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EspañolPrednisolone is a commonly used generic prescription drug used to treat a wide range of inflammatory, autoimmune, and cancerous conditions. In low-to-moderate doses, prednisolone is primarily intended to reduce inflammation. Higher doses are intended to suppress the immune system, particularly during severe allergic reactions or attacks of autoimmune diseases such as rheumatoid arthritis.
Prednisolone is taken as a tablet, oral solution, or syrup. Dosages will vary depending on the medical condition being treated. Prednisolone sodium phosphate and prednisolone acetate, both of which can be taken orally, are also prescribed as eye drops for topical application to the eye’s surface.
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Prednisolone dosage, forms, and strengths
Prednisolone can be taken orally as a tablet, orally disintegrating tablet, or liquid. Prednisolone eye drops can be applied topically to the eyes.
Tablet: 5 milligrams (mg)
Orally-disintegrating tablet (prednisolone sodium phosphate): 10 mg, 15 mg, 30 mg
Oral solution: 5 mg per 5 milliliters (mL), 10 mg/5 ml, 15 mg/5 mL, 20 mg/5 mL, 25 mg/5 mL
Eye drops (prednisolone acetate): 0.12%, 0.55%, 1%
Eye drops (prednisolone sodium phosphate): 1%
Prednisolone dosage for adults
Prednisolone is FDA-approved as a primary or supportive treatment for over 50 different medical conditions but is used off-label to treat many more. Dosages will vary widely depending on the type and severity of the medical condition being treated.
Standard dosage for adults: 5–60 mg per day
Standard ophthalmic dosage for adults: Two drops in each affected eye four times daily
Maximum dosage for adults: Varies by medical condition
| Prednisolone dosage chart for adults | |||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
|
AUTOIMMUNE DISORDERS |
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| Rheumatoid and arthritic conditions | 5–60 mg taken as a daily single dose or in doses divided throughout the day | 5–60 mg taken as a daily single dose or in doses divided throughout the day | Not specified |
| Psoriatic arthritis or severe plaque psoriasis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg taken as a single dose or in divided doses each day | 60 mg per day |
| Multiple sclerosis (acute exacerbation) | 1250 mg taken once per day for 3-5 days or 200 mg by mouth once daily for 1 week, then 80 mg every other day for one month | 1250 mg taken once per day for 3-5 days or 200 mg by mouth once daily for 1 week, then 80 mg every other day for one month | Not specified |
| Lupus erythematosus (exacerbation) | 5–60 mg per day taken as a single dose or in divided doses | 5–60 mg per day taken as a single dose or in divided doses | Not specified |
| Proteinuria due to lupus nephritis | 40–80 mg per day | 40–80 mg per day | Not specified |
| Immune thrombocytopenia (ITC) and thrombocytopenia purpura | 5–60 mg per day taken as a single dose or in divided doses | 5–60 mg per day taken as a single dose or in divided doses | Not specified |
| Acquired hemolytic anemia, congenital hypoplastic anemia, erythroblastopenia | 5–60 mg per day taken as a single dose or in divided doses | 5–60 mg per day taken as a single dose or in divided doses | Not specified |
|
ALLERGIC REACTIONS |
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| Allergic skin reactions | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Severe allergic skin reactions | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Severe allergic reactions | 5–60 mg per day taken as a single dose or in divided doses | 5–60 mg per day taken as a single dose or in divided doses | Not specified |
|
ASTHMA |
|||
| Asthma (hospital treatment) | 40–80 mg taken per day or divided into 2 doses per day | 40–80 mg taken per day or divided into 2 doses per day for 3-10 days until peak expiratory flow hits 70% of predicted or personal best | Not specified |
| Asthma (outpatient treatment) | 40–60 mg taken once per day or divided into 2 doses per day | 40–60 mg taken once per day or divided into 2 doses per day for 3-10 days until peak expiratory flow hits 80% of predicted or personal best | Not specified |
| Chronic asthma (maintenance treatment) | 7.5–60 mg taken once daily in the morning or every other day | 7.5–60 mg taken once daily in the morning or every other day | Not specified |
|
LUNG DISORDERS |
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| Pneumocystis pneumonia (PCP) infection | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Tuberculosis | 2.67 mg/kg per day | 2.67 mg/kg per day with a taper over 6-8 weeks | Not specified |
