How much prednisone is considered a high dose. What are the common side effects of prednisone. How to properly take prednisolone tablets and liquid. When should you consult your doctor about prednisone dosage. What are the risks of stopping prednisone suddenly.

Understanding Prednisone Dosage: From Low to High

Prednisone, a corticosteroid medication, is prescribed in various doses depending on the medical condition and individual patient needs. Understanding the different dosage levels is crucial for effective treatment and minimizing potential side effects.

Prednisone dosages are typically categorized as follows:

• Low dose: Less than 7.5 mg per day
• Moderate dose: Between 7.5 mg and 40 mg per day
• High dose: 40 mg to 60 mg per day

Is there a standard high dose of prednisone? While doses above 40 mg per day are generally considered high, it’s important to note that individual responses to prednisone can vary. In some cases, doctors may prescribe doses higher than 60 mg, especially for short-term intravenous administration.

Proper Use of Prednisolone: Tablets and Liquid Forms

Adhering to your doctor’s instructions when taking prednisolone is crucial for its effectiveness and your safety. Here are some general guidelines for proper use:

Dosage and Timing

How should you take prednisolone? It’s typically recommended to take prednisolone as a single dose once a day, preferably with breakfast. This timing helps reduce the risk of stomach upset and minimizes potential sleep disturbances.

For example, if prescribed a 40mg daily dose, you might be instructed to take eight 5mg tablets all at once. Always follow your doctor’s specific instructions, as dosing can vary based on your condition and individual needs.

Special Instructions for Certain Formulations

Are there special instructions for enteric-coated or gastro-resistant prednisolone tablets? Yes, these formulations should be swallowed whole and can be taken with or without food. It’s important to avoid taking indigestion medicines 2 hours before or after these special tablets to ensure proper absorption.

Navigating Prednisone Treatment Duration

The duration of prednisone treatment can vary significantly depending on the medical condition being treated. How long might you need to take prednisone?

• Short-term use: Some conditions may only require a brief course of prednisone, lasting up to one week.
• Long-term use: Certain chronic conditions may necessitate extended use, potentially for many years or even lifelong.

Your healthcare provider will determine the appropriate duration based on your specific situation and monitor your progress throughout the treatment.

Managing Missed Doses and Proper Discontinuation

Consistency in taking prednisone as prescribed is important for its effectiveness. However, missed doses can occur. How should you handle a missed dose of prednisone?

If you forget a dose, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed one and continue with your regular dosing schedule. Never take a double dose to make up for a missed one.

Can you stop taking prednisone abruptly? It’s crucial to understand that suddenly stopping prednisone, especially after long-term or high-dose use, can be dangerous. Abrupt discontinuation may lead to a flare-up of your health condition and cause withdrawal symptoms such as:

• Severe fatigue
• Weakness
• Body aches
• Joint pain

To prevent these complications, your doctor will likely recommend a gradual dose reduction over several weeks. Always consult your healthcare provider before making any changes to your prednisone regimen.

Recognizing and Managing Prednisone Side Effects

While prednisone can be highly effective in treating various conditions, it’s important to be aware of potential side effects. What are some common side effects of prednisone?

• Increased appetite and weight gain
• Mood changes, including irritability or euphoria
• Insomnia
• Fluid retention and swelling
• Increased blood sugar levels
• Increased risk of infections
• Skin thinning and easy bruising
• Osteoporosis (with long-term use)

These side effects are more likely to occur with higher doses or prolonged use. Your healthcare provider will work to prescribe the lowest effective dose for the shortest necessary duration to minimize these risks.

Special Considerations for Prednisone Use in Children

When it comes to prescribing prednisone for children, healthcare providers take a cautious approach. How does prednisone dosing differ for pediatric patients?

In children, prednisone doses are typically lower than those for adults with the same condition. Pediatric dosing is carefully calculated based on the child’s height and weight to ensure safety and effectiveness while minimizing potential side effects.

Parents and caregivers should closely follow the prescribing physician’s instructions and report any concerning side effects promptly. Regular monitoring of growth and development is crucial for children on long-term prednisone therapy.

