Omnacortil doses
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Omnacortil prednisolone doses indications
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Here is a complete dosing reference for Omnacortil (Prednisolone):
Omnacortil (Prednisolone) - Dosing Guide
Brand: Omnacortil (Macleods Pharmaceuticals)
Drug class: Synthetic corticosteroid (glucocorticoid)
Available strengths: 5 mg, 10 mg, 20 mg, 40 mg tablets; oral suspension/syrup
General Adult Dosing
| Situation | Dose |
|---|---|
| General range | 5-60 mg/day orally |
| Anti-inflammatory / immunosuppressive | 10-60 mg/day (single or divided doses) |
| High-dose (severe disease) | Up to 1-2 mg/kg/day |
| Maintenance (long-term) | 5-10 mg/day (lowest effective dose) |
General Pediatric Dosing
| Situation | Dose |
|---|---|
| General range | 0.14-2 mg/kg/day divided 3-4 times daily |
| Acute asthma / status asthmaticus | 1-2 mg/kg/day (max 40-60 mg/day) for 3-5 days |
| Nephrotic syndrome | 2 mg/kg/day (max 60 mg/day) initially; taper after remission |
Condition-Specific Dosing
| Condition | Dose |
|---|---|
| Rheumatoid arthritis (low-dose) | 5-7.5 mg/day; low-dose retards radiographic progression |
| SLE / Lupus nephritis (Euro-Lupus) | Start 0.5 mg/kg/day x 4 weeks; taper by 2.5 mg every 2 weeks; maintain at 5-7.5 mg/day |
| Asthma (acute severe) | 0.5-1 mg/kg/day (max 40 mg) for 5-7 days |
| Autoimmune hepatitis (induction) | 60 mg/day x 1 week, then taper; combine with azathioprine for maintenance |
| Autoimmune hepatitis (maintenance) | Taper by 10 mg/month as disease improves; target 10 mg/day |
| Nephrotic syndrome (adults) | 1 mg/kg/day (up to 80 mg/day), then taper |
| GPA / MPA (vasculitis) | 1 mg/kg/day prednisolone with cyclophosphamide |
| Acne fulminans | 0.5-1 mg/kg/day initially, then taper as isotretinoin is introduced |
| Organ transplant | Variable; per protocol |
| Allergic conditions | 20-40 mg/day short course; taper over days to weeks |
| Adrenal insufficiency | Physiologic replacement: 5-7.5 mg/day |
| Hematologic malignancies (CHOP) | Part of chemotherapy protocol per oncology |
How to Take
- Take once daily in the morning with breakfast to reduce gastric irritation and sleep disruption
- Take with food to minimize GI side effects
Tapering
- Short courses (<2 weeks): Can usually stop abruptly if low dose
- Longer courses: Taper gradually - do NOT stop suddenly (risk of adrenal insufficiency and disease flare)
- Typical taper: reduce by 5-10 mg every 1-2 weeks depending on disease and duration
Key Side Effects (long-term / high-dose)
- Weight gain, Cushingoid features
- Osteoporosis (prescribe calcium + vitamin D prophylactically)
- Hyperglycemia / steroid-induced diabetes
- Hypertension
- Peptic ulcer (prescribe PPI cover)
- Cataracts, glaucoma
- Immunosuppression / infection risk
- Growth retardation in children
- HPA axis suppression
Contraindications
- Systemic fungal infection
- Live vaccines during therapy
- Uncontrolled diabetes / hypertension (relative - requires monitoring)
Note: Always use the lowest effective dose for the shortest possible duration. Omnacortil is the brand name for prednisolone manufactured by Macleods Pharmaceuticals. Doses cited above are drawn from Mayo Clinic prednisolone dosing, NHS guidance, and standard rheumatology/nephrology textbook protocols.
