Prednisone Dosage

Usual Adult Dose for Allergic Reaction

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Ankylosing Spondylitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Aspiration Pneumonia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Bursitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Dermatitis Herpetiformis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Hypercalcemia of Malignancy

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Loeffler's Syndrome

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Osteoarthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Polymyositis/Dermatomyositis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Psoriasis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Rheumatoid Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Sarcoidosis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Seborrheic Dermatitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Systemic Lupus Erythematosus

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Ulcerative Colitis - Active

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Uveitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Iritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Optic Neuritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Gouty Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Hemolytic Anemia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Anti-inflammatory

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Immunosuppression

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Neoplastic Diseases

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Rheumatic Heart Disease

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Adrenocortical Insufficiency

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Corneal Ulcers

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Keratitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Pemphigus

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Mycosis Fungoides

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Psoriatic Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Epicondylitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Iridocyclitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Choroiditis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Synovitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Thrombocythemia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Stevens-Johnson Syndrome

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Serum Sickness

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Adult Dose for Multiple Sclerosis

Initial dose: 200 mg orally per day for 1 week, then 80 mg every other day for 1 month

Comments:

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
Controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, although they have not been shown to affect the natural history of the disease.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.

Use: For the treatment of acute exacerbations of multiple sclerosis.

Usual Adult Dose for Asthma - Acute

Short-course "burst" therapy: 40 to 80 mg orally once a day or in 2 divided doses until peak expiratory flow (PEF) reaches 70% of predicted or personal best

For OUTPATIENT "burst" therapy: 40 to 60 mg orally once a day or in 2 divided doses for a total of 5 to 10 days

Comments:

The National Heart, Lung and Blood Institute (NHLBI) guidelines for the management of asthma recommend short courses of oral systemic corticosteroids to gain prompt control when initiating long-term therapy.
Burst therapy should continue until symptoms resolve and the peak expiratory flow (PEF) is at least 70% of predicted or personal best; this is generally 3 to 10 days, but may be longer.
Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.

Use: Recommended for the treatment of acute episodes of asthma by the NHLBI National Heart, Lung and Blood Institute.

Usual Adult Dose for Nephrotic Syndrome

Initial episodes: 1 mg/kg (up to 80 mg/day) orally once a day or 2 mg/kg (up to 120 mg) orally once every other day
Duration of therapy: 4 to 16 weeks

Comments:

Once remission is achieved, taper slowly (up to 6 months).
For infrequent relapse, the same initial dose and duration outlined above may be used.

Use: Recommended for use in adults with minimal-change nephrotic syndrome by the KDIGO (Kidney Disease: Improving Global Outcome) glomerulonephritis work group.

Usual Adult Dose for Asthma - Maintenance

7.5 to 60 mg orally once a day or every other day

Comments:

Titrate dose to the lowest dose needed for control
Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.
Administer single dose in the morning or on alternate days in the morning; alternate-day therapy may produce less adrenal suppression.

Use: Recommended for long-term treatment of severe persistent asthma by the NHLBI National Heart, Lung and Blood Institute.

Usual Pediatric Dose for Allergic Reaction

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Ankylosing Spondylitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Aspiration Pneumonia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Bursitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Dermatitis Herpetiformis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Hypercalcemia of Malignancy

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Loeffler's Syndrome

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Osteoarthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Polymyositis/Dermatomyositis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Psoriasis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Sarcoidosis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Seborrheic Dermatitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Systemic Lupus Erythematosus

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Ulcerative Colitis - Active

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Uveitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Iritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Optic Neuritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Gouty Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Hemolytic Anemia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Anti-inflammatory

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Immunosuppression

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Neoplastic Diseases

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Rheumatic Heart Disease

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Adrenocortical Insufficiency

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Corneal Ulcers

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Keratitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Pemphigus

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Mycosis Fungoides

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Psoriatic Arthritis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Epicondylitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Iridocyclitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Chorioretinitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Choroiditis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Berylliosis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Synovitis

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Thrombocythemia

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Stevens-Johnson Syndrome

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Serum Sickness

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Erythema Multiforme

Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Usual Pediatric Dose for Nephrotic Syndrome

Age: 1 year or older:
Initial episode: 60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day for at least 4 to 6 weeks; follow with alternate-day therapy: 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for 2 to 5 months with tapering of dose
Duration of therapy: At least 12 weeks

Infrequent Relapsing Episodes: 1 relapse in 6 months or 1 to 3 relapses in 12 months:
60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day until urinary protein is negative for 3 days; follow with alternate-day therapy: 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for 4 weeks, then taper dose

Frequent Relapsing Episodes: 2 relapses in 6 months or 4 or more relapses in 12 months:
60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day until complete remission for at least 3 days, then 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for at least 3 months

For those who are frequent relapses: the lowest dose (preferably every other day) to maintain remission without major adverse effects should be used; consider corticosteroid-sparing agents.

Comments:

Studies have shown an initial steroid treatment period of 6 weeks followed by an alternate-day maintenance period of 6 weeks (total duration 12 weeks) has resulted in a lower rate of relapse.
Daily prednisone may need to be given during episodes of upper respiratory tract and other infections to reduce the risk for relapse in children with frequently relapsing steroid dependent nephrotic syndrome already on alternate-day therapy.

Use: Recommended for use in in children with steroid-sensitive nephrotic syndrome by the KDIGO (Kidney Disease: Improving Global Outcome) glomerulonephritis work group.

