Systemic corticosteroids (Formulary)

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card.  This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids.  For more information, including which patients should receive the card, see HIS for details.  Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

See Peri-operative guidelines for patients with or at risk of adrenal insufficiency

PREDNISOLONE

Important: Therapy notes

  • Do not use oral prednisolone or injectable corticosteroid prior to referral of a patient with suspected inflammatory joint disease.
  • Corticosteroids are used, along with disease modifying therapy in the induction of remission of inflammatory arthritis once baseline prognostic factors have been assessed and treatment stratification allocated.
  • For polymyalgia rheumatica, the majority of patients should respond to prednisolone 10 to 15mg daily. 
  • If patients fail to respond within 2 weeks cease treatment and review the diagnosis. 
  • Treatment is usually required for a minimum of 18 months; consider densitometry and bone protection at commencement (see Drugs affecting bone metabolism). 
  • Further advice is available on the Department of Rheumatology home page. 
  • Larger doses of prednisolone are used to treat connective tissue disease and temporal arteritis.
  • Dose varies according to condition.  If possible, avoid use of the high-cost prednisolone tablets 25mg and soluble tablets 5mg.

Important: Formulation and dosage details

Formulation:

Tablets 1mg, 5mg, 25mg

Important: Formulation and dosage details

Formulation:

Soluble tablets 5mg

Editorial Information

Document Id: F271