Prednisone Dosage

Prednisone, the most common anti-inflammatory steroid in the United States, can be prescribed at varying levels of prednisone dosage based on your condition and your response to the medication. Read on to discover what is the normal dosage of prednisone for certain conditions, plus find out how to take different prednisone dosages.

Prednisone Tablet Dosage Strengths

Manufacturers make prednisone in the following dosage strengths.

• Prednisone 1 mg tablet
• Prednisone 2.5 mg tablet
• Prednisone 5 mg tablet
• Prednisone 10 mg tablet
• Prednisone 20 mg tablet
• Prednisone 50 mg tablet

Manufacturers created many prednisone dosage options to enable very high prednisone doses (over 50 mg) and very small prednisone doses (less than 5 mg). Prednisone tapers require dosage reductions of small amounts which may require the use of 1 mg tablets.

Watch my Video About Prednisone Dosages

Find out some typical prednisone dosages in this video.

Normal Dose of Prednisone?

As the Prednisone Pharmacist, I often get asked, “Is my prednisone dosage normal?” It’s a hard question to answer because the truth is, there is no such thing as a normal prednisone dosage. You need to consider the following questions:

• What are you using it for?
• How bad is your condition?

Understanding Prednisone Dosage

Prednisone can be used for many reasons. And that affects what is the normal prednisone dosage that can be expected for your situation. Doctors from any specialty can prescribe prednisone to help with inflammation. The dose of prednisone the doctor prescribes depends on which diagnosis and how bad of a situation.

What is a Normal Prednisone Dosage?

Dosages around 10 mg to 20mg are a normal, average dose of prednisone. A typical starting dose of prednisone can range between 5 mg to 60 mg of prednisone. The dose of prednisone should be individualized for each patient.

But when it comes to prednisone dosage, there is no one-size-fits-all way of answering this question. Your dosage really depends on how severe your condition is. At the end of this article you can find typical doses of prednisone for common conditions prednisone is used for.

The Prednisone Dosage Principle

The adage, “Use the lowest effective dose for the shortest period of time,” guides prednisone dosages. While this is true for all drugs, it is especially true for prednisone because of the high risks of side effects. Only take prednisone if the benefits outweigh the risks.

Use the lowest effective dose for the shortest period of time.

Generally, doses around 20 mg of prednisone are a standard starting dose for most situations, although those with more serious conditions may require higher dosages. Ideally, doctors look to prescribe the lowest effective dose for the shortest period of time in order to minimize any associated risks.

Prednisone Dosage Situations from High to Low Dose and Short to Long-Term

• High Prednisone Dosage Example – Multiple Sclerosis Vision Loss

The worst, most acute or life-threatening situations receive the highest dosage for a short time. For example, when a person with multiple sclerosis (MS) suddenly loses vision, the neurologist doctor usually prescribes an extremely high dose of steroids of around 1000 mg prednisone equivalent a day for only a few days. That high of a dose is justified for preventing permanent blindness. Giving a super high dose for only a few days is called a steroid burst dose and is given as an intravenous bolus. But doctors rarely prescribe that high of a dose for more than a few days at a time because of the high risks of side effects.

Usually, the vision will return to normal and the person with multiple sclerosis will stop taking prednisone. The MS flare dies down and the emergency is over.

• Low Prednisone Dosage Example – Rheumatoid Arthritis

The opposite side of the spectrum is using a low dose for a long time. For example, people with rheumatoid arthritis (RA) often use prednisone 5-10 mg per day for years. The RA causes so much pain and disability to justify continued use over a long time. A low dosage of prednisone is between 5-10 mg per day.

• Short-Term Prednisone Dosage for Bronchitis or Lung Infections

Some conditions only need prednisone for a little while. The doctor might find a lung infection and prescribe something like 40mg for a day, then 30mg for a day, then to 20mg for a day, then 10 mg for a day, and finally 5 mg on the fifth day, until off of prednisone on day 6 (see the dosage taper schedule below). This is a typical short-term prednisone dosage prescription you might get from the emergency room. A short course of prednisone dosage usually lasts less than 14 days and usually less than a week.

• Longer-Term Prednisone Dosage for Inflammation

Another situation is if the doctor prescribes prednisone long-term but not permanent. You might get 40mg for a week, then 30mg for a week, then down to 20mg for a week, and 10 mg for a week, and then 5 mg for the last week and then stop after that 5th week. The starting dosage can range between 5 to 60 mg per day of prednisone. The tapering, or lowering of prednisone dosage, continues until you are finally off. Long term prednisone is generally considered longer than 21 days of prednisone treatment.

