The dosage of prednisolone depends on the disease to be treated and the individual responsiveness of the patient. In general, it can be said that severe and acute diseases are treated with higher doses of Prednisolone than mild and chronic diseases. Usually, prednisolone treatment starts with a high initial dose and, if clinical improvement is achieved, the treatment continues with a lower maintenance dose of 5 to 15 mg prednisolone per day.
A maintenance dose is the smallest dose that still has an effect. In extreme cases (e.g. rejection reactions after transplantation) one deviates from this scheme and administers a high-dose shock or pulse therapy, in which the entire prednisolone dose of 1000mg is injected intravenously. However, this can only be done for a few days at a time.
The dose level of prednisolone depends on the type of treatment, whereby substitution therapy or pharmacotherapy is possible. For substitution therapies – hormone replacement therapies – 5 to 7.5 mg prednisolone is prescribed daily, which is taken in one or two single doses. In the case of extraordinary stress such as trauma, surgery or infection, the prednisolone dose must be increased, as the turnover and thus the need for prednisolone increases.
In pharmacotherapy, on the other hand, the entire quantity of Prednisolon is usually taken at once in the morning between 6 and 8 a.m. Exceptions are high or medium doses, where the total amount can be divided into 2 to 4 (high dose) or 2 to 3 (medium dose) single doses. The guideline for pharmacotherapy is that high doses consist of 80 to 100 mg prednisolone per day, medium doses of 40 to 80 mg per day, low doses of 10 to 40 mg and very low doses of 1.5 to 7.5 mg prednisolone.
This is different with chemotherapy, where the dose level of prednisolone is determined by the established chemotherapy protocols of the respective cancer. In children, the amount of prednisolone is calculated on the basis of body weight and the administration is intermittent or alternating. In long-term therapy with prednisolone there is a limit dose which should not be exceeded, the so-called Cushing’s threshold dose.
This is 7.5 mg prednisolone per day. If more prednisolone is given, side effects are increasingly occurring. It should be noted in both adults and children that the drug must be discontinued when the prednisolone therapy is terminated.
This means a gradual reduction of the amount over several days. However, it is not necessary to discontinue the prednisolone during short therapies that last only a few days. Prednisolone tablets are taken unchewed with liquid, either with food or shortly after.
Alternatively, Prednisolone can be injected intravenously (e.g. for shock therapy). Prednisolone belongs to the group of glucocorticoids with a medium-long effect and is effective for 12 to 36 hours. The maximum concentration after oral uptake is reached in the blood after 1 to 2 hours where prednisolone is bound to transport proteins (transcortin, albumin). The drug is metabolised in the liver and excreted via the kidneys.
