PREDNISONE

Standard Prescription

prednisone __mg PO Q__H (__mg/kg/24 hr or __mg/m2/24 hr)

Dosages

Physiologic Replacement:
1-1.5 mg/m2/dose PO BID
Mild Stress:
2x physiologic replacement.
Moderate Stress:
3x physiologic replacement.

Asthma:
Acute Exacerbation: 1 mg/kg/dose PO daily x 5 days. Longer course may be required for prolonged hospitalization or intensive care treatment. Maximum: 60 mg/24 hr

Anti-inflammatory or Immunosuppressive:
0.25-1 mg/kg/dose PO BID or 0.5-2 mg/kg/dose PO once daily.

Nephrotic Syndrome:
Induction therapy at first presentation: 60 mg/m2/dose PO once daily x 6 weeks. Maximum: 60 mg/dose. Then change to 40 mg/m2/dose once daily every other day  x 6 weeks, then stop. Maximum: 40 mg/dose.
Treatment of relapse:
60 mg/m2/dose PO once daily until remission. Maximum of 60 mg/dose. Then change to 40 mg/m2/dose once daily every other day x 2 weeks, then stop. Maximum: 40 mg/dose.

Mechanism of Action

Corticosteroid.

Forms Supplied

tablet: 1 mg, 5 mg, 50 mg.
BCCH compounded suspension: 5 mg/mL.

Comments

Prednisone may be used for stress dose replacement in children with mild stress (eg. viral illness) or moderate stress (eg. fever) who are not vomiting.  Hydrocortisone IM/IV is preferred for major stress (eg. surgery, trauma) or when child is vomiting.

Methylprednisolone (IV) or prednisolone (PO) are preferred in hepatic disease as prednisone is hepatically metabolized to prednisolone.

4 mg of hydrocortisone = 1 mg of prednisone (anti-inflammatory response).

See Supplementary and References for Corticosteroid Equivalency Table and Surface Area Calculator.

Biological half-life ~12-36 h.

References

369

Last Edited

2022-04-24 02:09:54