From the FDA Drug Label
The National Heart, Lung, and Blood Institute (NHLBI) recommended dosing for systemic prednisone, prednisolone or methylprednisolone in children whose asthma is uncontrolled by inhaled corticosteroids and long-acting bronchodilators is 1–2 mg/kg/day in single or divided doses
- The patient is 16 years old and weighs 75 kg, which is considered an adult dose but since the information for viral symptoms is not available, we will use the dose for asthma as a reference.
- The dose for a 75 kg patient would be 1-2 mg/kg/day, which translates to 75-150 mg/day.
- However, since the question is about viral symptoms and not asthma, and there is no direct information about viral symptoms, the dose cannot be determined with certainty. 1
From the Research
Prednisolone is not typically recommended for viral symptoms in a 16-year-old male weighing 75 kg. Most viral illnesses are self-limiting and resolve without specific treatment, and corticosteroids like prednisolone can actually suppress the immune system, potentially worsening viral infections 2, 3. Instead, supportive care is recommended, including rest, adequate hydration, and over-the-counter medications like acetaminophen or ibuprofen for fever and pain relief. Acetaminophen can be given at 650-1000 mg every 6 hours (not exceeding 4000 mg daily) or ibuprofen 400-600 mg every 6-8 hours with food.
Key Considerations
- The use of corticosteroids in viral infections is generally not recommended due to the potential for immune system suppression and adverse effects 4, 5.
- In specific cases where prednisolone might be indicated, such as certain inflammatory conditions triggered by viruses or asthma exacerbations, a physician should evaluate the patient and determine an appropriate dose based on the specific condition being treated 6.
- Using corticosteroids without a clear indication can lead to adverse effects including increased susceptibility to infections, mood changes, elevated blood glucose, and long-term complications with extended use 3.
Dosing Considerations
- If a corticosteroid is deemed necessary, the dose should be determined by a physician based on the specific condition being treated, as the evidence does not support a standard dose for viral symptoms in a 16-year-old male weighing 75 kg 2, 3.
- The most recent and highest quality study, a systematic review and meta-analysis published in 2025, found that corticosteroids probably reduced short-term mortality and reduced the need for invasive mechanical ventilation in hospitalized patients with community-acquired pneumonia, but the dose ranged from 29 mg/day to 100 mg/day of prednisone-equivalent 3.