Drug summary - MICROMEDEX

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Prednisone
DrugPoint Summary

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DOSING/ADMINISTRATION
Adult Dosing
General Dosage Information
patients receiving predniSONE immediate-release, prednisoLONE, or methylPREDNISolone may
be switched to predniSONE delayed-release at an equivalent dose based on relative potency [3]
predniSONE 5 mg delayed-release tablets are equivalent to betamethasone 0.75 mg, cortisone
25 mg, dexamethasone 0.75 mg, hydrocortisone 20 mg, methylPREDNISolone 4 mg,
paramethasone 2 mg, prednisoLONE 5 mg, predniSONE 5 mg, and triamcinolone 4 mg [3]
Adrenal insufficiency
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Allergic condition (Severe), Intractable to adequate trials of conventional treatment
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Arthropathy - Pulmonary histoplasmosis, acute
0.5 to 1 mg/kg daily (maximum 80 mg daily) in tapering doses over 1 to 2 weeks (guideline
dosing) [5]
Asthma
(moderate and severe exacerbation; NHLBI asthma guidelines) 40 to 80 mg/day ORALLY in 1 or
2 divided doses until peak expiratory flow rate reaches 70% of predicted or personal best;
outpatient burst, 40 to 60 mg ORALLY in 1 or 2 divided doses for a total of 3 to 10 days [6]
(long-term therapy; NHLBI asthma guidelines) 7.5 to 60 mg ORALLY daily in the morning or
every other day as needed for control of asthma [6]
Bell's palsy
1 mg/kg orally once daily or in 2 equally divided doses for 5 to 10 days with gradual taper over 5
to 6 days, plus artificial tears during the day as well as oil-based eye ointment before
sleep(off-label dosage) [7][8]
Carcinoma of breast
Optimal dosing and timing not yet defined
Cerebral edema, Associated with brain tumor, craniotomy, head injury
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]

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Chemotherapy-induced nausea and vomiting; Prophylaxis

Optimal dosing and timing not yet defined
Chronic obstructive pulmonary disease, Exacerbation
methylPREDNISolone 40 mg IV on day 1, then predniSONE 40 mg ORALLY daily on days 2 to 5
(5-day course) was noninferior to the 14-day course in a clinical trial [9]
Collagen disease
Initial, 5 to 60 mg orally daily; dose should be individualized until an appropriate response is
achieved and then decreased in small decrements until the lowest maintenance dose that
maintains a favorable response is found [3][4]
Community acquired pneumonia; Adjunct
50 mg orally once daily for 7 days (off-label dosage) [10]
Disorder of endocrine system
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of eye
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of gastrointestinal tract
5 to 60 mg/day orally initially, vary dose depending on patient response [3][4]
Disorder of hematopoietic structure
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][11]
Disorder of respiratory system
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of skin
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Exacerbation of multiple sclerosis, Acute
(delayed-release) 5 to 60 mg/day ORALLY initially, vary dose depending on patient response
[3][4]
(Deltasone(R)) ORAL, 200 mg/day for 1 week, followed by 80 mg every other day for 1 month
[12]
Fever, Due to malignancy
Optimal dosing and timing not yet defined
Graft versus host disease
Standard dosage, initial: 1 to 2 mg/kg/day orally; 2 mg/kg/day with a rapid taper for patients

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with grade IIb or higher manifestations (off-label dosage) [13]

Lower dosage (mild to moderately severe symptoms), initial: 0.5 mg/kg/day orally (off-label
dosage) [13]
Hodgkin's disease
40 mg/m(2)/day ORALLY on days 1 through 14 as part of the MOPP/ABV regimen [14][15]
Hypercalcemia of malignancy
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Idiopathic thrombocytopenic purpura
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Inflammatory disorder of musculoskeletal system; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Intracranial tumor, Primary
Optimal dosing and timing not yet established
Leukemia, Palliative therapy
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [11]
Mediastinal lymphadenopathy - Pulmonary histoplasmosis, acute
0.5 to 1 mg/kg daily (maximum 80 mg daily) in tapering doses over 1 to 2 weeks (guideline
dosing) [5]
Multiple myeloma
Optimal dosing and timing not yet defined
Mycosis fungoides
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Neoplastic disease
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][11]
Nephrotic syndrome
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Non-Hodgkin's lymphoma
100 mg ORALLY daily on days 1 through 5 as part of the CHOP regimen; administer every 21
days
Pericarditis - Pulmonary histoplasmosis, acute
0.5 to 1 mg/kg daily (maximum 80 mg daily) in tapering doses over 1 to 2 weeks (guideline
dosing) [5]

