dosage

Serious and acute illnesses should be treated with higher doses of prednisolone.

The dosage of prednisolone depends on the disease to be treated and the individual responsiveness of the patient.
In general, it can be said that severe and acute diseases are treated with higher doses of prednisolone than lighter and chronic ones.
As a rule, prednisolone treatment begins with a high initial dose and, when the patient improves clinically, a lower maintenance dose of 5 to 15 mg prednisolone per day is used.

Under one Maintenance dose one understands the smallest dosage, which still has an effect. In extreme cases (for example with Rejection reactions after transplantation) one deviates from this scheme and gives a high dose Shock or pulse therapy, in which the entire prednisolone dose of 1000 mg is injected intravenously. However, this can only be done for a few days at a time.
The dose level of prednisolone depends on the type of treatment, with substitution or pharmacotherapy being possible.

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In substitution therapies - hormone replacement therapies - 5 to 7.5 mg of prednisolone are prescribed daily, which are taken in one or two single doses. In the event of extraordinary stresses such as trauma, surgery or infection, the prednisolone dose must be increased because the turnover and thus the demand for prednisolone increase.
In pharmacotherapy, on the other hand, the entire amount of prednisolone is usually taken all at once in the morning between 6 and 8 a.m.
Exceptions are high or medium doses, where the total amount can be divided into 2 to 4 (high dose) or 2 to 3 (medium dose) individual doses.
The guideline for pharmacotherapy is that high doses consist of 80 to 100 mg of prednisolone per day, medium doses of 40 to 80 mg daily, low doses of 10 to 40 mg and very low doses of 1.5 to 7.5 mg prednisolone.
This is different with chemotherapy, where the dose level of prednisolone is based on the chemotherapy protocols of the respective cancer.
In children, the amount of prednisolone is calculated based on body weight and the dose is given intermittently or alternately.
In long-term therapy with prednisolone, there is a limit dose that should not be exceeded, the so-called Cushing threshold dose. This is 7.5 mg of prednisolone per day. If more prednisolone is given, side effects increase.

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Further information can be found under our topics:

  • Cushing Syndrome
    and
  • Symptoms of Cushing's Syndrome

It should be noted in both adults and children that the drug must be tapered when the prednisolone therapy is terminated. This means a gradual reduction in the amount over several days. However, this tapering off of the prednisolone is not necessary for short therapies that only last a few days.
Prednisolone tablets are swallowed whole with liquid, either with food or shortly afterwards. Alternatively, prednisolone can be injected intravenously (for example, in shock therapy).

Read more on the topic: Taper off cortisone

Pharmacokinetics

Prednisolone belongs to the medium-long effective Glucocorticoids and has a duration of action of 12 to 36 hours.
The maximum concentration after oral intake is reached in the blood after 1 to 2 hours, where prednisolone is bound to transport proteins (transcortin, albumin). In the liver the drug is metabolized and via the Kidneys eliminated.


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