It diffuses across cell membranes and forms a complex with specific cytoplasmic receptors. These complexes then enter the cell nucleus, binds to DNA, and stimulate transcription of messenger RNA (mRNA). Messenger RNA leads to protein synthesis of various enzymes that are responsible for the effects of systemic corticosteroids

Specific Dosages

Dosing: Adult

Dose depends upon condition being treated and response of patient. Oral dosage expressed in terms of prednisolone base. Consider alternate day therapy for long-term therapy. Discontinuation of long-term therapy requires gradual withdrawal by tapering the dose. Patients undergoing unusual stress while receiving corticosteroids, should receive increased doses prior to, during, and after the stressful situation.

Usual dose (range): Oral: 5-60 mg/day

Rheumatoid arthritis: Oral: Initial: 5-7.5 mg/day, adjust dose as necessary

Multiple sclerosis: Oral: 200 mg/day for 1 week followed by 80 mg every other day for 1 month

Dosing adjustment in hyperthyroidism: Prednisolone dose may need to be increased to achieve adequate therapeutic effects.

Dosing: Pediatric

(For additional information see "Prednisolone (systemic): Pediatric drug information")

Dose depends upon condition being treated and response of patient; dosage for infants and children should be based on severity of the disease and response of the patient rather than on strict adherence to dosage indicated by age, weight, or body surface area. Oral dosage expressed in terms of prednisolone base. Consider alternate day therapy for long-term therapy. Discontinuation of long-term therapy requires gradual withdrawal by tapering the dose. Patients undergoing unusual stress while receiving corticosteroids, should receive increased doses prior to, during, and after the stressful situation.

Acute asthma: Oral: 1-2 mg/kg/day in divided doses 1-2 times/day for 3-5 days

Anti-inflammatory or immunosuppressive dose: Oral: 0.1-2 mg/kg/day in divided doses 1-4 times/day

Nephrotic syndrome: Oral:

Initial (first 3 episodes): 2 mg/kg/day or 60 mg/m2/day (maximum: 80 mg/day) in divided doses 3-4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1-1.5 mg/kg/dose or 40 mg/m2/dose given every other day for 4 weeks

Maintenance (for frequent relapses): 0.5-1 mg/kg/dose given every other day for 3-6 months

Dosing adjustment in hyperthyroidism: Refer to adult dosing.

Dosing: Geriatric

Use lowest effective adult dose. Dose depends upon condition being treated and response of patient; alternate day dosing may be attempted in some disease states.

Dosing: Renal Impairment

Hemodialysis: Slightly dialyzable (5% to 20%); administer dose posthemodialysis

Peritoneal dialysis: Supplemental dose is not necessary