3.2.4 Systemic steroids

Prescribing Notes

  • Acute attacks of asthma should be treated with short courses of 30 to 50mg prednisolone daily, reducing once the attack has been controlled. For example, a standard course could be 40mg daily for at least 5 days or until recovery. Usually doses of up to 40mg daily taken for less than 3 weeks can be stopped abruptly but in certain cases they should be tapered-see BNF Chapter 6 for more information.
  • For an exacerbation of COPD, recommended courses include prednisolone 40mg per day for 5 days or prednisolone 30mg per day for 7 days. For information on antibiotic choices in the management of exacerbations of COPD see NI Management of Infections Guidelines for Primary Care.
  • If a patient has received more than three to four courses of oral steroids per year they should be given a steroid card and considered for bone protection.
  • With regard to gastrointestinal effects, there is no advantage in using enteric coated prednisolone tablets; plain tablets should be used.