Importance of Prednisone Taper

Furthermore, many people undergo a prednisone taper which involves reducing the dosage each day until the drug has been completely stopped—this could mean dropping from 40mg to 30mg and then all the way down to 0 mg in five days or less depending on individual circumstances.

Five (5) Day Prednisone Dosage 40 mg Taper

For emergency situations like breathing problems, rashes, or various types of pain, doctors often prescribe a short-term prednisone dosage taper. This 5-day prednisone dosage often starts at prednisone 40 mg. The Prednisone Instructions generally follow this typical dosage taper:

• Day 1 – Prednisone 40 mg (for example, two 20 mg tablets)
• Day 2 – Prednisone 30 mg (#1.5 20 mg tablets)
• Day 3 – Prednisone 20 mg (#1 20 mg tablet)
• Day 4 – Prednisone 10 mg (half of a 20 mg tablet)
• Day 5 – Prednisone 5 mg (1/4 of a 20 mg tablet)
• Day 6 – Stop (Prednisone 0 mg)

This 5 day prednisone dosage taper listed above is typical but could be changed in many ways. Perhaps your doctor prescribes each dose for a week instead of a day. Or your doctor could use prednisone 10 mg tablets instead of 20 mg tablets. Your doctor could prescribe 40 mg every day for five days and then stop. Or the doctor could start at 20 mg and drop by 5 mg each day. All of these and many more are typical and normal prednisone dosages.

Read more about How to Taper Prednisone where you can also download a Free Prednisone Taper Chart.

How to Take Prednisone 20 mg Dosage for 5 Days

If your doctor prescribed prednisone 20 mg for 5 days, then you should take each tablet first thing in the morning with food once a day. The prednisone 20 mg dosage instructions are typically like this:

• Day 1 – Prednisone 20 mg tablet (take #1 tablet)
• Day 2 – Prednisone 20 mg tablet (take #1 tablet)
• Day 3 – Prednisone 20 mg tablet (take #1 tablet)
• Day 4 – Prednisone 20 mg tablet (take #1 tablet)
• Day 5 – Prednisone 20 mg tablet (take #1 tablet)
• Day 6 – Stop (don’t take any more prednisone)

However, your doctor can prescribe many variations of  the 5-day prednisone dosage of 20 mg, such as described in the section above starting with 40 mg. Or the doctor could start with 20 mg for two days and by Day 3 it could be 10 mg for two days, and then for the last day just 5 mg.

You might be wondering: “Is 20 mg of prednisone a low dose?” No, prednisone 20 mg and above is a high dose. Especially compared to our body’s natural cortisol equivalent of only 2.5 mg secreted per day, 20 mg of prednisone is 8 times more than naturally occurring in our bodies.

Watch this video to hear Dr. Megan explain How to Take Prednisone 20 mg for 5 days:

How to Take Prednisone 20 mg 3 tablets Daily (Prednisone 60 mg)

Your doctor may prescribe a total of 3 tablets per day of prednisone 20 mg, which is 60 mg of prednisone. If so, generally the entire dose, or all 3 tablets of prednisone 20 mg, are swallowed all at once, first thing in the morning.

How to take Prednisone 40 mg for 5 days

Doctors may prescribe 40mg of prednisone for 5 days for certain inflammatory, acute conditions. Since a 40 mg prednisone tablet is not commercially available in the United States, the doctor usually prescribes prednisone 20 mg tablets and instructs you to take 2 tablets by mouth. This prescription is for prednisone 20 mg #2 tablets daily. Unless instructed otherwise, the instructions for prednisone is to take both tablets–the entire daily dose of prednisone 40 mg–all at once in one swallow first thing in the morning.

5 Day Prednisone Dosage 40 mg

• Day 1 – Prednisone 20 mg tablet (take #2 tablets)
• Day 2 – Prednisone 20 mg tablet (take #2 tablets)
• Day 3 – Prednisone 20 mg tablet (take #2 tablets)
• Day 4 – Prednisone 20 mg tablet (take #2 tablets)
• Day 5 – Prednisone 20 mg tablet (take #2 tablets)
• Day 6 – Stop (don’t take any more prednisone)

Sometimes the doctor may prescribe 40 mg of prednisone for 7 days instead of just 5. In that case, continue the dosage chart above for two more days. Again, doctors can prescribe any variation of any of these prednisone dosage charts, so don’t be surprised if it doesn’t fit these exact schedules. Follow what your doctor prescribes and ask your pharmacist any questions about your prescription.

