Posology : מינונים

4.2    Posology and method of administration
Posology
The lowest dosage that will produce an acceptable result should be used (See section 4.4); when it is possible to reduce the dosage, this must be accomplished by stages.
During prolonged therapy any intercurrent illness, trauma or surgical procedure will require a temporary increase in dosage; if corticosteroids have been stopped following prolonged therapy they may need to be temporarily re-introduced.
The medicinal product should preferably be taken as a single dose in the morning.
However, divided daily dosages may be employed if required.

Note to the prescriber:
This 5 ml single-dose unit presentation should not be prescribed for doses exceeding 30 mg daily, because opening more than 6 containers in a day may increase the risk of dosing errors. For this reason, indications for Sintredius have been restricted to those where a large proportion of patients and a large proportion of doses (maintenance phase) in a particular patient will be 30 mg/day or below.

Adults:
The dose used will depend upon the disease, its severity, and the clinical response obtained. The following regimens are for guidance only. Divided dosage is usually employed.
Short-term treatment:
20 to 30 mg daily for the first few days, subsequently reducing the daily dosage by 2.5 or 5 mg every two to five days, depending upon the response.
Rheumatoid arthritis:
7.5 to 10 mg daily. For maintenance therapy the lowest effective dosage is used.
Most other indicated conditions:
Indications for Sintredius have been restricted to those where a large proportion of patients and a large proportion of doses (maintenance phase) in a particular patient will be 30 mg or below.
10 to 30 mg of Sintredius should be taken daily for one to three weeks, then reducing to the minimum effective dosage.
For the administration of higher doses in particular haematological forms, dermatologic forms, etc., the use of a more appropriate prednisolone presentation (e.g.
high dosage tablets) is recommended, to reduce the risk of dosing errors associated to opening several Sintredius containers.

Children:
Fractions of the adult dosage may be used (e.g. 75% at 12 years, 50% at 7 years and 25% at 1 year) but clinical factors must be given due weight.
For treatment of bronchial asthma:
Children under 2 years: up to 10 mg daily.
Children 2-5 years inclusive: up to 20 mg daily.
Children older than 5 years: 30 mg daily or more (up to 40 mg daily) may be used. To reduce the risk of dosing errors, should the doctor prescribe more than 30 mg daily, a more appropriate prednisolone presentation (e.g. high dosage tablets) should be used.

Corticosteroids cause growth retardation in infancy, childhood and adolescence which may be irreversible. Treatment should be limited to the minimum dosage for the shortest possible time. In order to minimise suppression of the hypothalamo-pituitary adrenal axis and growth retardation, treatment should be administered where possible as a single dose on alternate days.