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Pneumocystis pneumonia (Moderate to Severe); Adjunct

ORAL, 40 mg 2 times a day on days 1 to 5, 40 mg once a day on days 6 to 10, 20 mg once a
day on days 11 to 21; begin as early as possible and within 72 hours of PCP therapy [16]
Polymyositis
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Prostate cancer
predniSONE 5 mg ORALLY twice daily continuously with docetaxel 75 mg/m(2) IV over 1 hour
every 3 weeks [17]
Renal transplant rejection
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]
Rheumatoid arthritis; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Sjgren's syndrome
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Transplantation of heart
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]
Trichinosis, With neurologic or myocardial involvement
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Tuberculosis of meninges, With subarachnoid block or impending block; concurrent use
with antituberculosis therapy; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Waldenstrm macroglobulinemia
Optimal dosing and timing not yet defined

Pediatric Dosing
General Dosage Information
patients receiving predniSONE immediate-release, prednisoLONE, or methylPREDNISolone may
be switched to predniSONE delayed-release at an equivalent dose based on relative potency [3]
predniSONE 5 mg delayed-release tablets are equivalent to betamethasone 0.75 mg, cortisone
25 mg, dexamethasone 0.75 mg, hydrocortisone 20 mg, methylPREDNISolone 4 mg,
paramethasone 2 mg, prednisoLONE 5 mg, predniSONE 5 mg, and triamcinolone 4 mg [3]
Adrenal insufficiency

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5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]

Allergic condition (Severe), Intractable to adequate trials of conventional treatment
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Asthma
(moderate and severe exacerbation, 12 years or younger; NHLBI asthma guidelines) 1 to 2
mg/kg/day ORALLY in 2 divided doses (maximum 60 mg/day) until peak expiratory flow rate
reaches 70% of predicted or personal best; outpatient burst, 1 to 2 mg/kg/day ORALLY in 2
divided doses (maximum 60 mg/day) for a total of 3 to 10 days [6]
(long-term therapy, 11 years or younger; NHLBI asthma guidelines) 0.25 to 2 mg/kg ORALLY
daily in the morning or every other day as needed for control of asthma [6]
(moderate and severe exacerbation, older than 12 years ; NHLBI asthma guidelines) 40 to 80
mg/day ORALLY in 1 or 2 divided doses until peak expiratory flow rate reaches 70% of predicted
or personal best; outpatient burst, 40 to 60 mg ORALLY in 1 or 2 divided doses for a total of 3
to 10 days [6]
(long-term therapy, 12 years or older; NHLBI asthma guidelines) 7.5 to 60 mg ORALLY daily in
the morning or every other day as needed for control of asthma [6]
Cerebral edema, Associated with brain tumor, craniotomy, head injury
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]
Collagen disease
Initial, 5 to 60 mg orally daily; dose should be individualized until an appropriate response is
achieved and then decreased in small decrements until the lowest maintenance dose that
maintains a favorable response is found (FDA dosage) [3][4]
2 mg/kg per day orally divided into 3 daily doses for 1 month, then taper, if clinically stable, by
0.25 mg/kg/week to 1 mg/kg orally daily by the end of month 2, then taper gradually to 0.2
mg/kg orally daily from month 6 to 12, then reduce to 0.1 mg/kg orally daily for 6 months, then
every other day until 24 months; continue therapy past 24 months at the clinician's discretion;
discontinue therapy if disease becomes inactive (off-label dosage) [18]
Disorder of endocrine system
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of eye
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of gastrointestinal tract
5 to 60 mg/day orally initially, vary dose depending on patient response (FDA dosage) [3][4]
Active Crohn disease, induction of remission: 1 mg/kg orally once daily, MAX 40 mg/day. If
response is unsatisfactory, may consider increasing dose to 1.5 mg/kg orally once daily, MAX 60
mg/day. Not recommended for maintenance treatment (guideline dosage) [19].
Disorder of hematopoietic structure
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][11]

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Disorder of respiratory system

