What is the recommended prednisone (corticosteroid) taper dosing regimen for the treatment of full-body urticaria (hives)?

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From the Research

The recommended prednisone taper dosing regimen for the treatment of full-body urticaria starts with a dose of no more than 10 mg/day, with a weekly reduction of 1 mg, as suggested by the most recent and highest quality study 1. When treating full-body urticaria with prednisone, it is essential to consider the potential side effects and the importance of tapering the dose to avoid adrenal insufficiency.

  • The treatment should start with a low dose, such as 10 mg/day, and be gradually reduced by 1 mg every week, as recommended by 1.
  • It is crucial to monitor patients for side effects, including increased blood pressure, elevated blood sugar, mood changes, and insomnia, while using prednisone.
  • Antihistamines, such as cetirizine or diphenhydramine, should be continued during the prednisone treatment to manage breakthrough itching, as suggested by 2 and 3.
  • The use of prednisone should be limited to short periods, and other treatments, such as omalizumab or cyclosporine, should be considered for long-term management, as recommended by 4 and 5.
  • A gradual taper is necessary to avoid adrenal insufficiency, which can occur after prolonged use of prednisone, as noted by 1.

References

Research

Treatment of chronic spontaneous urticaria.

Allergy, asthma & immunology research, 2012

Research

Drug therapy for chronic urticaria.

Clinical reviews in allergy, 1992

Research

Treatment of chronic urticaria.

Immunology and allergy clinics of North America, 2014

Research

Treatment of urticaria: a clinical and mechanistic approach.

Current opinion in allergy and clinical immunology, 2019

Research

Clinical practice guideline for diagnosis and management of urticaria.

Asian Pacific journal of allergy and immunology, 2016

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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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