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 dosages of prednisolone than lighter and chronic ones.
In general, prednisolone treatment starts with a high initial dose and, when clinically improved, translates into a lower maintenance dose of 5 to 15 mg prednisolone per day.
A maintenance dose is understood as the smallest dosage which still has an effect. In extreme cases (for example, in rejection reactions after transplantation), this scheme deviates and is administered a high-dose shock or pulse therapy, in which the entire dose of prednisolone of 1000 mg is injected intravenously. However, this can only be done for a few days at a time.
The dose level of the prednisolone depends on the type of treatment, whereby a substitution or a pharmacotherapy are possible.
In substitution therapies - hormone replacement therapies - prescribed 5-7.5 mg prednisolone daily, which are taken in one or two single doses. In the case of extraordinary strains such as trauma, surgery or infection, the dose of prednisolone must be increased as the turnover and thus the demand for prednisolone increases.
In the case of pharmacotherapy, in turn, the entire amount of prednisolone is usually taken at once in the morning between 6 and 8 o'clock.
Exceptions are high or medium doses in which a total distribution of 2 to 4 (high dose) or 2 to 3 (medium dose) single doses is possible.
As a guideline in pharmacotherapy, high doses consist of 80 to 100 mg of prednisolone per day, medium of 40 to 80 mg of daily, low of 10 to 40 mg and very low of 1.5 to 7.5 mg of prednisolone.
This is different with chemotherapy, in which the dosage level of the prednisolone depends on defined chemotherapy protocols of the respective cancer.
In children, the amount of prednisolone is calculated on the basis of body weight and the dose is intermittent or alternating.
In a long-term therapy with prednisolone there is a limit dose, which should not be exceeded, the so-called Cushing threshold dose. This is 7.5 mg prednisolone per day. If more prednisolone given, more and more side effects occur.
It should be noted in both adults and children that the medication must be dosed out when prednisolone therapy is stopped. This refers to a gradual reduction of the quantity over several days. However, this decaying of the prednisolone is not necessary in short therapies, which last only a few days.
The prednisolone tablets are swallowed whole with liquid, either for dinner or shortly thereafter. Alternatively, prednisolone can be injected intravenously (for example, in stroke therapy).
Prednisolone is one of the medium-acting 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 eliminated via the kidneys.