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EspañolPrednisone is a generic prescription drug that is used alone or in combination with other drugs to treat a wide range of medical conditions including allergic reactions, autoimmune diseases, rheumatic disorders, arthritis, cancer, lung disorders, endocrine disorders, colitis, blood cell disorders, organ transplants, and connective tissue disorders. Prednisone itself is inactive in the body until it is converted into prednisolone, which belongs to a family of drugs called glucocorticoids or corticosteroids, a family of drugs that also includes hydrocortisone and dexamethasone.
Low-dose prednisone is used to reduce inflammation or in certain types of hormone replacement therapy. In larger doses and/or longer duration of treatment, prednisone suppresses the immune system or is part of a cancer treatment regimen. Usually prescribed as a generic drug, prednisone is also available under the brand name Rayos (delayed-release tablet). Prednisone is taken by mouth as a tablet or oral solution, but dosages will vary depending on the condition treated.
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Prednisone dosage, forms, and strengths
Prednisone is taken by mouth as a tablet or oral solution. Prednisone is also available as a delayed-release tablet under the brand name Rayos.
Tablets: 1 milligram (mg), 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
Delayed-release tablets (Rayos): 1 mg, 2 mg, 5 mL
Oral prednisone solution: 5 mg per 5 milliliters (mL)
Oral prednisone intensol concentrated solution: 5 mg/1 m
Prednisone dosage for adults
The U.S. Food and Drug Administration (FDA) has approved prednisone as a primary or supportive treatment for almost 60 different medical conditions. Prednisone is also used off-label to treat many more medical conditions. Dosages will vary widely depending on the type and severity of the medical condition being treated, from as little as 2.5 mg a day to as high as 1250 mg per day (for 3-5 days). Many conditions will require that doses be determined by body weight or body surface area.
Standard dosage for adults: 5–60 mg per day
Maximum prednisone dosage for adults: Varies by medical condition
| Prednisone dosage chart | |||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
| AUTOIMMUNE DISORDERS | |||
| Rheumatoid and arthritic conditions* | 5–30 mg taken once per day | 5–30 mg taken once per day | Not specified |
| Psoriatic arthritis or severe plaque psoriasis | 5–30 mg taken once per day | 5–30 mg taken once per day | 60 mg per day |
| Myasthenia gravis | 15–20 mg taken once per day | 15–20 mg taken once per day increased by 5 mg every 2-3 days to the lowest effective dose | 60 mg per day |
| Multiple sclerosis (acute exacerbation) | 1250 mg taken once per day for 3-5 days | 1250 mg taken once per day for 3-5 days | Not specified |
| Lupus erythematosus (exacerbation) | 20–40 mg taken once per day for mild/moderate cases and 60–300 mg in divided doses for severe cases | Once controlled, the dose is reduced by 10% every 5-7 days until discontinuation | 300 mg taken daily in divided doses |
| Lupus erythematosus (maintenance) | 10–20 mg taken once per day or 20–40 mg taken every other day | 10–20 mg taken once per day or 20–40 mg taken every other day | Not specified |
| Lupus nephritis | Methylprednisolone 500–1000 mg/day given intravenously once per day for 3 days, then oral prednisone 0.5 to 1 mg/kg/day | 0.5–1 mg/kg taken once per day (prednisone) | Not specified |
| Immune thrombocytopenia (ITC)/ thrombocytopenia purpura | 1 mg/kg taken once per day for short-term treatment | 5–10 mg taken once per day for long-term treatment | Not specified |
| Erythroblastopenia | 5–60 mg taken in 1-4 divided doses daily | 5–60 mg taken in 1-4 divided doses daily and gradually reduced until discontinued in 4-6 weeks | Not specified |
| Other autoimmune conditions* | 5–30 mg taken once per day | 5–30 mg taken once per day | Not specified |
| ALLERGIC REACTIONS | |||
| Allergic skin reactions | 5–60 mg taken divided into 1-4 doses per day | 5–60 mg taken divided into 1-4 doses per day | Not specified |