Usual Pediatric Dose for Asthma - Acute

Age: Less than 12 years:
Short-course "burst" therapy: 1 to 2 mg/kg orally in 2 divided doses until peak expiratory flow (PEF) is 70% of predicted or personal best

Dose of 1 mg/kg/day appears to be equally efficacious and may result in fewer behavioral side effects

Maximum dose: 60 mg/day
Duration of therapy: 3 to 10 days

Age: 12 years or older:
Short-course "burst" therapy: 40 to 80 mg orally once a day or in 2 divided doses until PEF is 70% of predicted or personal best

For OUTPATIENT "burst" therapy: 40 to 60 mg orally once a day or in 2 divided doses

Duration of therapy: 5 to 10 days

Comments:

The National Heart, Lung and Blood Institute (NHLBI) guidelines for the management of asthma recommend short courses of oral systemic corticosteroids to gain prompt control when initiating long-term therapy.
Short courses of oral corticosteroids should be considered at the first sign of infection in children who have a history of severe exacerbations with viral respiratory infections.
Burst therapy should continue until symptoms resolve and the PEF is at least 70% of predicted or personal best; this is generally 3 to 10 days, but may be longer.
Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.

Use: Recommended for treatment of acute episodes of asthma by the NHLBI National Heart, Lung and Blood Institute.

Usual Pediatric Dose for Asthma - Maintenance

Less than 12 years old:
0.25 mg/kg to 2 mg/kg orally once a day or every other day

12 years or older:
7.5 to 60 mg orally once a day or every other day

Comments:

Titrate dose to the lowest dose needed for control
Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.
Administer single dose in the morning or on alternate days in the morning; alternate-day therapy may produce less adrenal suppression.

Use: Recommended for long-term treatment of severe persistent asthma by the NHLBI National Heart, Lung and Blood Institute.

Renal Dose Adjustments

Use with caution

Liver Dose Adjustments

Use with caution; patients with cirrhosis may experience enhanced corticosteroids effects due to decreased metabolism and thereby may require lower doses

Dose Adjustments

Elderly: Dose selection should be cautious generally starting at the low end of the dose range.

Drug Discontinuation:

Abrupt discontinuation after high-dose or long-term therapy should be avoided.
Drug-induced adrenocortical insufficiency may persist for months after drug discontinuation.

Recommendations:

To reduce the effect of drug-induced adrenocortical insufficiency, gradual dose reduction is recommended.
In situation of stress, this drug may need to be restarted or doses increased during dose reduction or for up to 12 months after discontinuation to account for drug-induced adrenocortical insufficiency.

Alternate Day Therapy:

Alternate day therapy may be considered for long term oral glucocorticoid therapy to help minimize adrenal suppression, and other glucocorticoid-related side effects.
In the event of an acute flare-up, it may be necessary to return to the full suppressive daily dose for control; once control is established; alternate day therapy may be reinstituted.

Dose adjustments of antidiabetic agents may be necessary as corticosteroids may increase blood glucose concentrations.

Changes in thyroid status may require corticosteroid dose adjustment

Routine administration of vaccines or toxoids should be deferred until corticosteroid therapy is discontinued if possible.

Switching from Immediate-release to Delayed-release:

Patients on immediate-release prednisone, prednisolone, or methylprednisolone may be switched to delayed-release prednisone at an equivalent dose based on relative potency

Oral Corticosteroid Potency:
Prednisone 5 mg is approximately equivalent to: Betamethasone 0.75 mg; Cortisone 25 mg; Dexamethasone 0.75 mg; Hydrocortisone 20 mg; Methylprednisolone 4 mg; Prednisolone 5 mg; Triamcinolone 4 mg

Precautions

Consult WARNINGS section for additional precautions.

Dialysis

Supplemental dosing is not required

Other Comments

Administration advice:

Take orally, preferably with food or milk

Delayed-Release Tablets:

Take orally with food; active drug is released approximately 4 hours after administration
Swallow whole; do not break, divide, or chew

Storage requirements:

Protect from light and moisture
Oral Concentrate Solution (Intensol[R]) should be dispensed in original bottle with provided calibrated dropper; discard 90 days after opening.

General:

Current treatment guidelines may be consulted for more specific information on dose ranges.
Hydrocortisone or cortisone are the first choice for treating primary or secondary adrenocortical insufficiency, however, synthetic corticosteroids may be used in conjunction with mineralocorticoids where applicable.
Initial doses should be maintained or adjusted until a satisfactory response is achieved; this drug should be discontinued if there is a lack of response after a reasonable period of time and alternate therapy considered.
Constant monitoring is necessary in regards to dosing as dose adjustments may be needed due to changes in clinical status (e.g., remissions or exacerbations), stressful situations not directly related to the disease being treated, and individual responses to therapy.

Monitoring:

Monitor growth velocity in pediatric patients
Monitor intraocular pressure if therapy is continued for more than 6 weeks; regular eye exams should be encouraged
Routine laboratory studies (including 2-hour postprandial blood glucose and serum potassium), blood pressure, weight, bone mineral density, and chest x-rays should be performed at regular intervals for patients on long-term therapy
Consider obtaining upper gastrointestinal x-rays in patients with known or suspected peptic ulcer disease
Monitor for hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and hyperglycemia with chronic use
Consider monitoring renal function in elderly patients

Patient advice:

Patients should understand that this drug is a corticosteroid and that it is important not to stop therapy abruptly.
Patients should understand that during times of stress, such as surgery or infection, additional supplementation may be necessary; they should discuss with their healthcare professional whether they need to carry a medical identification card identifying their corticosteroid use.
Patients on immunosuppressant doses of corticosteroids should understand that a greater risk of infection exists; they should avoid exposure to chickenpox or measles and if exposed, they should consult their healthcare professional promptly.
Patients should check with their healthcare provider before starting any new medications, including herbal supplements and over the counter products, or receiving any vaccinations.
Patients should be advised of common adverse reactions including fluid retention, changes in glucose tolerance, high blood pressure, behavioral/mood changes, increased appetite, and weight gain.

Frequently asked questions

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