From the Guidelines
The recommended dose of oral corticosteroids is 40 mg/m2 or 1.5 mg/kg (maximum 40 mg on alternate days) for 2-5 months with tapering of the dose, as stated in the 2013 American Journal of Kidney Diseases study 1. This dose is specifically recommended for glomerulonephritis treatment, and it's essential to note that prednisone and prednisolone are equivalent and can be used interchangeably.
- Key points to consider when prescribing oral corticosteroids include:
- Starting with a daily dose for 4-6 weeks, followed by alternate-day medication
- Tapering the dose over 2-5 months to minimize side effects
- Being aware of potential side effects, such as mood changes, increased blood sugar, fluid retention, and increased infection risk
- Ensuring patients take the medication with food to reduce stomach irritation and follow the prescribed tapering schedule to avoid adrenal suppression Although another study from the same year suggests a daily single dose of 1 mg/kg (maximum 80 mg) or alternate-day single dose of 2 mg/kg (maximum 120 mg) 1, the first study 1 provides a more specific and detailed dosing regimen, making it a more reliable source for guiding clinical practice.
From the FDA Drug Label
5 mg may suffice, while in severe diseases doses higher than 9 mg may be required. The dose of oral corticosteroids, specifically dexamethasone, is 5 mg which may suffice, but in severe diseases, doses higher than 9 mg may be required 2.
From the Research
Dose of Oral Corticosteroids
- The dose of oral corticosteroids can vary depending on the specific medication and the condition being treated.
- For example, a single dose of dexamethasone (0.3 mg/kg) has been shown to be effective in treating mild-to-moderate asthma exacerbations 3, 4, 5.
- In contrast, prednisolone is often prescribed at a dose of 1 mg/kg per day for 3-5 days 4, 5.
- For acute relapses of multiple sclerosis, a dose of 1,250 mg of oral prednisone per day has been used 6.
- The choice of oral corticosteroid and dose should be individualized based on the specific needs of the patient and the condition being treated.
Administration and Compliance
- Oral corticosteroids can be administered in various forms, including tablets, liquids, and syrups 7.
- The ease of administration and patient compliance can vary depending on the form and dose of the medication.
- For example, a single dose of dexamethasone may be easier to administer and have better compliance than a multi-dose course of prednisolone 4, 5.
- Patient education and support can help improve compliance with oral corticosteroid therapy.
Comparison of Oral Corticosteroids
- Different oral corticosteroids have been compared in terms of their efficacy and safety.
- For example, dexamethasone has been shown to have a faster onset of action and fewer side effects than prednisolone in the treatment of acute asthma exacerbations 4, 5.
- The choice of oral corticosteroid should be based on the specific needs of the patient and the condition being treated, as well as the potential benefits and risks of each medication 3, 4, 5.