| Choice | Drug | Dosage |
| Formulary choices | Prednisolone tablets 1mg, 5mg; Note: Soluble tablets are high cost | Dose: |
| Or | ||
| Dexamethasone tablets 500micrograms, 2mg; injection 3.8mg/mL, 3.3mg/mL | Dose: | |
| Or | ||
| Hydrocortisone injection (Solu-Cortef®) hydrocortisone (as sodium succinate) 100mg vial with 2mL amp water for injections | Dose: Dependent on condition treated (refer to BNF) | |
| Or | ||
Methylprednisolone tablets 2mg, 4mg, 16mg, 100mg; | Dose: Dependent on condition treated (refer to BNF) |
Prescribing Notes
- Corticosteroids are used in the treatment of a wide range of conditions. Doses of corticosteroids used vary widely in different diseases and in different patients. Refer to relevant section of BNF.
- Steroid cards should be given when appropriate. Community pharmacies and GP practices can order these from pharmacystationeryorders@hscni.net.
- Patients receiving 7.5mg or more of prednisolone daily (or equivalent, see BNF chapter 6) for longer than 3 months should receive osteoporosis prophylaxis. No osteoporosis prophylaxis is indicated when corticosteroids are used as replacement therapy. See BNF chapter 6.
- Care should be taken in reducing pharmacological doses of glucocorticoids if the patient has been treated for longer than 3 weeks, to avoid cortisol insufficiency due to prolonged suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
- In terms of their anti-inflammatory properties, approximately 20mg hydrocortisone is equivalent to 5mg prednisolone or 750 micrograms dexamethasone. See BNF chapter 6.
- The table below shows the equivalent anti-inflammatory doses.
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