| Allergic or aspiration pneumonitis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Pulmonary fibrosis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Croup (off-label use in children) | 1-2 mg/kg taken once daily for 1-3 days | 1-2 mg/kg taken once daily for 1-3 days | Not specified |
|
CONNECTIVE TISSUE DISORDERS |
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| Osteoarthritis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Gout | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Bursitis, tenosynovitis, epicondylitis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Dermatomyositis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Polychondritis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Temporal arteritis, vasculitis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Carpal tunnel syndrome (off-label) | 20 mg daily | 20 mg daily for 2 weeks followed by 10 mg daily for 2 weeks | Not specified |
|
INFLAMMATORY BOWEL DISEASE |
|||
| Crohn’s disease (acute exacerbations) | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Ulcerative colitis (acute exacerbations) | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | 60 mg per day |
|
CANCER |
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| Acute lymphocytic leukemia (palliative treatment) | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Chronic lymphocytic leukemia (in children) | 0.14–2 mg/kg or 4–60 mg/m2 daily given in 3-4 divided doses | 0.14–2 mg/kg or 4–60 mg/m2 daily given in 3-4 divided doses | Not specified |
| Hodgkin lymphoma and non-Hodgkin lymphoma (in children) | 0.14–2 mg/kg or 4–60 mg/m2 daily given in 3-4 divided doses | 0.14–2 mg/kg or 4–60 mg/m2 daily given in 3-4 divided doses | Not specified |
| Mycosis fungoides | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Hypercalcemia (high blood calcium) due to cancer | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
|
ENDOCRINE (HORMONE) DISORDERS |
|||
| Addison’s disease or secondary adrenal insufficiency (maintenance treatment only) | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Congenital adrenal hyperplasia | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Subacute (slow onset) thyroiditis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Symptomatic sarcoidosis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
|
TRANSPLANT REJECTION PREVENTION |
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| Kidney transplant | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
|
EYE DISORDERS |
|||
| Eye disorders (prednisolone acetate) | 2 drops placed on the surface of each affected eye 3-4 times a day | 2 drops placed on the surface of each affected eye 3-4 times a day | Not specified |
| Eye disorders (prednisolone sodium phosphate) | 1-2 drops placed on the surface of each affected eye every hour while awake and every 2 hours while asleep | 1-2 drops placed on the surface of each affected eye 3-4 times daily | Not specified |
|
OTHER DISORDERS |
|||
| Loeffler’s syndrome, berylliosis, trichinosis | 5–60 mg daily taken as a single dose or in divided doses | 5–60 mg daily taken as a single dose or in divided doses | Not specified |
| Bell’s palsy | 1 mg/kg daily 60 mg | 1 mg/kg daily 60 mg for 7-14 days | 80 mg |
Some indications also show prednisolone dosage for children.
Prednisolone dosage for children
The FDA has approved prednisolone for children as young as newborns for some medical conditions. Prednisolone eye drops are approved to treat ocular conditions in children 2 years of age and older. As in adults, healthcare providers commonly use prednisolone off-label to treat children of all ages for a variety of conditions. Dosing is usually determined by weight or body area, but pediatric dosages will vary based on the condition.
| Prednisolone dosage by age | ||
|---|---|---|
| Age | Standard dosage | Maximum dosage |
| Infants and children | 0.14–2 mg per kg per day divided into 1-4 daily doses Ophthalmic dosage: 2 drops in each affected eye 4 times daily | Varies by condition |
Prednisolone dosage for autoimmune disorders
Autoimmune disorders are conditions in which the immune system attacks healthy tissues. Autoimmune flare-ups are often followed by periods of quiet. Prednisolone is typically given to reduce swelling or suppress the immune system during active attacks of rheumatic disorders (rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and rheumatic carditis), psoriasis, multiple sclerosis, systemic lupus, and autoimmune anemias.
