What is the equivalent dosage of prednisone 15 mg/5 mL for a child weighing 30.57 kg, originally prescribed 5 mg/mL, six mLs once daily?

From the Guidelines

To determine the equivalent dosage of prednisone for a child weighing 30.57 kg, originally prescribed 5 mg/mL, six mLs once daily, you should administer approximately 1 mg/kg of prednisone, which translates to 30.57 mg, and since the available formulation is 15 mg/5 mL, the child should receive 30.57 mg, which is roughly equivalent to 2 mL of the 15 mg/5 mL formulation, considering the original dose was 30 mg (5 mg/mL × 6 mL = 30 mg). The original prescription calls for 6 mL of prednisone 5 mg/mL, which equals 30 mg of prednisone daily. Given the child's weight and the recommended dosing of 60 mg/m2/d or 2 mg/kg/d as per the KDIGO clinical practice guideline for glomerulonephritis management in children 1, the calculated dose based on weight (2 mg/kg/d × 30.57 kg = 61.14 mg) exceeds the original prescribed dose, suggesting the original dose of 30 mg is appropriate for the child's condition and weight, aligning with the guideline's recommendation for a maximum dose. The dose of approximately 1 mg/kg (30 mg for a 30.57 kg child) is within the recommended range for pediatric conditions requiring corticosteroid therapy, as suggested by the guideline 1. Ensure the medication is taken with food to minimize gastrointestinal side effects, and follow the same duration of therapy as originally prescribed. It's crucial to monitor the child's response to the medication and adjust the dose according to clinical guidelines and the child's condition, considering the potential need for corticosteroid-sparing agents in cases of frequent relapses or steroid-dependent nephrotic syndrome, as outlined in the KDIGO recommendations 1.

From the Research

Calculating Equivalent Dosage of Prednisone

To calculate the equivalent dosage of prednisone for a child weighing 30.57 kg, we need to consider the original prescription of 5 mg/mL, six mLs once daily.

• The original dosage is 5 mg/mL * 6 mL = 30 mg per day.
• According to the study 2, the equation estimating a dose of 60 mg/m2 is [2 × W + 8], where W is the weight in kilograms.
• Using this equation, we can calculate the estimated dose for a child weighing 30.57 kg: [2 × 30.57 + 8] = 69.14 mg.
• However, the study 3 suggests that the dosage of prednisone at 2 mg/kg per day versus 60 mg/m2 per day is not equivalent for patients with weights <30 kg and/or dose <60 mg/day.
• The study 4 recommends a dosage of 2 mg/kg per day, which would be 2 mg/kg * 30.57 kg = 61.14 mg per day.
• The study 5 recommends a dosage of 0.75 mg/kg/day, which would be 0.75 mg/kg * 30.57 kg = 22.93 mg per day.

Comparison of Different Dosage Calculations

• The original dosage of 30 mg per day is lower than the calculated dosages based on the studies 2, 4, and 5.
• The study 2 provides an equation to estimate the dose based on body weight, but it may not be directly applicable to this specific case.
• The study 3 highlights the difference between dosing per body weight or body surface area in children with nephrotic syndrome, which may be relevant to this calculation.

Considerations for Dosage Calculation

• When calculating the equivalent dosage of prednisone, it is essential to consider the individual child's weight and the specific condition being treated.
• The studies 2, 4, 5, and 3 provide different perspectives on dosage calculation, and the most appropriate method may depend on the specific clinical context.
• It is crucial to consult with a healthcare professional to determine the most appropriate dosage for a child weighing 30.57 kg, originally prescribed 5 mg/mL, six mLs once daily.