2-Day Tapering Dose of Prednisolone for a 2-Year-Old Boy Weighing 10kg
For a 2-year-old boy weighing 10kg, the appropriate 2-day tapering dose of prednisolone syrup would be 20mg (2mg/kg) on day 1, followed by 10mg (1mg/kg) on day 2.
Dosing Calculation
- The standard initial dose of prednisolone for children is 1-2 mg/kg/day or 60 mg/m²/day (maximum 60 mg/day) 1
- For a 10kg child, this translates to:
- Weight-based dosing: 10kg × 2mg/kg = 20mg for day 1
- For the tapering dose on day 2: 10kg × 1mg/kg = 10mg 2
Administration Considerations
- Prednisolone syrup is appropriate for young children who cannot swallow tablets 2
- The medication should be given as a single daily dose in the morning to minimize adrenal suppression 1
- Administration with food can help reduce gastric irritation 2
Important Clinical Considerations
- Short-term corticosteroid courses (2 days) have minimal risk of serious adverse effects compared to longer courses 2
- Common short-term side effects may include:
- Increased appetite
- Irritability or mood changes
- Sleep disturbances 2
Special Considerations for Pediatric Patients
- For very young children (under 3 years), careful monitoring for adverse effects is important even with short courses 2
- If this is part of a longer treatment plan, be aware that weight-based dosing (mg/kg) may result in relative underdosing compared to body surface area (BSA) dosing in smaller children 3
- Studies have shown that relative underdosing doesn't affect initial response to treatment but may increase the likelihood of frequent relapses in conditions like nephrotic syndrome 3
Tapering Considerations
- For this ultra-short 2-day course, a simple 50% reduction on day 2 is appropriate 2
- Longer corticosteroid courses would require more gradual tapering schedules, typically reducing by 5-10 mg/m² per week 2, 1
Common Pitfalls to Avoid
- Avoid abrupt discontinuation even after a 2-day course, as the tapering helps minimize the risk of adrenal suppression 2
- Do not exceed the maximum recommended dose of 60 mg/day, even if the weight-based calculation suggests a higher dose 1, 4
- Be aware that prednisolone and prednisone are not identical but are typically used at equivalent doses 2