Standard dosage for adults for exacerbations: 5–60 mg per day
Standard dosage for adults for multiple sclerosis exacerbations: 1250 mg per day taken for three to five days, or 200 mg by mouth once daily for 1 week, then 80 mg every other day for one month
Standard dosage for infants and children: 0.05–2 mg per kilogram (kg) per day or 4–60 mg per square meter (m2) divided into one to four daily doses
Renally impaired patients: No adjustment, no supplement for dialysis
Hepatically impaired patients: Not defined
Prednisolone dosage for allergic reactions
For allergic skin reactions, such as contact dermatitis, eczema, or pemphigus, and more severe allergic reactions, such as severe seasonal allergies, food allergies, drug allergies, laryngeal swelling, angioedema, and anaphylaxis, prednisolone is used in low doses to reduce swelling. Prednisolone is used in high doses to block the immune system in people experiencing severe and possibly life-threatening skin reactions such as Stevens-Johnson syndrome and erythema multiforme.
Standard dosage for adults for allergic reactions: 5–60 mg per day taken in one to four divided doses
Standard dosage for infants and children: 0.14–2 mg per kilogram (kg) per day divided into one to four daily doses
Prednisolone dosage for asthma
For children and adults experiencing severe, sudden asthma attacks, prednisolone is used in high doses to open airways and make breathing easier. In lower doses, prednisolone is used to keep airways open in people with chronic uncontrolled asthma.
Standard dosage for adults: 40–80 mg divided into one or two daily doses (hospital management); 40–60 mg taken once per day (short-burst treatment); 7.5–60 mg taken once per day or once every other day (persistent asthma)
Standard dosage for children: 1–2 mg/kg divided into one or two daily doses (hospital management); 1–2 mg/kg taken once per day for three to 10 days (short-burst treatment); 0.25–2 mg/kg taken once per day or once every other day (persistent asthma)
Prednisolone dosage for other lung disorders
Prednisolone is used to reduce airway swelling for various lung disorders including pneumocystis pneumonia (PCP), aspiration pneumonia, allergic pneumonia, tuberculosis, and pulmonary fibrosis (lung scarring). It is also commonly used off-label to open airway swelling caused by chronic obstructive pulmonary disease (COPD) and, in infants, croup.
Standard dosage for adults: 5–60 mg taken once per day
Standard dosage for infants and children: 1–2 mg/kg daily
Prednisolone dosage for connective tissue disorders
Prednisolone can reduce swelling and pain due to flare-ups of osteoarthritis, gout, bursitis, tenosynovitis, and polychondritis. It is also commonly used off-label to relieve pain due to carpal tunnel syndrome. To avoid side effects, the lowest possible dose will be used for the shortest possible duration.
Standard dosage for adults: 5–60 mg taken once per day
Standard dosage to treat carpal tunnel syndrome in adults: 20 mg taken once per day for two weeks followed by 10 mg taken once per day for two weeks
Prednisolone dosage for inflammatory bowel disease
Prednisolone is used to reduce inflammation during active flare-ups of ulcerative colitis or Crohn’s disease. Doses and the duration of treatment will depend on treatment response.
Standard dosage for adults: 5–60 mg per day
Standard dosage for children: 0.14–2 mg/kg per day
Prednisolone dosage for cancer
Because prednisolone blocks the growth of white blood cells, it is commonly used in white blood cell and bone marrow cancers such as acute lymphocytic leukemia, chronic lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, or, off-label, multiple myeloma. Prednisolone is also used to reduce tumor swelling and to treat high blood calcium caused by a tumor.
Standard dosage for adults: 5–60 mg per day
Standard dosage for children: 0.14–2 mg/kg or 4–60 mg/m2 given daily in three to four divided doses
Prednisolone dosage for endocrine disorders (adrenal insufficiency)
Prednisolone is similar to cortisol, a natural hormone produced by the body’s adrenal glands. Adrenal insufficiency occurs when the adrenal glands do not make enough cortisol due to a variety of causes including Addison’s disease, congenital adrenal insufficiency, or steroid use. Prednisolone or prednisone are commonly used as hormone therapy for adrenal insufficiency using the lowest effective dose.