You might be wondering: “Is 40 mg of prednisone a high dose?” Yes, anything over 20 mg is a high dose, so prednisone 40 mg is a high dose. Especially compared to our body’s natural cortisol equivalent of only 2.5 mg secreted per day, 40 mg of prednisone is 16 times more than naturally occurring in our bodies.

50 mg Prednisone for 5 Days

Prednisone can be prescribed at any dose and the 50 mg prednisone tablet dose is the least commonly prescribed. If your doctor prescribes prednisone 50 for 5 days, either the 50 mg tablet or an equivalent dose using other strengths may be used. Either Prednisone 10 mg (take #5 tablets per day for 5 days) or Prednisone 20 mg (take #2.5 tablets per day for 5 days) may be prescribed to reach 50 mg per day. You can split prednisone pills in half or in fourths if needed to reach the correct dose.

3 Day Dose of Prednisone

Doctors can prescribe prednisone for any length of time, from just one dose, to three days, to long-term. Typically a 3 day prednisone dosage will be either 40 mg every day for 3 days, or 20 mg every day for 3 days, or 10 mg every day for three days. Any variation is possible.

Do I Have to Taper Prednisone?

If you’re prescribed prednisone for less than 10 to 14 days, then it may be unnecessary to taper. You might be just fine to simply stop when the prescription finishes as your doctor directed. However, never stop taking prednisone suddenly (go “cold turkey”) without consulting with your doctor as it could be fatal.

Read more about the nuances of tapering prednisone.

What’s the Most Common or Normal Dosage of Prednisone?

According to ClinCalc online, the most common dosage strength of prednisone is prednisone 10 mg. They compared all prescriptions in the United States and showed that prednisone 10 mg is dispensed 30.6% of the time. Close in line at 2^nd place, pharmacies dispense prednisone 20 mg 29.3% of the time. Next, and in a virtual three-way tie, the prednisone 5 mg strength is 27.9% of the time. A tiny minority of the time pharmacies dispense prednisone 1 mg, at only 6.2% of all prescriptions dispensed. Finally, “other” accounts for 6.0% of the time, which could include 2.5 mg tablets, 50 mg tablets, liquids, compounded powders, or otherwise a dosage not tracked in the prescription dispensing data.

Key = Dosage Form Strength: % of Dispensed Prednisone Products

• Prednisone 10 mg: 30.6%
• Prednisone 20 mg: 29.3%
• Prednisone 5 mg: 27.9%
• Prednisone 1 mg: 6.2%

Next they compared the number of days supplied per prescription of prednisone. ClinCalc showed in the following chart that the range is most often between 5 days of prednisone and a 90 days supply of prednisone. 

Key = Color: # days supply: percent of prescriptions of prednisone.

• Royal blue: 5 days supply of prednisone: 22.1%
• Red: 30 days supply of prednisone: 21.8%
• Orange: 90 days supply of prednisone: 14.8%
• Green: 6 days supply of prednisone: 6.2%
• Purple: 12 days supply of prednisone: 5.6%
• Other/unspecified supply of prednisone: 29.5%

What is the difference between a Dosage Form compared to a Prednisone Dosage compared to a Prednisone Dose?

The Dose of a drug is “the specified amount of medication taken at one time. By contrast, the dosage is how to take the medication as prescribed: a specific amount, number, and frequency of doses over a specific period of time” (AMA Manual of Style).

When it comes to the prednisone dose, that’s the exact amount of prednisone to take. Let’s say it’s the prednisone 10 mg dose.

Then to turn that prednisone 10 mg dose into a dosage, we’d describe it how your doctor wrote it on the prescription. For example, the prednisone dosage becomes, “Take 1 (prednisone 10 mg) tablet by mouth every morning for 5 days.”

Finally, a Dosage Form is the exact method of getting prednisone 10 mg into your body. Most commonly, prednisone is a tablet meant to be taken by mouth and swallowed to be absorbed by the gut and distributed into the body through the liver and blood. Prednisone could also be put into other dosage forms such as a capsule, a liquid to swallow, a liquid to inject, a cream to rub on, or even a suppository to place in the rectum.