Alternatives and Complementary Approaches to Prednisone Treatment

While prednisone can be highly effective, some patients may seek alternatives or complementary approaches to manage their conditions. Are there alternatives to prednisone for certain conditions?

Depending on the specific medical condition, alternative treatments may include:

• Other immunosuppressant medications
• Biologic therapies
• Topical treatments (for skin conditions)
• Lifestyle modifications (diet, exercise, stress reduction)
• Physical therapy or occupational therapy

It’s important to discuss these options with your healthcare provider, as they can help determine the most appropriate treatment plan for your individual needs. Never discontinue or change your prednisone regimen without medical supervision.

Monitoring and Follow-up During Prednisone Treatment

Regular monitoring is essential when undergoing prednisone treatment, especially for long-term or high-dose regimens. What should patients expect in terms of follow-up care?

Your healthcare provider may recommend:

• Regular blood tests to check blood sugar levels, electrolytes, and other markers
• Bone density scans to monitor for osteoporosis risk
• Eye examinations to check for cataracts or glaucoma
• Blood pressure monitoring
• Regular weight checks

These follow-up measures help ensure the treatment remains effective while minimizing potential complications. Be sure to attend all scheduled appointments and report any new or worsening symptoms promptly.

Understanding the proper use of prednisone, including dosage, administration, potential side effects, and necessary monitoring, is crucial for patients and caregivers. By working closely with your healthcare provider and following prescribed guidelines, you can maximize the benefits of prednisone treatment while minimizing potential risks. Remember, never adjust your prednisone dosage or stop treatment without consulting your doctor, as this can lead to serious health complications.

How and when to take prednisolone tablets and liquid

It’s important to take prednisolone as your doctor has advised.

Dosage and strength

The dose of prednisolone you’ll take depends on your health problem and whether you are taking it as a short course or for longer.

The usual dose varies between 5mg and 60mg daily but occasionally higher doses may be prescribed.

The strength of tablets range from 1mg to 25mg. There are 2 strengths of liquid with either 1mg or 10mg in every 1ml.

In children, the dose may be lower than for an adult with the same problem because it is calculated based on their height and weight.

Changes to your dose

Your dose may go up or down.

Once your health problem or condition starts to get better, it’s likely that your dose will go down.

Your doctor may reduce your dose before you stop treatment completely. This is to reduce the risk of withdrawal symptoms.

Your dose may go up if your symptoms get worse.

How to take it

Unless your doctor or pharmacist gives you different instructions, it’s best to take prednisolone as a single dose once a day, with breakfast. For example, if your dose is 40mg daily, your doctor may tell you to take 8 tablets (8 x 5mg) all at the same time.

Take prednisolone with breakfast so it does not upset your stomach. Taking prednisolone in the morning also means it’s less likely to affect your sleep.

If your prednisolone tablets are labelled as “enteric coated” or “gastro resistant”, you can take these with or without food but make sure to swallow them whole. Do not take indigestion medicines 2 hours before or after taking enteric coated or gastro resistant tablets.

Sometimes, your doctor may advise you to take prednisolone on alternate days only.

How long to take it for

This depends on your health problem or condition.

You may only need a short course of prednisolone for up to 1 week.

You may need to take it for longer, even for many years or the rest of your life.

If you forget to take it

If you miss a dose of prednisolone, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take the next one at the usual time.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Stopping prednisolone

It can be dangerous to stop taking prednisolone suddenly, especially if you have been on a high dose for a long time.

Your health condition may flare up again. You may also get withdrawal side effects including:

• severe tiredness
• weakness
• body aches
• joint pain

These side effects are most likely to happen if you have taken prednisolone for more than a few weeks or you take more than 40mg daily.

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects.

Important

Do not stop taking prednisolone without talking to your doctor – you will need to reduce the dose gradually.

If you take too much

Taking too many prednisolone tablets is unlikely to harm you.

If you’re worried, talk to your doctor or pharmacist.

Page last reviewed: 24 February 2022

Next review due: 24 February 2025

What is considered a high dose of prednisone?

