Skip to Main Content Skip to Site Map Skip to Accessibility Statement

6.3.2 Glucocorticoid therapy


Prednisolone tablets 1mg, 5mg

Note: Soluble tablets are high cost

Dexamethasone tablets 500micrograms, 2mg; solution for injection vials 3.3mg/mL, 3.8mg/mL

Formulary choices

Hydrocortisone sodium succinate 100mg powder and solvent for solution for injection vials

Methylprednisolone tablets 2mg, 4mg, 16mg, 100mg

Methylprednisolone sodium succinate (Solu-Medrone®) powder and solvent for injection vials 40mg, 125mg, 500mg, 1g

Intramuscular depot: Methylprednisolone acetate (Depo-Medrone®) suspension for injection vials 40mg/mL, 80mg/2mL, 120mg/3mL

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.
  • A Steroid Emergency Card for Northern Ireland has been developed in response to a National Patient Safety Alert issued in August 2020. The alert highlights the dangers associated with adrenal insufficiency for patients taking corticosteroid medication, and recommends that all eligible patients prescribed (or initiated on) steroids are assessed and where necessary issued with a Steroid Emergency Card. Community pharmacies and GP practices can order these from
  • Consider osteoporosis prophylaxis for patients receiving 7.5mg or more of prednisolone daily (or equivalent) for longer than 3 months. For further details refer to NOGG guideline. No osteoporosis prophylaxis is indicated when corticosteroids are used as physiological replacement therapy for the management of adrenal insufficiency unless replacement doses exceed hydrocortisone 30mg per day, prednisolone 7.5mg per day or equivalent. 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.

Equivalent anti-inflammatory doses of oral corticosteroids – see table.

Also in this Section