Prednisone dosage, forms, and strengths

Prednisone 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 conditions, rheumatic disorders, various types of arthritis, certain types of cancer, lung disorders, endocrine disorders, ulcerative 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 class of medications called glucocorticoids (a subset of a larger group called corticosteroids), which also includes drugs like 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 available as immediate-release and delayed-release tablets and oral solutions. The 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.

• Tablets: 1 milligram (mg), 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg

• Delayed-release tablets: 1 mg, 2 mg, 5 mg

• Oral solution:

• Prednisone solution: 5 mg per 5 milliliters (mL)

• Prednisone Intensol concentrated solution: 5 mg/1 mL

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

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* Acquired hemolytic anemia, congenital hypoplastic anemia, and symptomatic sarcoidosis

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 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: 1–2 mg per kg per day divided into one to four daily doses (maximum 60 mg per day)

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. In some cases, 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); 7.5–60 mg taken once per day or every other day (maintenance treatment of asthma)

• Standard dosage for children: 1–2 mg/kg/day divided into one or two doses (hospital management); 0.25–2 mg/kg/day taken once per day or every other day (maintenance treatment of 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 may be used when the infection spreads to the heart or nervous system, such as in cases of meningitis. For some lung conditions, such as pulmonary fibrosis, long-term low-dose prednisone may be required to prevent the progression of the disease.

• Standard dosage for adults: 5–60 mg taken once per day 

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: 5–60 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 (to manage 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 the 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. Conditions such as Addison’s disease and congenital adrenal insufficiency, as well as long-term steroid use, may require prednisone. 

• Standard dosage for adults: 2.5–7.5 mg taken daily

• Standard dosage for infants and children: 1.5 to 3.5 mg per m2 taken daily in two divided doses; higher doses may be needed at times

Prednisone dosage for organ transplants

Low-dose prednisone treatment is used along with more powerful immune-suppressing drugs for several months to one year to prevent the immune system from attacking transplanted kidneys. High-dose prednisone is also used 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 (water pills) 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: 5–60 mg taken daily

• Standard for children: 0.14–2 mg/kg/day in 1 to 4 divided doses

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 treat 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/kg 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.

Before you take prednisone, tell your healthcare provider about your medical history, including any health condition you have, as well as the medications you take.

• Talk to your healthcare provider about the potential side effects of prednisone. Know what signs to look out for, such as symptoms of high blood sugar, which require medical attention. 

• 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.

• While taking prednisone, you should not receive a live vaccine. Before receiving any type of vaccine, check with your healthcare provider.

TABLET

• Take as directed. The extended-release tablets should be swallowed whole with a full glass of water. Do not crush, break, or chew the extended-release 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 also available. 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 often recommended to be taken at bedtime and activate about four to 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, which can possibly reduce the drug’s effectiveness.

What are the common side effects of prednisone?

Common potential side effects of prednisone include but are not limited to, the following.

• Headache

• Dizziness 

• Personality changes 

• Mood changes 

• Trouble sleeping 

• Bulging eyes

• Acne

• Thin skin 

• Slow healing of cuts and bruises

• Red/purple blotches under the skin

• Increased hair growth

• Changes in fat distribution

• Weakness and tiredness

• Menstrual changes

• Decreased interest in sex

• Stomach upset or heartburn

• Increased sweating

This is not a full list of adverse effects, and others may occur. Consult your healthcare provider for more information and a complete list of possible side effects. 

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 8 to 15 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. If you are not sure what to do, ask your doctor or pharmacist.

How long can you take prednisone?

For many conditions, healthcare providers aim to prescribe low doses of prednisone for a short time, specifically the lowest possible effective dose for the shortest possible length of time.

In addition to causing difficult side effects, the use of this medication, especially long-term, suppresses 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. Taking prednisone for a long time and/or at higher doses could also cause serious side effects. Long-term prednisone use may cause complications such as vision problems (including glaucoma or cataracts), glucose intolerance, weight gain, and bone loss due to calcium depletion (osteoporosis). Due to concerns about slow growth, children who take prednisone will be closely monitored for any growth issues. 

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

• Skin peeling or shedding

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

• Heart failure

• 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 should consult their healthcare professional 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. 

Sources:

• Anti-inflammatory agents: present and future, Cell (2013)

• Corticosteroids, StatPearls (2023)

• Corticosteroids overdose, St. Luke’s Hospital

• Half-life, StatPearls (2023)

• Prednisone, Prescribers Digital Reference

• Prednisone, Medline Plus (2024)

• Prednisone compound summary

• Prednisone (Deltasone), American College of Rheumatology

• Prednisone tablet, prednisone solution, prednisone Intensol prescribing information, U.S. National Library of Medicine (2024)

• Relapse management, National Multiple Sclerosis Society

• Plumb’s Veterinary Handbook, 7th Edition

• Immunosuppressive medication for the treatment of autoimmune disease, American Academy of Allergy Asthma & Immunology

• The steroid withdrawal syndrome: A review of the implications, etiology, and treatments, Journal of Pain and Symptom Management (2007)