Prednisone Dosage Forms

Innovators even created different dosage forms of prednisone tablets to improve how it works. Rayos is a delayed-release tablet meant to be taken at night (normally prednisone is taken in the morning) and then it doesn’t kick in (delayed release) until early in the morning for people with early-morning inflammatory conditions like rheumatoid arthritis. Orapred ODT is an orally disintegrating tablet that dissolves in the mouth without swallowing (however, Orapred’s active ingredient is actually prednisolone, not prednisone).

The only FDA-approved prednisone dosage forms are the oral immediate-release tablet, the oral delayed-release tablet Rayos, and an oral solution (Prednisone Intensol Oral Solution, 5 mg per 5 mL prednisone dosage). Other dosage forms (cream, suppository, lozenge, etc.) could be compounded by a specialized pharmacy for individual patients but are not commercially available at traditional pharmacies. The most common dosage form of prednisone is the oral immediate-release tablet due to its ease of dosing and low price (about $10 total drug cost per prednisone prescription in the USA in 2020).

Total Cost Per Day of Prednisone Therapy (USD/day)

The oral solution of prednisone costs much more and patients report that the prednisone solution tastes awful, so it isn’t commonly prescribed and pharmacies may not have it in stock. Rayos is more expensive because it is still a branded product designed for a special niche.

How does the Prednisone Dosage Compare to Other Oral Steroids?

In the United States, prednisone is the most common oral corticosteroid, reaching over 19 million prescriptions a year. The other oral steroids hydrocortisone, prednisolone, methylprednisolone, budesonide, and dexamethasone are less commonly prescribed and have different potencies. That means that the same number of milligrams of prednisone needed to treat a condition would require a different number of milligrams of the other steroids.

Anti-inflammatory Prednisone Dosage Equivalents of Glucocorticoids

Prednisone is a steroid, glucocorticoid, and corticosteroid related to our naturally occurring hormone cortisol. Other drugs also in these classes of drugs can possibly replace prednisone and your doctor may switch you to a prednisone alternative. In doing so, normally the prescription is for an equivalent dosage of prednisone based on the new glucocorticoid’s anti-inflammatory activity.

Prednisone 5 mg is approximately equivalent to the potencies of the following dosages of other glucocorticoids:

• Cortisone 25 mg
• Hydrocortisone 20 mg
• Prednisolone 5 mg
• Prednisone 5 mg
• Triamcinolone 4 mg
• Methylprednisolone 4 mg
• Betamethasone 0.6 mg
• Dexamethasone 0.75 mg

Injectable Corticosteroids

Prednisone is not available as an injectable or intravenous (IV) form and if you are hospitalized, you will likely receive a replacement steroid such as IV hydrocortisone (Solu-Cortef), IV methylprednisolone (Solu-Medrol), or IV or intramuscular dexamethasone.

Prednisone is also not available as a steroid cream. Steroid creams and injections are common, but these aren’t prednisone itself, and instead are other related corticosteroids.

How to Take Prednisone

What is the proper way of taking prednisone? What is the best way of taking prednisone to minimize side effects? While the instructions for prednisone can vary, this is generally how to take prednisone:

1. Take prednisone first thing in the morning.
2. The best way of taking prednisone is to take it with food if you have stomach upset or if you’re taking other medications like Ibuprofen, Naproxen, Meloxicam and NSAID.
3. Take with a tall glass of water.

Can I take all 6 Prednisone Pills at once?

You might be wondering about how many prednisone can you take at once. How should you take the extra pills per day–do you spread them out or take them at once? Although some “Prednisone Dose Packs” may instruct you to spread out the doses throughout the day, generally that’s not recommended. Instead, it’s best to take all 6 prednisone pills at once the first day, and so on. Or if you’re prescribed 20 mg tablets to take #2 on the first day, take both at once as soon as you get the prescription from the pharmacy. You can take 60 mg of prednisone all at once as #3 tablets of prednisone 20 mg.

Watch this video to find out more about How to Take Prednisone:

Get Help No Matter the Dosage

No matter which dosage of prednisone your doctor prescribes, I want to help you. I created the Prednisone Checklist to help you cope with prednisone side effects.

Balance Your Health By Changing The Things That Are In Your Control To Change

• Discover exactly how to have the good effects outweigh the side effects
• 25+ tips for how to get your life back while taking this horrible, miracle drug
• The top 15 side effects of prednisone and what YOU can do about it.