Medically reviewed by Sally Chao, MD. Last updated on Sep 1, 2021.

The starting dose of prednisone may be between 5 mg to 60 mg per day. A dose above 40 mg per day may be considered a high dose. However, everybody responds differently to prednisone, so what might be a high dose depends on the person and the condition.

In general:

• Low dose: less than 7.5 mg per day
• Moderate dose: between 7.5 mg and 40 mg per day
• High dose: 40 mg to 60 mg per day

Sometimes doses much higher than the upper limit of 60 mg are given through an IV for short periods.

Doctors prescribe prednisone at the lowest effective dose for the shortest possible time. If prednisone is not effective, it should be stopped as soon as possible. The dose and time need to be adjusted for each patient based on the condition and response to treatment.

The reason that prednisone is used with care is that prednisone can pose serious side effects and long-term risks. In patients who need longer dosing of prednisone, it may be given every other day. This may reduce side effects and complications.

Side effects

Common side effects from prednisone are due to the effect it has on lowering your immune system’s response to an infection. Prednisone also affects many other parts of your body. These effects may occur at high doses, or even lower doses if the treatment continues for a longer time. Side effects may include:

• Fluid retention that can lead to swelling, high blood pressure or heart failure
• Muscle weakness and loss of muscle
• Weakening of bones that can cause osteoporosis, spinal and long bone fractures or death of bone tissue
• Ulcers of the stomach or esophagus
• Swelling of the belly or inflammation of the pancreas
• Poor wound healing
• Effects on the skin may include thinning, bruising, redness, increased sweating and bleeding under the skin
• Effects on the nervous system may include headaches, dizziness, insomnia, mood swings, personality changes, depression and psychosis
• Effects on glands of the body may include irregular menstrual periods, slowed growth in children and high blood sugar
• Effects on the eyes may include cataracts, increased pressure inside the eyes, bulging eyes and glaucoma

Some people are at higher risk of adverse effects from higher doses or longer use of prednisone. These include people with:

• Hypothyroid disease
• Cirrhosis of the liver
• Herpes infection of the eye
• Mental health conditions
• Aspirin use
• Ulcerative colitis
• Ulcer disease
• Kidney failure
• An infected abscess
• High blood pressure
• Osteoporosis
• Recent intestinal surgery

Use of prednisone at any dose is not considered safe during pregnancy or breastfeeding. Vaccinations may need to be avoided if you are taking prednisone at high doses.

Prednisone is a powerful anti-inflammatory drug used to treat conditions of inflammation. Even a normal dose may be considered high for some people. It is important to always weigh the risks against the benefits when taking this medication.

References

1. U.S. National Library of Medicine DailyMed. Prednisone. December 2020. Available at: https://dailymed. nlm.nih.gov/dailymed/lookup.cfm?setid=263ed4fa-3c29-4abb-9cb1-bc016bd34a05&version=3#. [Accessed August 9, 2021].
2. American Osteopathic College of Dermatology (AOCD). Steroids (Oral). Available at: https://www.aocd.org/page/SteroidsOral. [Accessed August 13, 2021].
3. Drugs.com. Prednisone. December 2020. Available at: https://www.drugs.com/pro/prednisone.html. [Accessed August 9, 2021].

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Medical Disclaimer

Prednisolone – what you need to know about taking this drug

Most often in non-medical circles it is called a steroid or glucocorticoid, many people think that this is a very dangerous drug and are very reluctant to agree to treatment with this drug.

But for certain diseases, it is prednisolone that is considered an obligatory and necessary drug of first choice in the treatment of a disease (for example, nephrotic syndrome, which you can read about here).

We are not talking about the drug itself and for what diseases it should be prescribed, but our information block about what doctors usually forget when they prescribe prednisolone. Usually, children come for a consultation while taking prednisolone in combination with asparkam. Believe me, hypokalemia (decrease in the level of potassium in the blood), in connection with which asparks are prescribed, is not the most common complication when prescribing prednisolone.

In our practice, almost 90% of patients receiving this drug are diagnosed with nephrotic syndrome.

Prednisolone is prescribed for a long period of time (the full course of therapy before the drug is discontinued may last 6-12 months), additional drugs must be prescribed to prevent the side effects of prednisolone. They are:

1. In order to protect the mucosa of the upper gastrointestinal tract (esophagus, stomach, duodenum), prednisolone may cause indigestion, nausea, vomiting and more serious complications such as steroid ulcers. However, all this can be avoided by taking the so-called – gastroprotective drugs (i.e. Protection of the stomach in literal translation). These are antacids (eg Maalox, phosphalugel, etc.), H+ pump blockers (eg Omeprazole), drugs that improve the motility of the gastrointestinal tract. All doses of drugs are selected individually according to age and body weight.
2. Bone protection. Long-term use of steroids can cause a decrease in bone mass, so-called steroid osteoporosis (bone thinning) can develop, which ultimately leads to bone fractures. But this condition can also be prevented, it is necessary to take calcium and vitamin D preparations . The dose of drugs is also selected individually.

Other things to watch out for:

1. Mandatory blood pressure monitoring
2. Observation of an ophthalmologist: control of vision, the state of intraocular pressure and the lens of the eye.
3. When taking prednisolone for a very long time, check blood glucose levels.
4. State of mental health. Children very often become capricious, sometimes even aggressive. This condition resolves on its own after discontinuation of the drug.
5. Watch your weight and diet. Against the background of taking prednisolone, the appetite increases very much. However, you, as a parent, can control the nutrition of your child, it is necessary to limit the intake of easily digestible carbohydrates.
6. In order to monitor and evaluate the effectiveness of gastroprotective therapy, the mucous membrane of the upper gastrointestinal tract is assessed by – EGDS (gastroscopy).

This information has been prepared by an employee of the department (pediatrician) for informational purposes only. It is necessary to consult with your doctor.

If you have any questions or suggestions about this topic, we are happy to answer questions and accept your suggestions.

What helps, analogues, dosage, side effects

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. It is necessary to consult a specialist. Allergies in joints and muscles of the joint -bearing asthma -powder of joint -tank -tag -tanks from allergies

, author of Article

Podoynitsyna Alena Andreevna,

Diploma of pharmaceutical education: 105924 3510722 reg. number 31917

All authors

Contents of the article

• Prednisolone: ​​from what
• Prednisolone for allergies
• Prednisolone for covid
• Prednisolone: ​​dosage
• Consequences treatment with Prednisolone
• Prednisolone: ​​side effects
• Prednisolone and alcohol
• Prednisolone: analogues
• Ask an expert on the topic of the article

Prednisolone has been successfully used to treat inflammatory and autoimmune diseases since 1955 years old. This is a proven drug. Prednisolone has thousands of clinical studies in its “baggage”, is included in the list of vital and essential drugs in Russia and WHO.

We tell you when Prednisolone helps, what side effects it has and how to use the drug correctly.

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Prednisolone: ​​what

Prednisolone is a synthetic hormone glucocorticoid. In the human body, glucocorticoids are produced by the adrenal glands. They regulate carbohydrate, protein and mineral metabolism.

Prednisolone has the following actions:

• anti-inflammatory
• decongestant
• antiallergic
• anti-shock
• immunosuppressive

The drug has a wide range of indications, it is used for:

• shock conditions
• allergic diseases, including anaphylactic shock
• cerebral edema
• bronchial asthma
• systemic lupus erythematosus and rheumatoid arthritis
• inflammatory diseases of the joints
• acute adrenal insufficiency
• thyrotoxic crisis, thyroiditis
• hepatitis and hepatic coma
• diseases of the skin and eyes
• diseases of the hematopoietic organs
• lung diseases (including tuberculosis and cancer)
• in organ transplantation

Hormone treatment seriously affects the organs and systems of the human body. There are a lot of contraindications for Prednisolone, a complete list is indicated in the instructions for the drug and in the Register of Medicines of Russia (RLS). The drug is contraindicated in pregnancy and breastfeeding.

For life-saving use, the only contraindication is hypersensitivity to prednisolone or the components of the drug.