Standard dosage for adults: 5–60 mg taken daily on one or two divided doses
Standard dosage for infants and children: 0.14–2 mg/kg or 4–60 mg/m2 daily given in three to four divided doses
Prednisolone dosage for organ transplants
In combination with other immune-suppressing drugs, prednisolone is used to block the immune system to prevent or treat kidney transplant rejection. It is also used off-label to prevent heart transplant rejection.
Standard dosage for adults: 5–60 mg taken daily in one or two divided doses
Standard dosage for children: 0.14–2 mg/kg or 4–60 mg/m2 daily in three to four divided doses
Prednisolone dosage for eye disorders
Prednisolone sodium phosphate or prednisolone acetate eye drops are used to reduce swelling due to several eye conditions including conjunctivitis, infection, sores, surgical procedures, or injury.
Standard prednisolone acetate dosage for adults, children, and infants:
Two drops placed on the surface of each affected eye four times daily
Standard prednisolone sodium phosphate dosage for adults, children, and infants:
One to two drops placed on the surface of each affected eye each hour while awake and every two hours at night as initial dosage; one to two drops on each affected eye three to four times a day as a maintenance dose
Prednisolone dosage for other disorders
Prednisolone is used at the lowest effective dose to reduce airway blockage caused by a parasite infection (Loeffler’s syndrome), lung inflammation due to beryllium poisoning of the lungs (berylliosis), and tissue swelling caused by trichinosis parasites. Other disorders that can be treated by prednisolone include excess protein in the urine (proteinuria), kidney swelling, Bell’s palsy, and Kawasaki disease.
Standard dosage for adults: 5–60 mg taken daily
Standard dosage for children: 0.14–2 mg/kg/day
Prednisolone dosage for pets
Prednisolone is commonly used in cats, dogs, and other animals for a variety of conditions. Veterinarians use low doses of prednisolone to reduce swelling, typically 0.5-1 mg/kg in dogs and 0.55-1.1 mg/kg in cats. High-dose prednisolone is used to suppress the immune system or fight cancer, typically up to 2.2 mg/kg for dogs and as high as 4.4 mg/kg for cats. For sudden-onset adrenal insufficiency, dexamethasone is the preferred glucocorticoid. For maintenance hormone replacement in animals with adrenal insufficiency, prednisolone can be prescribed in very small doses, typically 0.1 mg/kg taken daily.
How to take prednisolone
Prednisolone is administered as a tablet, disintegrating tablet, oral solution, or applied topically as eye drops.
Take prednisolone as directed. The dose may need to change several times.
The healthcare provider will usually specify particular times of day to take the medication. It’s important to follow the schedule to ensure the drug’s maximum effectiveness.
Take this medicine with food or milk.
A doctor may prescribe calcium supplements for patients who have osteoporosis or are taking prednisolone for several weeks. Take these calcium supplements as prescribed to prevent bone loss.
Side effects like mood swings, fluid retention, and weight gain are commonly experienced by people taking prednisolone. Mood or personality changes can emerge even after a single dose. If side effects become a problem, seek medical advice before stopping this medicine.
Do not stop prednisolone without speaking to a healthcare provider, especially if you have been taking it for a long time.
TABLET
Swallow the tablet whole with a full glass of water. Do not crush, break, or chew it.
DISINTEGRATING TABLET
Keep the disintegrating tablet in the blister pack until it’s time to take a dose.
Open the blister pack and handle the disintegrating tablet only with dry hands.
Peel back the foil from the blister pack to remove the tablet. Do not push the tablet through the foil.
Do not break the tablet or use a broken tablet.
Place the tablet in your mouth and allow it to melt. Do not chew the tablet.
Swallow several times as the tablet melts.
Once it has melted, drink a glass of water.
Store prednisolone disintegrating tablets at room temperature (68°F–77°F).
ORAL SOLUTION
Oral solution prednisolone comes with a metered oral syringe, medicine cup, or spoon. If it is missing, ask the pharmacist for a free replacement.
Shake the closed container well before measuring out a dose.
When taking the oral suspension, always use the measuring device supplied with the medicine to measure out a dose.
Store prednisolone oral solution in a tightly closed container at room temperature (68°F–77°F). Do not refrigerate.
EYE DROPS
Shake the closed container well before each use.
