What is the recommended dose of prednisone (corticosteroid) for the treatment of urticaria (hives)?

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From the Research

For hives (urticaria), a typical prednisone dose is 20-25 mg daily for adults, taken as a short course of 3-5 days, as supported by the study 1 and other evidence. The medication should be taken in the morning with food to minimize gastrointestinal side effects.

  • After the initial dose, a tapering schedule may be used, gradually reducing the dose over several days.
  • For children, the dosage is typically 1-2 mg/kg/day, not exceeding adult doses.
  • Prednisone works by suppressing the immune response and reducing inflammation that causes hives. However, it's essential to note that prednisone is generally reserved for severe or persistent hives that don't respond to antihistamines, which are the first-line treatment.
  • Short-term use of prednisone minimizes potential side effects such as mood changes, increased appetite, fluid retention, and elevated blood sugar. If hives persist beyond the treatment course or recur frequently, further medical evaluation is necessary to identify potential underlying causes, as suggested by the study 2. The most recent and highest quality study 2 provides a comprehensive evaluation of pharmacologic treatments for H1 antihistamine-refractory chronic spontaneous urticaria, but the study 1 specifically addresses the use of prednisone in this context.
  • Other studies, such as 3, 4, and 5, provide additional information on the treatment of urticaria, but the study 1 is the most relevant to the question of prednisone dosing.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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