Dosage Forms & Strengths
concentrate

5mg/mL
oral solution

5mg/5mL
tablet






1mg
2.5mg
5mg
10mg
20mg
50mg
tablet, delayed release



1mg
2mg
5mg
MORE...
Glucocorticoid-Responsive Conditions
5-60 mg/day PO in single daily dose or divided q6-12hr
Dosing considerations
 When converting from immediate-release to delayed-release formulation, note that
delayed-release formulation takes about 4 hours to release active substances
 Note that exogenous steroids suppress adrenal cortex activity least during
maximal natural adrenal cortex activity (between 4:00 and 8:00 AM)
Acute Asthma
40-60 mg/day PO in single daily dose or divided q12hr for 3-10 days
Giant Cell Arteritis
40-60 mg PO qDay (1-2 years usual duration of treatment)
Idiopathic Thrombocytopenic Purpura
1-2 mg/kg/day PO
Dose Tapering
Day 1: 10 mg PO before breakfast, 5 mg after lunch and after dinner, and 10 mg at
bedtime
Day 2: 5 mg PO before breakfast, after lunch, and after dinner and 10 mg at bedtime
Day 3: 5 mg PO before breakfast, after lunch, after dinner, and at bedtime
Day 4: 5 mg PO before breakfast, after lunch, and at bedtime
Day 5: 5 mg PO before breakfast and at bedtime
Day 6: 5 mg PO before breakfast
Rheumatoid Arthritis
Immediate-release: ≤10 mg/day PO added to disease-modifying antirheumatic drugs
(DMARDs)
Delayed-release: 5 mg/day PO initially; maintenance: lowest dosage that maintains
clinical response; may be taken at bedtime to decrease morning stiffness with
rheumatoid arthritis
Advanced Pulmonary/Extrapulmonary Tuberculosis
40-60 mg/day PO, tapered over 4-8 weeks
Pneumocystis (carinii) jiroveci Pneumonia in Patients With AIDS (Off-label)
40 mg PO q12hr for 5 days, then 40 mg PO q24hr for 5 days, then 20 mg q24hr for 11
days
Crohn's Disease (Off-label)
40-60 mg PO qDay until resolution and resumption of weight gain (7-28 days usual
duration)
Autoimmune Hepatitis
60 mg PO qDay for 1 week; THEN 40 mg qDay for 1 week; THEN 30 mg qDay for 2
weeks; follow by 20 mg qDay; give half this dose if giving in combinaiton with
azathioprine
Administration
Take with meal or snack
High-dose glucocorticoids may cause insomnia; immediate-release formulation is
typically administered in morning to coincide with circadian rhythm
Delayed-release formulation takes about 4 hours to release active substances; thus,
with this formulation, timing of dose should take into account delayed-release
pharmacokinetics and disease or condition being treated (eg, may be taken at bedtime
to decrease morning stiffness with rheumatoid arthritis)
Prednisone Tapering
by Hanna
(Arizona)
Rx: Prednisone 40mg daily for 3 days. Reduce the dose by 5mg every 3
days until complete. Prednisone is available in 5mg tablets. How many
tablets are required to fill this order.
A. 100 tablets
B. 120 tablets
C. 108 tablets
D. 99 tablets
Reply (by Keith)
Prednisone is a corticosteroid. With steroid drugs, it is important to slowly
reduce the dosage over a period of time, which is often called 'tapering'.
So, we know that's what is happening here. So, every three days, the Dr.
wants to "taper" the dose by 5mg. So, the dosing schedule will look like
this:
Day 1 40mg = 8 Tabs
Day 2 40mg = 8 Tabs
Day 3 40mg = 8 Tabs
Day 4 35mg = 7 Tabs
Day 5 35mg = 7 Tabs
Day 6 35mg = 7 Tabs
Day 7 30mg = 6 Tabs
Day 8 30mg = 6 Tabs
Day 9 30mg = 6 Tabs
Day 10 25mg = 5 Tabs
Day 11 25mg = 5 Tabs
Day 12 25mg = 5 Tabs
Day 13 20mg = 4 Tabs
Day 14 20mg = 4 Tabs
Day 15 20mg = 4 Tabs
Day 16 15mg = 3 Tabs
Day 17 15mg = 3 Tabs
Day 18 15mg = 3 Tabs
Day 19 10mg = 2 Tabs
Day 20 10mg = 2 Tabs
Day 21 10mg = 2 Tabs
Day 22 5mg = 1 Tabs
Day 23 5mg = 1 Tabs
Day 24 5mg = 1 Tabs