5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Disorder of skin
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Exacerbation of multiple sclerosis, Acute
(delayed-release) 5 to 60 mg/day ORALLY initially, vary dose depending on patient response
[3][4]
(Deltasone(R)) ORAL, 200 mg/day for 1 week, followed by 80 mg every other day for 1 month
[12]
Hypercalcemia of malignancy
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Inflammatory disorder of musculoskeletal system; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Leukemia, Palliative therapy
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [11]
Mycosis fungoides
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Neoplastic disease
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][11]
Nephrotic syndrome
5 to 60 mg/day ORALLY initially, vary dose depending on patient response (manufacturer
dosing) [3][4]
first 3 episodes, ORAL, initial, 2 mg/kg/day or 60 mg/m(2)/day every day (MAX 80 mg/day)
divide 2 to 4 times/day for 4 to 6 weeks, then 2 mg/kg or 40 mg/m(2) every other for 4 to 6
weeks (clinical trial dosing) [20][21][22]
Pneumocystis pneumonia (Moderate to Severe); Adjunct
ORAL (adolescents), 40 mg 2 times a day on days 1 to 5, 40 mg once a day on days 6 to 10, 20
mg once a day on days 11 to 21; begin as early as possible and within 72 hours of PCP therapy
[23]
ORAL (infants and children), 1 mg/kg twice daily on days 1 to 5, 0.5 mg/kg twice daily on days 6
to 10, 0.5 mg/kg once a day on days 11 to 21; begin as early as possible and within 72 hours of
PCP therapy [23]
Polymyositis
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]

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Renal transplant rejection

5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]
Rheumatoid arthritis; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Sjgren's syndrome
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Transplantation of heart
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3]
Trichinosis, With neurologic or myocardial involvement
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]
Tuberculosis of meninges, With subarachnoid block or impending block; concurrent use
with antituberculosis therapy; Adjunct
5 to 60 mg/day ORALLY initially, vary dose depending on patient response [3][4]

FDA Uses
Adrenal insufficiency
Allergic condition (Severe), Intractable to adequate trials of conventional treatment
Asthma
Cerebral edema, Associated with brain tumor, craniotomy, head injury
Collagen disease
Disorder of endocrine system
Disorder of eye
Disorder of gastrointestinal tract
Disorder of hematopoietic structure
Disorder of respiratory system
Disorder of skin
Exacerbation of multiple sclerosis, Acute
Hodgkin's disease
Hypercalcemia of malignancy
Idiopathic thrombocytopenic purpura
Inflammatory disorder of musculoskeletal system; Adjunct
Leukemia, Palliative therapy
Mycosis fungoides
Neoplastic disease

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Nephrotic syndrome
Non-Hodgkin's lymphoma
Polymyositis
Renal transplant rejection
Rheumatoid arthritis; Adjunct
Sjgren's syndrome
Transplantation of heart
Trichinosis, With neurologic or myocardial involvement
Tuberculosis of meninges, With subarachnoid block or impending block; concurrent use with
antituberculosis therapy; Adjunct

Non-FDA Uses
Amyloidosis
Arthropathy - Pulmonary histoplasmosis, acute
Bell's palsy
Carcinoma of breast
Chemotherapy-induced nausea and vomiting; Prophylaxis
Chronic obstructive pulmonary disease, Exacerbation
Community acquired pneumonia; Adjunct
Disseminated candidiasis, chronic; Adjunct
Exophthalmos due to thyroid eye disease
Fever, Due to malignancy
Graft versus host disease
Henoch-Schnlein nephritis
Intracranial tumor, Primary
Mediastinal lymphadenopathy - Pulmonary histoplasmosis, acute
Multiple myeloma
Myasthenia gravis
Myelosclerosis with myeloid metaplasia
Otitis media
Pericarditis - Pulmonary histoplasmosis, acute
Pneumocystis pneumonia (Moderate to Severe); Adjunct
Prostate cancer
Steinert myotonic dystrophy syndrome
Temporal arteritis
Thyrotoxicosis
Trabeculectomy ab externo
Waldenstrm macroglobulinemia

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Dose Adjustments
geriatric: start at low end of dosing range [3][4]
renal: no adjustment necessary [24]
hemodialysis: no maintenance dose necessary [24]
hyperthyroidism: increase dose for hyperthyroid patients in order to achieve adequate
therapeutic effects [25]

Administration
Oral
take with food [3][4]
do not break, divide, or chew delayed-released tablets [3]

Comparative Efficacy
No results available

Place In Therapy
No results available

ABOUT
References
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Evaluation and Research. Rockville, MD. 2002. Available from URL: http://www.fda.gov/cder/drug
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PubMed Article: http://www.ncbi.nlm.nih.gov/...

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Last Modified: August 09, 2016

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