| Severe allergic skin reactions | 60 mg taken once a day | 60–250 mg taken once a day | Not specified |
| Severe allergic reactions | 5–60 mg taken divided into 1-4 doses per day | 5–60 mg taken divided into 1-4 doses per day | Not specified |
| ASTHMA | |||
| Asthma (acute exacerbation) | 40–80 mg taken per day or divided into 2 doses per day | 40–80 mg taken once per day or divided into 2 doses per day until peak expiratory flow hits 70% (usually 3 to 10 days) | Not specified |
| Asthma (short burst) | 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 to 10 days until peak expiratory flow hits 80% | Not specified |
| Asthma (persistent) | 7.5–60 mg taken once per day or once every other day | 7.5–60 mg taken once per day or once every other day | Not specified |
| LUNG DISORDERS | |||
| Pneumocystis pneumonia (PCP) infection | 40 mg taken twice per day for 5 days | 40 mg taken twice per day for 5 days, then 40 mg taken once per day for 5 days, then 20 mg taken once per day for 11 days | Not specified |
| Disseminated pulmonary tuberculosis | 60 mg taken once per day | 60 mg taken once per day and reduced by 10 mg each week until discontinued in 6-8 weeks | Not specified |
| Allergic or aspiration pneumonitis | 5–60 mg taken once per day | 5–60 mg taken once per day and gradually reduced until discontinued in 4-6 weeks | Not specified |
| Pulmonary fibrosis | 0.5 mg/kg per day taken for 4 weeks | 0.5 mg/kg/day taken for 4 weeks followed by 0.25 mg/kg/day taken for 8 weeks then 0.125 mg/kg/day or 0.25 mg/kg/day every other day | Not specified |
| CONNECTIVE TISSUE DISORDERS | |||
| Osteoarthritis | 5–30 mg taken once per day | 5–30 mg taken once per day | Not specified |
| Gout | 5–30 mg taken once per day | 5–30 mg taken once per day | Not specified |
| Bursitis, tenosynovitis, synovitis, epicondylitis | 5–30 mg taken once per day | 5–30 mg taken once per day | Not specified |
| Dermatomyositis | 20 to 40 mg/day for moderate illness, 60 to 100 mg/day for severe illness | 10 to 20 mg once daily or 20 to 40 mg every other day | 200 to 300 mg per day in divided doses |
| Polychondritis | 20 to 40 mg/day for moderate illness, 60 to 100 mg/day for severe illness | 10 to 20 mg once daily or 20 to 40 mg every other day | 200 to 300 mg per day in divided doses |
| Temporal arteritis, vasculitis | 20 to 40 mg/day for moderate illness, 60 to 100 mg/day for severe illness | 10 to 20 mg once daily or 20 to 40 mg every other day | 200 to 300 mg per day in divided doses |
| INFLAMMATORY BOWEL DISEASE (IBD) | |||
| Crohn’s disease (acute exacerbations) | 40–60 mg per day for 1-2 weeks | Steadily tapering dose (by 5 mg weekly) to 20 mg per day, then steadily tapering dose (by 2.5–5 mg weekly) until discontinuation | Not specified |
| Ulcerative colitis (acute exacerbations) | 40–60 mg once per day | 40–60 mg once per day until remission of symptoms (usually 5-7 days) | 60 mg per day |
| CANCER | |||
| Acute lymphocytic leukemia (palliative treatment) | 40–50 mg/square meter of body surface area taken once per day | 40–50 mg/square meter of body surface area taken once per day | Not specified |
| Chronic lymphocytic leukemia (palliative treatment) | 5–60 mg taken once per day | Individualized according to response | Not specified |
| Hodgkin lymphoma | 40 mg/square meter of body surface area per day on days 1 through 22 then taper, repeat cycle every 57 days | 40 mg/square meter of body surface area per day on days 1 through 22 then taper, repeat cycle every 57 days | Not specified |
| Mycosis fungoides | 5–60 mg taken divided into 1-4 doses per day | 5–60 mg taken divided into 1-4 doses per day | Not specified |
| Hypercalcemia (high blood calcium) due to cancer | 50–100 mg taken once per day for 3-5 days | 50–100 mg taken once per day for 3-5 days | Not specified |
| ENDOCRINE (HORMONE) DISORDERS | |||
| Addison’s disease or secondary adrenal insufficiency (maintenance treatment only) | 5 mg taken in the morning and 2.5 mg taken in the evening every day | 5 mg taken in the morning and 2.5 mg taken in the evening every day | Not specified |
| Congenital adrenal hyperplasia | 2.5–5 mg taken at bedtime every day | 2.5–5 mg taken at bedtime every day | Not specified |
