What is the equivalent dose of prednisolone for a child prescribed prednisone 5 mg/mL, six mL once daily, given the available formulation is prednisolone 15 mg per 5 mL?

From the Guidelines

I recommend giving 10 mL of prednisolone 15 mg per 5 mL once daily as a conversion for the prescribed prednisone. The original prescription calls for prednisone 5 mg/mL with 6 mL once daily, which equals 30 mg of prednisone daily. Since prednisolone and prednisone are considered therapeutically equivalent at equal doses (1:1 conversion), you need to provide 30 mg of prednisolone. With your available prednisolone concentration of 15 mg per 5 mL, you would need 10 mL to deliver 30 mg (15 mg × 2). This dose is appropriate for the child's treatment, as it falls within typical pediatric dosing ranges for corticosteroids, as seen in the KDIGO 2021 clinical practice guideline for the management of glomerular diseases 1. Be sure to use an oral syringe for accurate measurement, and administer the medication with food to minimize gastrointestinal side effects. The conversion maintains the same therapeutic effect since both medications are glucocorticoids with similar potency, though prednisolone is the active metabolite of prednisone. Some key points to consider when administering corticosteroids to children include:

• Using the lowest effective dose to minimize side effects
• Monitoring for signs of adrenal insufficiency when discontinuing therapy
• Considering the potential impact on growth and development in pediatric patients It is essential to consult the KDIGO guideline for more information on managing glomerular diseases in children, including dosing recommendations for prednisolone and other corticosteroids 1.

From the FDA Drug Label

Each 5 mL (teaspoonful) of prednisolone sodium phosphate oral solution contains 20. 2 mg prednisolone sodium phosphate (15 mg prednisolone base) The child is prescribed prednisone 5 mg/mL, six mL once daily, which is a total dose of 30 mg of prednisone. To find the equivalent dose of prednisolone, we need to know the conversion factor between prednisone and prednisolone. However, this information is not provided in the drug label. The FDA drug label does not answer the question.

From the Research

Equivalent Dose of Prednisolone

To determine the equivalent dose of prednisolone for a child prescribed prednisone 5 mg/mL, six mL once daily, we need to consider the available formulation of prednisolone 15 mg per 5 mL.

• The dose of prednisone is 5 mg/mL, and the child is taking six mL once daily, which is a total dose of 30 mg/day.
• The available formulation of prednisolone is 15 mg per 5 mL, so we need to calculate the equivalent dose of prednisolone.
• According to 2, the equivalent dose of prednisolone can be estimated based on the dose of prednisone, as both medications have similar effects on muscle strength and function in children with Duchenne muscular dystrophy.
• However, there is no direct conversion factor provided in the studies to calculate the equivalent dose of prednisolone for a given dose of prednisone.
• The studies 3, 2, 4, 5, 6 provide information on the dosing regimens and efficacy of prednisone and prednisolone in various conditions, but do not provide a direct conversion factor.
• Therefore, based on the available information, it is not possible to calculate the exact equivalent dose of prednisolone for a child prescribed prednisone 5 mg/mL, six mL once daily, given the available formulation of prednisolone 15 mg per 5 mL.

Key Points

• The dose of prednisone is 30 mg/day.
• The available formulation of prednisolone is 15 mg per 5 mL.
• There is no direct conversion factor provided in the studies to calculate the equivalent dose of prednisolone for a given dose of prednisone.
• The studies provide information on the dosing regimens and efficacy of prednisone and prednisolone in various conditions, but do not provide a direct conversion factor 3, 2, 4, 5, 6.