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Dosages of less than 5 mg prednisolone per day are not significant and no steroid cover is requiredwhile on a subcutaneous injection route. No significant changes in serum hormones are seen with dosages above this level. A single dose of 5 mg prednisolone is contraindicated in children younger than 4 years of age, as 5 mg dosages in young infants may lead to hypoglycaemia and hypotension. When using a subcutaneous route and an injectable route of delivery, consider the use of a pediatric dose of 5 g prednisolone with a dose of 5 or 10 mg prednisolone. Dosage Adjustments and Prescription Drug Monitoring In most instances, pediatric patients receive their initial dosage from the primary care physician, depending on the needs and symptoms of the child. Additional dosages are usually dictated by a review of the pediatric health history and laboratory work-up. Dosages may also be made available to parents when indicated by the physicians in an individualized family planning plan. A child should be instructed to use the minimum effective dose for the condition and age group. Additional treatment, monitoring, and prescribing are the responsibility of the child's physician. Special Considerations for Patients With Breast Cancer Patients with breast cancer may need to take medication with concomitant use of immunosuppressive medications. Patients With Hepatitis C Patients who are infected with hepatitis C are advised to receive a low-dose daily oral immunosuppressant in combination with an immunosuppressant-free oral glucocorticoid (cholestyramine/prednisolone/daclizumab) for several weeks (minimum of 48 hours) before initiating treatment with immunosuppressive therapy for hepatitis C. This regimen has been shown to provide protection against infection for approximately five to six weeks and to prevent liver damage. Nontraditional Dosages The following recommended dosages have not been adequately established in adults with nonmalignant diseases or in individuals with a compromised immune system (Table 16). In addition to a minimum age-appropriate dose adjustment, most children, adolescents, and even adults can safely tolerate low to moderate doses of prednisolone; therefore, a lower dose may be provided in a situation other than an inpatient setting where an alternative method of suppressive therapy (e.g., injection, or intravenous) has been successfully utilized. This may lead to more rapid initiation of treatment and reduced treatment costs. However, in the setting of an outpatient treatment program in which Similar articles:
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