| TRANSPLANT REJECTION PREVENTION | |||
| Kidney transplant | 5–30 mg taken once per day with other immune-suppressing drugs | 5–30 mg taken once per day | Not specified |
| Chronic graft vs. host disease | 1 mg/kg taken once per day alternating with cyclosporine | Varies | Not specified |
| OTHER DISORDERS | |||
| Proteinuria | 40–80 mg taken once per day | 40–80 mg taken once per day until urine is clear of protein, then taper off | Not specified |
| Loeffler’s syndrome, berylliosis, trichinosis | 5–60 mg taken in 1-4 divided doses daily | 5–60 mg taken in 1-4 divided doses daily and gradually reduced until discontinued in 4-6 weeks | Not specified |
Prednisone dosage for autoimmune disorders
Prednisone is prescribed in low or high doses to reduce swelling or suppress the immune system during active attacks of autoimmune disorders such as rheumatic disorders (rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and rheumatic carditis), psoriasis, multiple sclerosis, systemic lupus, myasthenia gravis, and other conditions in which the body’s immune system attacks healthy tissues. For some autoimmune conditions, lower-dose prednisone is used in the long term to prevent relapses.
Standard dosage for adults for exacerbations: 5–60 mg per day
Standard dosage for infants and children: 0.05–2 mg per kg per day divided into one to four daily doses
Renally impaired patients: No adjustment, no supplement for dialysis
Hepatically impaired patients: Not defined. Prednisone is converted to its active metabolite, prednisolone, in the liver. In patients with severe liver problems, prednisolone may be preferred.
Prednisone dosage for allergic reactions
Low-dose prednisone is used to reduce swelling due to allergic skin reactions (dermatitis, eczema, pemphigus) and more severe allergic reactions (anaphylaxis, angioedema, drug reactions, food reactions, laryngeal edema, seasonal allergies, and allergic rhinitis). High-dose prednisone is used to suppress the immune system during attacks of severe and life-threatening allergic skin reactions including 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: 0.05–2 mg per kg per day divided into one to four daily doses
Prednisone dosage for asthma
High-dose prednisone is used as a short-term treatment with other asthma drugs to reduce airway swelling due to severe, sudden asthma attacks in children and adults. It is also used long-term in the lowest effective dose to treat persistent, hard to control asthma.
Standard dosage for adults: 40–80 mg divided into one or two daily doses (hospital management); 40–60 mg divided into one or two daily doses (short-burst treatment); 7.5–60 mg taken once per day or every other day (persistent asthma)
Standard dosage for children: 1–2 mg/kg/day divided into one or two doses (hospital management); 1–2 mg/kg/day divided into 1 or 2 doses (short-burst treatment); 0.25–2 mg/kg/day taken once per day or every other day (persistent asthma)
Prednisone dosage for lung disorders
Depending on the underlying medical condition, low to high-dose prednisone is used in the short term to reduce airway swelling in a variety of lung disorders or infections. For tuberculosis, prednisone is used when the infection spreads to the heart or nervous system (meningitis). For some lung disorders, such as pulmonary fibrosis, long-term low-dose prednisone may be required to prevent progression of the disease.
Standard dosage for adults: 5–60 mg taken once per day
Standard dosage for infants and children: 1–2 mg/kg daily (max 60 mg per day) in 1 to 4 divided doses
Prednisone dosage for connective tissue disorders
Prednisone is commonly used at the lowest effective dose to reduce swelling and pain due to flare-ups of osteoarthritis, bursitis, gout, and other chronic or temporary connective tissue problems.
Standard dosage for adults: 5–30 mg taken once per day
Prednisone dosage for inflammatory bowel disease (IBD)
High-dose prednisone is used in the short term to reduce swelling during active attacks of ulcerative colitis or Crohn’s disease. Treatment typically will last a few days or weeks and doses will be steadily tapered until discontinuation.
