A taste comparison of three different liquid steroid preparations: prednisone, prednisolone, and dexamethasone

To determine whether significant differences exist in the taste, texture, smell, and aftertaste of three commonly used liquid steroid preparations: prednisone, prednisolone, and dexamethasone.

This was a double-blind study of medical students and residents. Participants were asked to drink 5 mL of each steroid preparation, and grade each on a one-to-five-point scale for the categories of smell, texture, taste, and aftertaste. A score of 5 was considered most positive, 3 neutral, and 1 most negative. The medications were placed in small cups with the letter A, B, or C on them. The steroids were then administered in an advancing alphabetical format. A saltine cracker and water were administered between tastings in an attempt to remove any residual flavor. Data were analyzed using mean score and standard deviations, and mean rank and standard deviation by the Friedman test. Statistical significance was set at p < 0.05.

Eighty-six adult volunteers participated in the study: 53 (62%) were male and 33 were female. The overall mean scores and standard deviations (+/-SDs) for prednisolone, dexamethasone, and prednisone were 3.43 (+/-1.05), 3.19 (+/-1.01), and 2.29 (+/-0.98), respectively. Using the Friedman test, the mean ranks for smell, texture, taste, and aftertaste for dexamethasone were 2.37, 2.06, 2.19, and 2.22. The corresponding mean ranks for prednisone were 1.80, 1.52, 1.31, and 1.27; and for prednisolone, the mean ranks were 1.83, 2.41, 2.51, and 2.52, respectively. Dexamethasone scored better in all four categories than prednisone (p < 0.05). Prednisolone scored better than prednisone in the categories of texture, taste, and aftertaste (p < 0.05); there was no statistical difference in smell. Dexamethasone had a higher mean rank than prednisolone for smell (p < 0.05); for the remaining three categories, there was no statistical difference.

In adult volunteers, both prednisolone and dexamethasone liquid were more palatable than prednisone liquid.