You may be interested in: Bronchial asthma clinical guidelines for treatment and prevention

Prednisolone for allergies

The antiallergic effect of Prednisolone is due to the fact that the drug changes the body’s immune response to allergens. The hormone inhibits the synthesis of biologically active substances – allergy mediators. Reduces the number of cells responsible for immunity. Inhibits the formation of antibodies.

In case of anaphylactic shock and bronchial status, prednisolone is administered intravenously, in other cases, for allergies, the doctor prescribes intramuscular injections or tablets.

Prednisolone for covid

Glucocorticoids, including Prednisolone, are indicated for the complicated course of coronavirus infection. They are prescribed when pneumonia develops with respiratory failure.

World Health Organization (WHO) Interim Guidelines published based on clinical trial data:

• Recommendation #1: WHO strongly recommends oral or intramuscular corticosteroids (dexamethasone, hydrocortisone, or prednisolone) for the treatment of patients with severe and critical COVID-19.
• Recommendation #2: WHO does not recommend the use of corticosteroids in the treatment of patients with non-severe COVID-19 unless the patient is already taking the drug for another condition.

Prednisolone: ​​dosage

The dose of Prednisolone and the duration of therapy are set by the doctor individually, depending on the indications and the severity of the disease.

At the beginning of the course, the drug is prescribed in a higher dose. When a therapeutic effect is achieved, it is reduced to maintenance.

The daily dose is best taken once in the morning. This corresponds to the biological rhythm of the adrenal glands. The high dose can be divided into 2-4 doses, and the largest dose taken between 6 and 8 am.

Withdrawal of the drug is carried out gradually. A smooth dose reduction is due to the “withdrawal” syndrome. When treated with Prednisolone, the adrenal glands stop producing their own glucocorticoids. With a sharp cessation of the intake of Prednisolone, the body remains without hormones.

A serious condition occurs with a risk to life. It is necessary to gradually reduce the intake of the hormone from the outside in order to restore the function of the adrenal glands. The doctor should draw up a scheme on how to reduce the dose of Prednisolone. For each case, it is individual and depends on the duration of treatment and the dose that the patient took during treatment.

If Prednisolone is used urgently and not more than 3 days, then gradual withdrawal is not required

Effects of treatment with Prednisolone

Hormone treatment should be taken very seriously. Long-term therapy with large doses of Prednisolone is accompanied by numerous adverse reactions.

One of the most noticeable is weight gain. It is better from the first days of therapy to choose a diet with a lot of vegetables, exclude sugar, limit carbohydrates, fatty and fried foods. Arrange fasting days, drink plenty of water and give yourself physical activity.

Still needed:

• take medicines to protect the digestive tract, heart and bones
• monitor blood pressure
• see an ophthalmologist
• monitor glucose levels
• stop taking the drug gradually under the supervision of the attending physician

Prednisolone: ​​side effects

The frequency and severity of side effects depends on the duration of treatment, the level of doses taken and compliance with the rules for taking the drug. We indicate the most severe negative effects:

• development of diabetes
• adrenal suppression
• bleeding and gastrointestinal ulcers
• increased blood pressure, cardiac arrhythmias up to cardiac arrest, heart failure
• thrombosis
• osteoporosis
• mental disorders
• development and exacerbation of infections

Antacids and potassium preparations are prescribed to reduce side effects.

Prednisolone and alcohol

Do not drink alcohol during treatment with Prednisolone. Alcohol increases the risk of erosions, ulcers and bleeding in the gastrointestinal tract.

Prednisolone analogues

Hormone therapy is a complex and responsible process. Only the attending physician can choose an analogue to replace Prednisolone. For information, we indicate drugs that also belong to glucocorticoids:

• Dexazon
• Dexamethasone
• Kenalog
• Cortef
• Medrol
• Methylprednisolone
• Metipred
• Polcortolone
• Triamcinolone

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Let’s summarize the information.

Prednisolone is a powerful analog of natural glucocorticoids. It suppresses the immune system and has an anti-inflammatory effect.