Standard dosage for adults: 40–60 mg per day
Prednisone dosage for cancer
Prednisone is used in combination with other drugs as a palliative treatment (treats symptoms) for certain types of leukemia and lymphoma. Prednisone is also used alone or in combination with other drugs to treat other conditions related to cancer such as anemia, allergic reactions, and high calcium levels.
Standard dosage for adults: Varies depending on condition and role of prednisone in cancer treatment
Standard for children: Varies depending on condition and role of prednisone in cancer treatment
Prednisone dosage for endocrine disorders (adrenal insufficiency)
When the adrenal glands do not produce adequate levels of cortisol, the body’s natural corticosteroid, prednisone can be used as a hormone replacement. Doses will be very small, essentially enough to replace the body’s production of cortisol, called a physiologic dose. Addison’s disease, congenital adrenal insufficiency, and long-term steroid use can all cause adrenal insufficiency.
Standard dosage for adults: 2.5–7.5 mg taken daily
Standard dosage for infants and children: 4–20 mg per meter squared of body area taken daily in 1 to 4 divided doses
Prednisone dosage for organ transplants
Low-dose prednisone treatment is used along with more powerful immune-suppressing drugs for several months to 1 year to prevent the immune system from attacking and killing transplanted kidneys. High-dose prednisone is used also as an immune suppressant in people with chronic graft-versus-host disease, a condition in which a stem cell or bone marrow transplant produces immune cells that attack the host’s tissues.
Standard dosage for adults: 5–30 mg taken daily for three to 12 months
Prednisone dosage for other disorders
Prednisone is used at the lowest effective dose to reduce airway swelling due to Loeffler’s syndrome (caused by a parasite infection), lung inflammation due to berylliosis (beryllium poisoning), and tissue swelling due to trichinosis (a parasite infection). High-dose prednisone is commonly used as a first-line treatment along with diuretics to reduce protein in the urine in people with proteinuria (or nephrotic syndrome), a medical condition in which too much protein is passed into the urine.
Standard dosage for adults: 5–80 mg taken daily
Standard for children: 0.14–2 mg/kg/day in 1 to 4 divided doses
Prednisone dosage for children
As for adults, prednisone is used for a wide range of pediatric medical conditions. Dosages will be determined by the child’s weight but can vary widely based on the condition being treated. Prednisone can be given to children as young as newborns, but the appropriate age limit will vary by condition.
| Prednisone dosage by age | ||
|---|---|---|
| Age | Standard dosage | Maximum dosage |
| Infants and children | 0.05–2 mg per kg per day divided into 1-4 daily doses | Varies by condition |
* Acquired hemolytic anemia, congenital hypoplastic anemia, nonsuppurative thyroiditis (swollen thyroid), and symptomatic sarcoidosis
Prednisone dosage for pets
Prednisone is commonly used in pets and animals for a variety of conditions. Low-dose prednisone is used to reduce inflammation; high-dose prednisone is used to suppress the immune system or fight cancer, and physiological-dose prednisone is used for hormone replacement. Dosage is determined by weight but will depend on the type of animal and medical condition being treated. For dogs, the standard dosage is 0.5 to 1 mg/lb taken by mouth once per day. Cats will typically be given prednisolone, the active form of prednisone.
How to take prednisone
Prednisone is taken by mouth as a tablet or oral solution. Prednisone should be taken with food. As a general rule, prednisone is usually taken in the morning to align with the body’s natural cycle of corticosteroid production. Some conditions, however, may require dosing at other times of the day.
Take prednisone as directed. The dose may change several times, for example, if it is tapered.
A 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.
Tablet
Take as directed. Rayos tablets are extended-release and should be swallowed whole with a full glass of water. Do not crush, break, or chew Rayos tablets.
Store prednisone tablets in a tightly closed container at room temperature (68°F–77°F) and protected from light, heat, and moisture.
Oral solution
Oral solution prednisone comes with a metered oral syringe, medicine cup, or spoon. If it is missing, ask the pharmacist for a free replacement.
When taking the oral solution, always use the measuring device supplied with the medicine to measure out a dose.
Store prednisone oral solution in a tightly closed container at room temperature (68°F–77°F).
Prednisone dosage FAQs
Prednisone vs. delayed-release prednisone: What’s the difference in doses?