Wash your hands with soap and water before and after using this medicine.
Do not use prednisolone eye drops while wearing soft contact lenses.
Tilt the head back and pull down the lower eyelid.
Hold the dropper close to the eye. Do not touch the eye with the dropper.
Put two drops into the pocket between the lower lid and eyeball.
Gently close your eyes for one to two minutes.
To avoid contamination, do not rinse or wipe the dropper or allow it to touch anything.
Put the cap on the bottle immediately.
Wait at least 15 minutes before putting in contact lenses.
Store the closed bottle in an upright position at cooler room temperatures (46°–75°F).
Prednisolone dosage FAQs
How long does it take prednisolone to work?
Prednisolone reaches peak concentrations in the blood in about one to two hours. However, some medicines can reduce the concentration and therapeutic benefits of prednisolone.
How long does prednisolone stay in your system?
Prednisolone is cleared from the body relatively quickly. With a half-life of two to three and a half hours, it is usually completely cleared from the body in 12 hours.
What happens if I miss a dose of prednisolone?
Take a dose as soon as it’s remembered but not if it’s nearly time to take the next dose. In that case, skip the missed dose and take the next scheduled dose on time. In order to prevent changes to the body’s regulation of natural corticosteroid hormones, it is crucial to take each dose as scheduled. If that’s a problem, talk to a pharmacist about alarms, apps, or other devices that can help ensure doses are taken on schedule.
How long can you take prednisolone?
For most medical conditions, prednisolone is prescribed at the lowest effective dose for the shortest possible duration to prevent side effects or hormone disruptions. However, some conditions may require that prednisolone be taken indefinitely. For long-term treatment, Alternate Day Therapy (ADT) is sometimes used to prevent serious side effects and reduce prednisolone’s disruption of the body’s hormone (endocrine) system. ADT involves taking a double dose every other day and taking no dose on alternate days.
How do I stop taking prednisolone?
Unless taken for a very short duration, prednisolone doses must be tapered to prevent adrenal insufficiency.
Prednisolone suppresses the body’s natural production of the hormone cortisol by disrupting the HPA axis (hypothalamic-pituitary-adrenal axis), causing adrenal insufficiency. The body stops producing enough cortisol, a hormone vital to regulating blood pressure, electrolyte balance, glucose, and some brain functions. When adrenal insufficiency lasts for only a few days or weeks, healthcare professionals call this “steroid withdrawal.” Symptoms of steroid withdrawal include:
Fever
Malaise (“Feeling bad”)
Nausea
Loss of appetite
Weight loss
Joint pain
Weakness
Lethargy
Healthcare providers use a steadily decreasing dose of prednisolone over a period of weeks or even months to help the body recover normal cortisol production.
There are, however, reasons why prednisolone therapy may need to stop—sometimes quickly. Any serious hypersensitivity or allergic reaction, such as anaphylaxis, will end treatment immediately. Also, serious side effects such as heart failure, an elevation of intracranial pressure, a rise in intraocular pressure, glaucoma, swelling of the optic nerve (optic neuritis), vision loss, high blood pressure (hypertension), gastrointestinal perforation, peptic ulcer, muscle damage (myopathy), and alkaline blood due to low potassium (hypokalemic alkalosis).
Other medical conditions may arise that may require quickly discontinuing treatment include herpes simplex infection of the eye, fungal infections of the body’s organs (systemic fungal infection), exposure to measles or chickenpox, underactive thyroid (hypothyroidism), or exacerbations of diverticulitis, inflammatory bowel disease, myasthenia gravis, or multiple sclerosis. Prednisolone can cross the placenta and is present in breast milk, so the risks and benefits when pregnant or breastfeeding should be discussed with a healthcare professional.
There are alternatives if prednisolone can’t be taken. For milder inflammatory conditions, the first alternative will be prescription or over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). Other prescription drugs reduce inflammation by modulating the immune system including sulfasalazine and hydroxychloroquine. Depending on the condition, immunosuppressive substitutes for high-dose prednisolone include methotrexate, colchicine, dapsone, azathioprine, leflunomide, minocycline, tacrolimus, pimecrolimus, cyclosporine, and biologics.
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