Orapred (Prednisolone Sodium Phosphate) is a liquid corticosteroid medication originally manufactured by Concordia Pharmaceuticals (formerly Shionogi). It is FDA-approved to treat a wide range of inflammatory and immune-related conditions, including:

• Asthma exacerbations
• Severe allergic reactions and allergic rhinitis
• Inflammatory conditions such as arthritis and dermatitis
• Autoimmune disorders including lupus and multiple sclerosis flares
• Nephrotic syndrome in children
• Croup in children
• Hematologic disorders like idiopathic thrombocytopenic purpura (ITP)
• Adrenal insufficiency (replacement therapy)
• Inflammatory bowel disease flares

Orapred is also used off-label for acute sinusitis, Bell's palsy, gout flares, COPD exacerbations, and severe poison ivy or contact dermatitis. The liquid formulation makes it especially popular in pediatric care, where children may have difficulty swallowing tablets. Typical adult dosing is 5–60 mg/day depending on the condition, while children usually receive 1–2 mg/kg/day for short 3–5 day bursts.

Orapred contains prednisolone, a synthetic glucocorticoid that works by suppressing the immune system and reducing inflammation throughout the body. It binds to intracellular glucocorticoid receptors, which then modulate gene transcription to decrease the production of pro-inflammatory proteins. Specifically, prednisolone inhibits the release of inflammatory mediators such as prostaglandins, leukotrienes, and cytokines — the chemical signals that cause swelling, redness, and pain. This broad anti-inflammatory and immunosuppressive effect is what makes corticosteroids like Orapred effective across such a wide range of conditions, from asthma flares to autoimmune diseases.

• Orapred Oral Solution: 15 mg/5 mL
• Orapred ODT (Orally Disintegrating Tablets): 10 mg, 15 mg, 30 mg
• Generic Prednisolone Sodium Phosphate Solution: 15 mg/5 mL
• Pediapred Oral Solution: 5 mg/5 mL
• Prelone Syrup: 15 mg/5 mL

Orapred (Prednisolone Sodium Phosphate) receives a findability score of 5 out of 100, placing it in the very difficult range. Brand-name Orapred oral solution and Orapred ODT have become increasingly hard to locate at retail pharmacies due to intermittent manufacturing shortages and limited production. Prednisolone oral solution shortages have occurred periodically since 2020, driven by increased demand during respiratory illness seasons and supply chain disruptions. The liquid formulation is particularly affected because fewer manufacturers produce it compared to tablet forms of corticosteroids. If you're struggling to find Orapred or its generic equivalent, Medfinder can help you search nearby pharmacies with current stock.

Orapred is commonly prescribed by a wide range of physicians, given its broad utility:

• Pediatricians — the liquid formulation makes it a go-to choice for children with asthma, croup, and allergic reactions
• Allergy and Immunology specialists
• Pulmonologists — for asthma and COPD exacerbations
• Rheumatologists — for autoimmune and inflammatory joint conditions
• Primary Care and Family Medicine physicians
• Emergency Medicine physicians — for acute allergic reactions and croup
• Dermatologists — for severe skin conditions like contact dermatitis

Orapred is also available through telehealth platforms, making it accessible for patients who need a quick prescription for acute inflammatory conditions.

No, Orapred (Prednisolone Sodium Phosphate) is not a controlled substance. It does not have a DEA schedule classification, which means it can be prescribed with standard refills and dispensed without the additional regulatory requirements that apply to scheduled medications like opioids or stimulants. Your doctor can call in or electronically send the prescription to your pharmacy of choice.

Common side effects of Orapred, especially with short-term use, include:

• Increased appetite and weight gain
• Mood changes and irritability
• Difficulty sleeping (insomnia)
• Stomach upset or nausea
• Increased blood sugar
• Fluid retention and swelling
• Acne
• Headache

Serious side effects that may occur with prolonged use include adrenal suppression, osteoporosis and bone fractures, immunosuppression with increased infection risk, cataracts and glaucoma, Cushing syndrome (moon face, buffalo hump), GI bleeding or peptic ulcer, hyperglycemia or new-onset diabetes, psychiatric effects (psychosis, severe mood swings), growth suppression in children, and avascular necrosis of bone. Orapred does not carry a boxed warning, but corticosteroids have important warnings about not stopping abruptly after prolonged use due to the risk of adrenal crisis. Always taper as directed by your doctor.

If Orapred is unavailable or not the right fit, your doctor may consider these alternatives:

• Prednisone — The most common oral corticosteroid, available as inexpensive tablets. Prednisone is converted to prednisolone in the liver, so it has the same active effect. However, it requires liver metabolism, which may be a consideration in patients with liver impairment.
• Dexamethasone — A more potent, longer-acting corticosteroid available as oral solution and tablets. Often used as a single-dose alternative for croup in children, and widely available.
• Methylprednisolone (Medrol) — Available as tablets (including the Medrol Dosepak) and injection. Similar potency to prednisolone with potentially less sodium retention.
• Hydrocortisone — A lower-potency corticosteroid used for adrenal insufficiency replacement and milder inflammatory conditions.

For patients who specifically need a liquid formulation (such as young children), generic prednisolone oral solution or dexamethasone liquid are the most practical alternatives when brand-name Orapred is unavailable.

Yes, Orapred has several important drug interactions:

• NSAIDs (Ibuprofen, Naproxen) — Increased risk of GI bleeding when combined with corticosteroids
• Warfarin and anticoagulants — Prednisolone can alter their effectiveness; monitoring is needed
• Live vaccines — Should be avoided during immunosuppressive doses of Orapred due to infection risk
• CYP3A4 inhibitors (Ketoconazole) — May increase prednisolone levels in the blood
• CYP3A4 inducers (Phenytoin, Rifampin, Barbiturates) — May decrease prednisolone levels, reducing effectiveness
• Diabetes medications — Corticosteroids raise blood sugar, potentially requiring dose adjustments
• Diuretics — Increased risk of potassium loss
• Fluoroquinolone antibiotics — Increased risk of tendon rupture

You should also avoid grapefruit juice (may increase prednisolone levels), limit alcohol (increased GI irritation and bleeding risk), and watch sodium intake (may worsen fluid retention). Always tell your doctor and pharmacist about all medications and supplements you take.

Orapred (Prednisolone Sodium Phosphate) is a trusted corticosteroid that has been a staple in pediatric and adult medicine for treating inflammatory and immune-related conditions. While the generic prednisolone tablet is widely available and affordable at $5–$50, the liquid oral solution formulation — which is essential for many pediatric patients — has faced significant supply challenges in recent years. With a findability score of just 5 out of 100, Orapred is one of the harder medications to locate at your local pharmacy. If you're having trouble finding Orapred or generic prednisolone solution, Medfinder can help you search pharmacies near you with current availability. Talk to your doctor about whether a different formulation or alternative corticosteroid might work while supply is constrained, and never stop taking corticosteroids abruptly without medical guidance.