Prednisone Volume Calculation for 47-Pound Pediatric Patient
For a 47-pound (21.3 kg) pediatric patient, the recommended prednisone dose is 21-43 mg daily (1-2 mg/kg/day), with a practical maximum of 60 mg/day for most acute conditions. 1 The volume in milliliters depends entirely on the concentration of your liquid prednisone formulation—you must check the bottle label for mg/mL concentration before calculating the volume.
Weight Conversion and Dose Calculation
Patient weight: 47 pounds = 21.3 kg 1
Volume Calculation Based on Concentration
You must identify your prednisone liquid concentration to calculate milliliters. Common pediatric formulations include:
If using 5 mg/mL concentration:
- For 21 mg dose: 4.2 mL
- For 43 mg dose: 8.6 mL
If using 15 mg/5 mL (3 mg/mL) concentration:
- For 21 mg dose: 7 mL
- For 43 mg dose: 14.3 mL
If using 1 mg/mL concentration:
- For 21 mg dose: 21 mL
- For 43 mg dose: 43 mL
Condition-Specific Dosing Guidance
For asthma exacerbations: Use 1-2 mg/kg/day (21-43 mg daily, maximum 60 mg) for 3-10 days 1, 3
For nephrotic syndrome (first episode): Use 2 mg/kg/day (43 mg daily, maximum 60 mg) as a single daily dose for 4-6 weeks 2, 1
For Crohn's disease (moderate to severe): Use 1 mg/kg daily (21 mg daily, maximum 40 mg), with possible increase to 1.5 mg/kg (32 mg daily, maximum 60 mg) if response is unsatisfactory 2
For autoimmune hepatitis: Use 1-2 mg/kg/day (21-43 mg daily, maximum 60 mg) for two weeks, then taper over 6-8 weeks 1, 3
Critical Administration Guidelines
Administer as a single morning dose before 9 AM to minimize adrenocortical suppression and mimic physiologic cortisol secretion patterns 1, 4
If the child is significantly overweight, calculate the dose based on ideal body weight rather than actual weight to avoid excessive steroid exposure 1, 3
For courses longer than 10-14 days, implement a structured taper: reduce by 5 mg every week until reaching 10 mg/day, then by 2.5 mg/week until reaching maintenance dose 1, 3
Essential Monitoring and Prevention
Initiate calcium and vitamin D supplementation immediately when starting therapy to protect bone health 1, 3
Monitor regularly for common side effects: Cushingoid features, growth deceleration, weight gain/increased appetite, hypertension 1, 4
For therapy anticipated to last more than 2-3 weeks at doses above 7.5 mg daily, anticipate HPA axis suppression and implement osteoporosis prevention measures 1, 3
Important Clinical Caveat
The actual milliliter volume cannot be determined without knowing the specific concentration (mg/mL) of your prednisone liquid formulation. 5 Check the medication bottle label, then divide the calculated mg dose by the concentration to determine the correct volume in milliliters.