Prednisolone Dosing for a 106-Pound Child
For a 106-pound (48 kg) child, use adult dosing protocols: administer 75 mg (12.5 mL of the 15 mg/5 mL suspension) as the standard dose for most indications.
Weight-Based Dosing Framework
Since this child weighs 48 kg (>40 kg threshold), adult dosing becomes appropriate 1, 2. The American Academy of Pediatrics and American Academy of Family Physicians establish 40 kg as the cutoff where adult dosing protocols become standard 1, 2.
Specific Dosing by Indication
The actual dose depends entirely on the clinical indication, as prednisolone dosing varies dramatically by condition 3:
Common Pediatric Indications
Asthma exacerbation: 1-2 mg/kg/day in single or divided doses (48-96 mg/day for this child), typically given as a short "burst" for 3-10 days 3
Nephrotic syndrome: 60 mg/m² body surface area per day in three divided doses for initial therapy 3. Using the approximation equation [2 × W + 8] for 60 mg/m², this yields approximately 104 mg/day total 4
General inflammatory conditions: Initial doses range from 0.14 to 2 mg/kg/day (7-96 mg/day for this child) depending on severity 3
Volume Calculation for 15 mg/5 mL Suspension
The prednisolone 15 mg/5 mL suspension provides 3 mg per mL 3. Common dose volumes include:
- 15 mg dose = 5 mL
- 30 mg dose = 10 mL
- 45 mg dose = 15 mL
- 60 mg dose = 20 mL
- 75 mg dose = 25 mL
Critical Dosing Considerations
Avoid weight-based underdosing: Simple mg/kg calculations often underdose children because drug elimination does not scale linearly with weight 5. Body surface area-based dosing is more physiologically appropriate 4, 6.
Individual disease requirements: The FDA label emphasizes that "dosage requirements are variable and must be individualized on the basis of the disease under treatment" 3. Initial doses may range from 5-60 mg prednisolone base per day depending on disease severity 3.
Duration matters: For acute conditions like asthma, short courses (3-10 days) do not require tapering 3. However, prolonged therapy requires gradual withdrawal 3.
Common Pitfalls
- Using pediatric dosing for children ≥40 kg: This child qualifies for adult dosing protocols 1, 2
- Forgetting the indication: A 48 kg child with mild allergic rhinitis needs far less than one with severe asthma or nephrotic syndrome 3
- Calculation errors with suspension concentration: The 15 mg/5 mL concentration means 3 mg/mL, not 15 mg/mL 3