Prednisone Dosage for Adults for Common Conditions Prednisone is Used For

Below outlines the prednisone dosages recommended by the drug database Micromedex for some of the most common conditions people take prednisone for. For other conditions not listed below, the prednisone dosage for adults is between 5 to 60 mg per day depending on the factors above.

Asthma Exacerbation Prednisone Dosage

• For the treatment of moderate to severe asthma exacerbations, the recommended dose of prednisone is 40 to 80 mg per day orally in 1 or 2 divided doses until peak expiratory flow reaches 70% of predicted.
• For an outpatient steroid burst, the recommended dose is 40 to 60 mg of prednisone for a total of 5 to 10 days.

Chronic Obstructive Pulmonary Disease Exacerbation Prednisone Dosage

• Methylprednisolone 40 mg IV on day 1 then prednisone 40 mg by mouth on days 2 to 5.

Community Acquired Pneumonia Prednisone Dosage

• Prednisone 40-50 mg orally per day for 5-10 days.

Gout Acute Exacerbation Prednisone Dosage

• Prednisone dosage 0.5 mg/kg/day or more by mouth for 5-10 days and then discontinued.
• Prednisone dosage 0.5 mg/kg/day for 2-5 days followed by a 7-10 day taper and then discontinued.

Rheumatoid Arthritis Prednisone Dosage

• Bridging therapy: 10 mg per day or less by mouth added at initiation of disease-modifying antirheumatic drug (DMARD) therapy or biologic agent until the other drug is effective and then tapered to the lowest effective dose of prednisone.
• Disease flare: use at lowest possible dose for up to 3 months.

Ulcerative Colitis Prednisone Dosage

• Prednisone dosage 40 to 60 mg orally once daily with response expected within 5-7 days of initiation. Use as short as possible with early initiation of steroid-sparing therapy.

Other Typical Prednisone Dosages

The following prednisone dosages do not have a defined dose by a published clinical treatment guideline, but I included them here for your information. Your doctor may prescribe something different so follow your doctor’s prescription.

Polymyalgia Rheumatica Prednisone Dosage

• First diagnosis: between 15 to 25 mg of prednisone dosage per day and slowly tapered over a year or more.

Giant Cell Arteritis Prednisone Dosage

• Prednisone dosage for first diagnosis: between 40 mg to 60 mg with the goal to taper off long-term.

Idiopathic Thrombocytopenic Purpura/Immune ThrombocytoPenia (ITP: what I took prednisone for) Prednisone Dosage

• Generally the prednisone dosage for ITP starts at 1 mg/kg per day (range of 0.5 – 2 mg/kg/day) and is tapered down from there depending on response to platelets. I was prescribed 60 mg per day to start.
• Steroid Burst Dosing: an alternative that may work better than prednisone for ITP is to take dexamethasone 40 mg per day for 4 days total.

Bronchitis Prednisone Dosage

• 5 Day Prednisone Dosage for Bronchitis: the dose may be between 40 to 60 mg of prednisone for 5 days but this is controversial as studies have shown that prednisolone is not effective for bronchitis symptoms in people without asthma. Read more about prednisone for cough–herbals and alternative treatments may be more effective than prednisone for cough.

Sources:

1. DiPiro JT, Talbert RL, Yee GC, et al, eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. McGraw-Hill; 2008:1403. Link
2. Samuel S, Nguyen T, Choi HA. Pharmacologic Characteristics of Corticosteroids. J Neurocrit Care 2017;10(2):53-59 https://doi.org/10.18700/jnc.170035
3. Kane SP. Prednisone, ClinCalc DrugStats Database, Version 2022.08. ClinCalc: https://clincalc.com/Drug/Stats/Drugs/Prednisone. Updated August 24, 2022. Accessed May 18, 2023
4. Pharmacia and Upjohn and Company. Deltasone (prednisone) tablet. 2007 [rev. 2007 Mar]. In: DailyMed [Internet]. [2005] –   . [about 20 p.]. Bethesda (MD): National Library of Medicine (US). Available from: Link
5. Prednisone. DRUGDEX®. [updated 2021 Apr 09] In: IBM Micromedex® [Internet]. Truven Health Analytics, Greenwood Village, Colorado. Available at: http://www.micromedexsolutions.com/
6. Horizon Therapeutics plc P-RAY-00129-4 03/22. Rayos (Prednisone) Delayed-release Tablets. Available from: Rayosrx.com