Methylpredinsolone doses
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Here is a complete dosing reference for Methylprednisolone (Solu-Medrol, Depo-Medrol, Medrol):
Methylprednisolone - Dosing Guide
Available forms:
- Oral (Medrol): 2, 4, 8, 16, 32 mg tablets; Medrol Dosepack 4 mg (21 tabs)
- IV/IM (Solu-Medrol - sodium succinate): 40 mg, 125 mg, 500 mg, 1000 mg vials
- IM/Intra-articular (Depo-Medrol - acetate): 20 mg, 40 mg, 80 mg/mL - NOT for IV use
Potency: 1.25x more potent than prednisolone (5 mg prednisolone = 4 mg methylprednisolone)
General Anti-inflammatory / Immunosuppressive Dosing
| Route | Adult | Pediatric |
|---|---|---|
| PO / IM / IV | 0.5-1.7 mg/kg/day divided Q6-12h | Same weight-based dosing |
| Standard range | 10-250 mg IM/IV up to Q4h PRN | 0.5-1.7 mg/kg/day |
Condition-Specific Dosing
Pulse / High-Dose IV Therapy
| Indication | Dose |
|---|---|
| Life-threatening conditions (anaphylaxis, severe shock) | 30 mg/kg IV over ≥30 min; repeat Q4-6h for up to 48h |
| Pulse therapy (adults) | 500-1000 mg/day IV x 3-5 days |
| Pulse therapy (pediatric) | 15-30 mg/kg/dose IV (max 1000 mg/dose) x 3 days |
Neurological
| Indication | Dose |
|---|---|
| Multiple sclerosis (acute relapse) | 1000 mg/day IV x 3-5 days (oral 1000 mg/day x 3 days is non-inferior) |
| Acute spinal cord injury | 30 mg/kg IV over 15 min, then 45 min later start 5.4 mg/kg/hr infusion x 23 hr |
| ADEM / Autoimmune encephalitis | 20-30 mg/kg/day IV (max 1000 mg/day) x 3-5 days |
| Optic neuritis | 1000 mg/day IV x 3 days |
| Transverse myelitis | 1000 mg/day IV x 3-5 days |
Respiratory
| Indication | Dose |
|---|---|
| Asthma exacerbation (child ≤12 yr) | 1-2 mg/kg/day IV/IM in 2 divided doses (max 60 mg/day) until PEF ≥70% |
| Asthma exacerbation (adult / >12 yr) | 40-80 mg/day IM/IV divided Q12-24h until PEF ≥70% |
| Status asthmaticus IV | 1 mg/kg/dose IV Q6h (max 125 mg/dose) |
| Oral asthma burst (child ≤12 yr) | 1-2 mg/kg/day PO in 1-2 divided doses (max 60 mg/24h) x 3-10 days |
| Oral asthma burst (adult / >12 yr) | 40-60 mg/day PO divided Q12h x 3-10 days |
| Diffuse alveolar hemorrhage | High-dose IV (>30 mg/day) associated with better outcomes |
Rheumatology / Autoimmune
| Indication | Dose |
|---|---|
| Rheumatoid arthritis (pulse) | 1 g/day IV x 1-4 days, or 1 g/month IV x 6 months |
| SLE / Lupus nephritis (induction) | 0.25-0.5 g/day IV x up to 3 days, then oral prednisone 0.3-1 mg/kg/day |
| Lupus nephritis (off-label) | 30 mg/kg IV every other day x 6 doses |
| GCA (Giant Cell Arteritis) | 500-1000 mg/day IV x 5 days |
| JIA / Kawasaki / severe glomerulonephritis | 10-30 mg/kg/day IV (max 1000 mg/day) x 3 days |
| Vasculitis (GPA/MPA) | 1000 mg IV pulse x 3 days at induction |
| Organ transplant rejection | 500 mg/day IV x 3-5 days |
IM Depot (Depo-Medrol - acetate) - NOT for IV
| Indication | Dose |
|---|---|
| Asthma (IM, for vomiting/non-adherence) child ≤4 yr | 7.5 mg/kg IM x 1 (max 240 mg) |
| Asthma (IM) child >4 yr / adult | 240 mg IM x 1 |
| Intra-articular (large joint) | 20-80 mg per joint |
| Soft tissue / intralesional | 4-40 mg per site |
Medrol Dosepack (Standard 6-day taper)
| Day | Morning | Midday | Evening | Bedtime | Total |
|---|---|---|---|---|---|
| Day 1 | 2 tabs (8 mg) | 1 tab (4 mg) | 1 tab (4 mg) | 2 tabs (8 mg) | 24 mg |
| Day 2 | 1 tab | 1 tab | 1 tab | 2 tabs | 20 mg |
| Day 3 | 1 tab | 1 tab | 1 tab | 1 tab | 16 mg |
| Day 4 | 1 tab | 0 | 1 tab | 1 tab | 12 mg |
| Day 5 | 1 tab | 0 | 0 | 1 tab | 8 mg |
| Day 6 | 1 tab | 0 | 0 | 0 | 4 mg |
Administration Notes
- IV infusion rate: Doses <250 mg over ≥5 min; doses ≥250 mg over ≥30 min; pulse doses (1 g) over 60 min
- Timing: Take oral dose in the morning with food
- Depo-Medrol (acetate) must NEVER be given IV - for IM, intra-articular, and soft tissue use only
- IV succinate form (Solu-Medrol) is used for IV/IM routes
Steroid Equivalence (Anti-inflammatory)
| Drug | Equivalent Dose |
|---|---|
| Hydrocortisone | 20 mg |
| Prednisolone / Prednisone | 5 mg |
| Methylprednisolone | 4 mg |
| Dexamethasone | 0.75 mg |
Key Side Effects
Same as all systemic corticosteroids: hyperglycemia, hypertension, Cushing's syndrome, osteoporosis, adrenal suppression, GI bleeding, immunosuppression, hypertrophic cardiomyopathy (premature infants), pseudotumor cerebri.
Rare: High-dose cyclic IV therapy (especially for MS) can cause toxic acute hepatitis - discontinue immediately if it occurs, and avoid re-challenge.
- Source: Harriet Lane Handbook 23rd Ed., Goodman & Gilman's, Medscape, StatPearls, Pfizer Solu-Medrol prescribing information
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