Simple clinical audit and research for patient benefit
Is prednisolone 3.75mg once daily the ideal replacement therapy?
Evidence that we have obtained to date suggests that doses over 4mg of prednisolone are supraphysiological and replacement doses of 2mg to 4mg daily work well in many patients. It is becoming clear that we have used excessive doses of replacement, either with hydrocortisone or with prednisolone, and in the long term, this is likely to contribute to osteoporosis, hyperglycaemia, and increased cardiovascular morbidity and mortality.
In countries where the smallest dose of prednisolone available is 5mg, we suggest a trial of three quarters of a tablet daily, which will supply approximately 3.75mg daily. Practically this will involve breaking a 5mg tablet into half and half again: