Orapred ODT Dosing for a 12-Year-Old
For a 12-year-old with an asthma exacerbation, administer prednisolone 40-60 mg daily as a single dose or in 2 divided doses for 3-10 days. 1
Standard Dosing Protocol
For adolescents 12 years and older, the weight-based calculation is 1-2 mg/kg/day (maximum 60 mg/day) until peak expiratory flow reaches 70% of predicted or personal best. 1 However, most 12-year-olds will fall into the adult dosing range of 40-60 mg daily. 1
Administration Guidelines
- Single morning dose preferred to minimize adrenocortical suppression, though divided dosing (twice daily) is acceptable for acute exacerbations. 2
- Duration: 3-10 days is standard for asthma exacerbations or "burst" therapy. 1
- No taper needed for courses less than 1 week, and tapering is probably unnecessary for courses up to 10 days if the patient is concurrently taking inhaled corticosteroids. 1, 2
Practical Considerations
Orapred ODT Advantages
Orapred (orally disintegrating tablet) has significantly better palatability and a 3-fold lower vomiting rate (5.4% vs 17.7%) compared to generic liquid prednisolone formulations. 3 This makes it particularly useful for children who may have difficulty tolerating liquid formulations.
Weight-Based Adjustments
For significantly overweight adolescents, use ideal body weight rather than actual body weight to calculate the dose and avoid unnecessary steroid exposure. 2
Common Pitfalls to Avoid
- Do not exceed 60 mg/day for short-course burst therapy in this age group. 1
- Do not routinely taper short courses (≤10 days), as there is no evidence this prevents relapse. 1
- Ensure concurrent inhaled corticosteroid therapy is initiated or continued, as systemic steroids alone are insufficient for long-term asthma control. 1
Monitoring
Watch for short-term adverse effects including: 1
- Reversible glucose metabolism abnormalities
- Increased appetite and fluid retention
- Mood alterations
- Hypertension (rare with short courses)