Estilsona in Spain: Prednisolone Drops, Uses and Safety for Children

Estilsona is prednisolone, a steroid medicine, as oral drops. In Spain it is used for asthma, allergic and inflammatory problems, some joint diseases and some skin diseases. It is often given to children, and it is only sold with a prescription. This guide is by Dr. Pedro Yelamo Vera, an English-speaking GP licensed in Spain (Colegiado No. 484814280) who sees patients by video in English and Spanish.

What is Estilsona?

Estilsona is a medicine that contains prednisolone, a man-made corticosteroid (steroid). It calms inflammation and damps down the immune system. Its full name in Spain is Estilsona 7 mg/ml gotas orales en suspensión. The prednisolone is in a form called prednisolone steaglate. It is a white liquid you swallow, which makes it easy to give to small children.

What is Estilsona used for?

Estilsona treats inflammatory and autoimmune diseases in adults and in children from 1 month old. The official Spanish product information (ficha técnica) lists:

• asthma;
• allergic and inflammatory problems;
• rheumatoid arthritis and other connective tissue diseases;
• dermatitis and other skin diseases, such as long-lasting eczema, psoriasis and pemphigus.

The doctor decides if a steroid is needed and which one. The leaflet says children should only take it when there are strong medical reasons.

What is Estilsona called in the UK and US?

In both countries the medicine is called prednisolone. UK brands include Deltacortril and Pevanti; US brands include Orapred, Pediapred and Flo-Pred. The rules are the same as in Spain: prednisolone is prescription-only in the UK and in the US. Spanish pharmacies ask for a prescription from a doctor licensed in Spain, so a foreign prescription is normally refused.

Is Estilsona used for croup?

The Estilsona leaflet does not name croup (in Spain, laringitis). It lists asthma and allergic and inflammatory problems. If a child with croup needs a steroid, a doctor decides which one after checking the child. Do not use a bottle left over from last time.

What is the Estilsona dose for children?

The Estilsona dose for a child is worked out by the doctor for that child. It depends on the child's weight, the illness and how bad it is, and it is written on the prescription. So this guide gives no drops or millilitres. If the prescription is unclear, ask the doctor or pharmacist before giving it.

How do you give the drops?

• Shake the bottle well before each use. This stops foam forming, which can change the amount.
• Use only the dropper or the oral syringe that comes in the pack. Rinse the syringe with water after each use.
• You can mix it with milk, broth or orange juice.
• Avoid large amounts of grapefruit juice during treatment.
• If you miss a dose, do not give a double dose. Carry on as the prescription says.

How long does treatment last?

The doctor sets the length. Sometimes it is only a few days; sometimes it is much longer. After a long course, the product information says the dose must come down slowly. Stopping suddenly can cause muscle and joint pain, sickness, fever, low blood pressure or low blood sugar.

Can you repeat Estilsona without a doctor?

No. Do not repeat or extend a course on your own, even if the symptoms look the same as last time. Steroids can hide the signs of an infection and can make an infection worse.

What are the side effects of Estilsona?

Side effects in the leaflet include weight gain, mood changes, sleep problems, higher blood sugar and acne. Others are seen mainly with long courses or high doses:

• slower growth in children;
• weaker bones (osteoporosis);
• cataracts or raised pressure in the eye;
• more infections and wounds that heal slowly;
• high blood pressure and fluid retention.

It contains methyl parahydroxybenzoate (E218), which can cause allergic reactions, sometimes delayed. See a doctor if your child has blurred vision, a big change in behaviour or any effect that worries you.

What about chickenpox, measles and vaccines?

If your child has never had chickenpox or measles, keep them away from people who have it. If they are in contact with it during treatment, tell a doctor straight away. The leaflet also says not to have vaccines while taking Estilsona. The product information lists the weeks around a vaccine as a time not to use it: about 8 weeks before and 2 weeks after. Talk to the paediatrician about the vaccine schedule.

Who should not take Estilsona?

The leaflet says not to take it if there is:

• an allergy to prednisolone, other steroids or any ingredient;
• active chickenpox, cold sores (herpes simplex) or shingles;
• tuberculosis, a bacterial infection or a fungal infection that has spread;
• a stomach or duodenal ulcer;
• glaucoma or a herpes infection of the eye;
• a past mental health illness.

Tell the doctor about other medicines. Anti-inflammatories such as ibuprofen raise the risk of ulcers, and other drugs can change how it works. In pregnancy it is only used when truly needed, and breastfeeding is not advised during treatment.

Do you need a prescription for Estilsona in Spain?

Yes. Estilsona is a prescription-only medicine in Spain, according to the Spanish medicines agency register (AEMPS, CIMA). Pharmacies hand it over with a prescription from a doctor licensed in Spain, on paper or as a private electronic prescription.

What if a child takes too much?

If a child takes more than prescribed, call the doctor or pharmacist straight away. In Spain you can also call the poisons information service (Servicio de Información Toxicológica) on 91 562 04 20.

When to see a doctor

• Your child makes a loud, harsh sound when breathing at rest (stridor): see a doctor the same day.
• Cough, wheeze or fever do not get better, or get worse, during treatment.
• Your child has been near someone with chickenpox or measles.
• Blurred vision, a big change in mood or bad tummy pain.
• A vaccine is due while your child is taking Estilsona.

When to call 112

• Your child is struggling to breathe.
• The skin sucks in between or under the ribs with each breath.
• Lips, tongue or skin look blue or grey.
• Your child is very drowsy, hard to wake, or floppy and not responding as usual.
• Your child is drooling, cannot swallow, or the face, lips or tongue swell.

Frequently asked questions about Estilsona

Getting a medical assessment

If you have questions about Estilsona for yourself or your child, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain who also sees children with their parents or guardians. You can also read about asthma, Dacortin (prednisone) in Spain and online doctor visits for children. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.