens are added to or withdrawn from this combination.

Antivirals

Prednisolone interacts with an antiviral drug (ritonavir), which is used to treat viral infection. This medicine increases the levels of Prednisolone in the blood.

Cholesterol Lowering Agents

There may be an interaction of Prednisolone with cholestyramine, which is used to lower the high levels of cholesterol in the blood. This medicine may increase the excretion of corticosteroids.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Prednisolone is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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