What is the recommended dose of Prednisone (prednisone) for severe allergic reactions?

From the Guidelines

For severe allergies, the recommended prednisone dose is 0.5–1.0 mg/kg daily, with a maximum of 80 mg daily, in tapering doses over 1–2 weeks, as suggested by the Infectious Diseases Society of America 1. This dosing guideline is crucial for managing severe allergic reactions, especially when there's evidence of hemodynamic compromise or unremitting symptoms after initial therapy. The medication should be taken as directed, typically as a single morning dose with food to minimize gastrointestinal side effects. Key considerations include:

• The dose may need to be adjusted based on the patient's response and the severity of the allergic reaction.
• Monitoring for common side effects such as increased appetite, mood changes, insomnia, and elevated blood sugar is essential.
• In cases of life-threatening allergic reactions (anaphylaxis), immediate emergency care with epinephrine is necessary before initiating prednisone therapy. It's also important to note that prednisone works by suppressing the immune system and reducing inflammation, which helps control severe allergic symptoms. However, the decision to use prednisone and the dosing should always be personalized based on the patient's specific condition, medical history, and other medications they may be taking, as emphasized in guidelines for managing patients with severe reactions 1.

From the FDA Drug Label

The initial dosage of PredniSONE tablets may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated. In situations of less severity lower doses will generally suffice, while in selected patients higher initial doses may be required IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT

The dose of prednisone for severe allergies is not explicitly stated in the label. However, the label does provide a general dosage range of 5 mg to 60 mg per day, depending on the specific disease entity being treated.

• The dosage requirements are variable and must be individualized based on the disease under treatment and the response of the patient.
• In situations of less severity, lower doses will generally suffice, while in selected patients, higher initial doses may be required 2.

From the Research

Prednisone Dose for Severe Allergies

• The provided studies do not directly address the optimal prednisone dose for severe allergies 3, 4, 5, 6.
• However, the studies discuss the use of corticosteroids, such as methylprednisolone and hydrocortisone, in treating various conditions, including allergic reactions and inflammatory bowel disease 4, 5, 6.
• One study found that some patients experienced immediate allergic reactions to methylprednisolone, which were mediated by specific IgE antibodies 4.
• Another study reported a case of a patient who experienced an immediate allergic reaction to methylprednisolone, but tolerated other corticosteroids 6.
• A comparison of intravenous methylprednisolone and hydrocortisone for the treatment of acute inflammatory bowel disease found that methylprednisolone was associated with a greater requirement for rescue therapy, but reduced rates of hypokalemia 5.

Corticosteroid-Induced Hypersensitivity Reactions

• Corticosteroid-induced hypersensitivity reactions can range from minor rashes to more serious cardiovascular collapse 3.
• The mechanisms of these reactions vary from patient to patient, and can be either classic immunoglobulin E-mediated or pseudoallergic in nature 3.
• Skin testing and provocative challenges can be used to diagnose corticosteroid-induced hypersensitivity reactions 3, 4, 6.