Usual dosages for oral glucocorticoids in asthma

Medication	Oral preparations	Dose	Comments
Methylprednisolone	2, 4, 8, 16, and 32 mg tablets	Short-course "burst" for asthma exacerbation: 32 to 48 mg per day as a single dose in the morning for 3 to 10 days; typically 32 mg daily for 5 days.	Short course therapy: Short courses or "bursts" are effective for establishing control when initiating therapy, during an acute exacerbation or a period of deterioration. The burst should be continued until patient achieves substantial symptom improvement or resolution, which is usually associated with PEFR >70 to 80 percent of predicted or personal best. This usually requires 3 to 10 days, but may require longer treatment. In patients receiving inhaled glucocorticoids, there is no evidence that tapering the oral dose following improvement prevents relapse. Long-term control: Oral glucocorticoids are used only rarely as long-term control medications, eg, in patients with very poorly controlled symptoms despite an optimal treatment regimen and environmental controls. The lowest effective dose is given daily in the morning, or on alternate days to minimize adrenal suppression.
Prednisolone*	5 mg tablets; 10, 15, and 30 mg orally disintegrating tablets (ODT)	Short-course "burst" for asthma exacerbation: 40 to 60 mg per day as single dose in the morning for 3 to 10 days; typically 40 mg daily for 5 days.
Prednisone*	1, 2.5, 5, 10, 20, and 50 mg tablets
Dexamethasone*	0.5, 0.75, 1, 1.5, 2, 4, and 6 mg tablets	Short-course "burst" to achieve symptom control: 6 to 9 mg per day as a single dose in the morning for 3 to 10 days; typically 6 mg daily for 5 days.

For specific recommendations about the use of oral glucocorticoids in asthma, refer to UpToDate reviews on the management of asthma exacerbations and severe asthma.

PEFR: peak expiratory flow rate.
* Oral liquids are available for use by patients who are unable to swallow pills.

Data from:

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2017. Available from: www.ginaasthma.org (accessed February 17, 2017).

Graphic 66549 Version 11.0

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Usual dosages for oral glucocorticoids in asthma