Prednisone is usually administered as an immediate-release tablet or oral solution, but delayed-release prednisone is available under the brand name, Rayos. Doses will not vary but the dosing schedule will. Prednisone doses are timed to align with the body’s peak production of cortisol, the natural corticosteroid made by the body. This happens in the early morning hours, so an immediate-release prednisone dose is taken first thing in the morning. Delayed-release tablets are taken at bedtime and activate about six hours later.
How long does it take for prednisone to work?
Prednisone starts working in about one hour after an oral dose. Delayed-release prednisone reaches peak effectiveness in six hours. Food does not affect the absorption of prednisone, but some medicines can speed up the body’s metabolic breakdown of prednisone, reducing the drug’s benefits.
How long does prednisone stay in your system?
Prednisone has a half-life of about two to three hours, meaning that it takes the body that much time to clear half the dose of prednisone and its active form, prednisolone. It takes four to five half-lives to clear a drug from the body, so a dose of prednisone should be cleared from the body in 10 to 12 hours.
What happens if I miss a dose of prednisone?
Take a missed dose as soon as it’s remembered. If it’s almost time for the next dose, skip the missed dose and take the next dose at the scheduled time. Do not take extra medicine to make up for a missed dose.
How long can you take prednisone?
For most conditions, prednisone will be given at the lowest possible dose for the shortest possible duration. In addition to causing difficult side effects, prednisone and other corticosteroids suppress important hormone production in the pituitary and adrenal glands. This suppression can lead to hormone disorders, growth suppression in children, and potentially serious withdrawal symptoms when the medication is discontinued. Long-term prednisone treatment can also cause serious side effects such as glaucoma, cataracts, glucose intolerance, weight gain, and bone loss due to calcium depletion (osteoporosis).
For some medical conditions, prednisone will be given indefinitely as long as it is effective and side effects are tolerable. To reduce prednisone’s effects on the body’s hormones, long-term prednisone treatment may involve Alternate Day Therapy (ADT) dosing. A double dose is taken every other day followed by a day off.
How do I stop taking prednisone?
Unless taken as a short-term treatment, prednisone will always be discontinued in a steadily tapering dose to prevent withdrawal. Prednisone suppresses the body’s production of a natural hormone similar to prednisolone called cortisol. When taken long enough, the hormone suppression caused by prednisone can cause potentially serious and even fatal withdrawal. Symptoms of steroid withdrawal include:
Fever
Malaise (Feeling bad)
Nausea
Loss of appetite
Weight loss
Joint pain
Weakness
Lethargy
There are, however, many reasons prednisone may need to be discontinued, such as serious side effects or medical conditions such as:
Fungal infections
Chickenpox, herpes simplex eye infections, or other viral infections
Digestive system problems such as ulcers, perforation, or diverticulitis
Cushing’s syndrome (when the body produces too much cortisol)
Drug interactions
Because prednisone and prednisolone can cross the placenta and are present in breast milk, women who are pregnant or breastfeeding may choose to stop prednisone treatments. The healthcare professional should be consulted regarding prednisone and pregnancy or breastfeeding.
Alternatives to prednisone depend on the condition being treated. For inflammation, alternative treatments include nonsteroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter aspirin or ibuprofen as well as prescription NSAIDs. For immune suppression, several drugs are available including methotrexate, colchicine, dapsone, azathioprine, tacrolimus, cyclosporine, and newer monoclonal antibodies and biologics.
What is the maximum dosage for prednisone?
The Food and Drug Administration has not specified a maximum dosage of prednisone. Healthcare providers try to use the lowest possible effective dose for the shortest period. The largest recommended prednisone dosage is 1250 mg per day (25, 50 mg tablets per day) for 3 to 5 days for active flare-ups of multiple sclerosis.
Can you overdose on prednisone?
High doses of prednisone will increase the incidence and severity of side effects. Symptoms of prednisone overdose include mood swings, burning or itching skin, high blood pressure (hypertension), hearing problems, muscle weakness, agitation, nausea, vomiting, low potassium, high blood sugar, menstrual irregularities, and fluid retention. If prednisone doses have been exceeded, call a poison helpline or seek professional medical advice.
Related resources for prednisone dosages:
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