Prednisolone Dosing for Pediatric Poison Ivy
For pediatric poison ivy, the recommended dose of prednisolone is 1-2 mg/kg/day (maximum 60 mg) for 5-10 days, with longer courses potentially beneficial for severe cases. 1, 2, 3
Dosing Guidelines
Initial dosing:
Duration options:
Treatment Considerations
Severity-Based Approach
- Mild cases: Topical treatments may be sufficient
- Moderate cases: 1 mg/kg/day for 5-7 days
- Severe cases: 2 mg/kg/day for 5-10 days
Tapering Schedule
For severe or extensive poison ivy that requires a longer course:
- Full dose for 5 days
- Then taper as follows:
- 75% of initial dose for 2 days
- 50% of initial dose for 2 days
- 25% of initial dose for 2 days
- Consider additional 5 mg daily for 4 days in very severe cases 3
Important Clinical Pearls
Weight considerations: For significantly overweight children, dosing should be based on ideal body weight rather than actual weight to minimize adverse effects 1
Monitoring: Watch for common corticosteroid side effects including:
- Blood glucose elevation
- Mood changes
- Sleep disturbances
- Increased appetite 1
Efficacy note: Research shows that longer course regimens (15 days total) may reduce the need for additional medications compared to short courses (5 days), with a number needed to treat of approximately 3 3
Administration timing: Give with food to reduce gastrointestinal side effects 2
Contraindications: Use with caution in patients with:
- Active untreated infections
- Diabetes
- Hypertension 1
Clinical Decision Making
The FDA label emphasizes that "dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patient" 2. However, the 1-2 mg/kg/day dosing (maximum 60 mg) provides a reliable starting point for pediatric poison ivy treatment, with duration determined by severity and extent of the rash.