10.1.2.1 Systemic corticosteroids

ChoiceDrugDosage
1st choice (oral)

Prednisolone tablets 1mg, 5mg

Note: Soluble tablets are high cost

Dose:
See BNF and Prescribing Notes below
1st choice (parenteral)Intramuscular depot injection: methylprednisolone acetate (Depo-Medrone®\) vials 40mg/mL, 80mg/2mL, 120mg/3mLDose:
By deep intramuscular injection into gluteal muscle, 40–120mg
Dosage must be individualised and depends on the condition being treated and its severity. Deep intramuscular injection reduces the risk of steroid atrophy to skin
Or
Intramuscular injection: triamcinolone acetonide 40mg/mL (Kenalog® Intra-articular/Intramuscular)Dose:
By deep intramuscular injection into gluteal muscle, 40mg. Repeat at intervals according to the patient’s response; maximum single dose 80mg. Deep intramuscular injection reduces the risk of steroid atrophy to skin
Or
Intravenous injection: methylprednisolone (as sodium succinate) (Solu-Medrone®) vials 40mg, 125mg, 500mg, 1g, 2g: slow intravenous injection or infusion Dose:
initially 40–500mg