Prednisone Dosing for Bell's Palsy
The recommended dose of prednisone for Bell's palsy is 50 to 60 mg per day for five days followed by a five-day taper. 1
Medication Regimen Details
- First-line treatment: Oral corticosteroids are strongly recommended for adult Bell's palsy with high-quality evidence showing significantly improved recovery rates with early steroid administration 2
- Timing: Treatment should be initiated within 72 hours of symptom onset for maximum effectiveness 1, 3
- Duration: 10-day course (5 days at full dose followed by 5-day taper) 1
- Alternative dosing considerations:
Treatment Efficacy
- Prednisone significantly improves recovery rates:
Combination Therapy Considerations
- Antivirals: While sometimes prescribed with steroids, evidence shows minimal additional benefit when combined with steroids 2
- Antiviral options when considered:
- Valacyclovir (1 g three times daily for 7 days) or
- Acyclovir (400 mg five times daily for 10 days) 1
- Antivirals alone are ineffective and not recommended 1
Important Clinical Considerations
- Eye protection is crucial for patients with impaired eye closure:
- Use artificial tears during the day
- Apply lubricating ointment at night
- Consider taping eyelids closed if necessary 2
- Physical therapy may benefit patients with more severe paralysis 1
- Early treatment accelerates recovery and may reduce time away from work 6