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Typical oral glucocorticoid doses and taper for treatment of noninfectious uveitis in adults

Typical oral glucocorticoid doses and taper for treatment of noninfectious uveitis in adults
Parameter Chronic uveitis Acute flare of uveitis
Initial dose Typically 40 to 60 mg/day of prednisone or its equivalent (maximum 80 mg/day) Typically 40 to 60 mg/day of prednisone or its equivalent (maximum 80 mg/day)
Tapering schedule for prednisone or equivalent*
  • Taking >40 mg/day
Decrease by 10 mg/day every 1 to 2 weeks Decrease by 10 mg/day every 1 to 2 days
  • Taking 20 to 40 mg/day
Decrease by 5 mg/day every 1 to 2 weeks Decrease by 5 mg/day every 1 to 2 days
  • Taking 10 to 20 mg/day
Decrease by 2.5 mg/day every 1 to 2 weeks Decrease by 2.5 mg/day every 1 to 2 days
  • Taking <10 mg/day
Decrease by 1 to 2.5 mg/day every 1 to 4 weeks until the patient is off or to the lowest dose that controls inflammation Decrease by 1 to 2.5 mg/day every 1 to 4 days until the patient is off or to the lowest dose that controls inflammation
To be used with UpToDate content on the treatment of uveitis. For monitoring and management of glucocorticoid adverse effects, refer to separately available table and topic on adverse effects of systemic glucocorticoids.

* Tapering should only start once patients are in remission, which typically occurs within 1 month of initial high-dose therapy. Dose and tapering are adjusted based on the degree of inflammation, associated symptoms, and the tolerance of and response to treatment.

¶ Patients may require the addition of glucocorticoid-sparing immunosuppressive therapy if they are unable to taper off of glucocorticoids. Refer to UpToDate content on the treatment of uveitis for specific indications.
Adapted from: Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 2000; 130:492.
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