netFormulary

Prednisolone

First Choice

The lowest cost formulation should be used when clinically appropriate. Formulations approved include:
- 1mg, 5mg tablets;
- 1mg in 1ml oral solution (Prednisolone Dompé®);
- 5mg suppositories.
- 5mg soluble tablets - to be restricted to patients who have a genuine need e.g. swallowing difficulties. 5mg plain tablets can be dispersed in water (an off-label administration method) which may be suitable for most patients.

Hydrocortisone sodium phosphate Efcortesol^®

Formulary

100mg/ml solution for injection
As an additional option to hydrocortisone sodium succinate for patients who are steroid dependent (pituitary or adrenal cause and occasionally non-endocrine reasons for long term steroid use) to manage sick day rules to avoid an Addisonian crisis.
Paraesthesia and pain may follow intravenous injection.

Dexamethasone

Formulary

500microgram & 2mg tablets
500microgram soluble tablets
2mg in 5ml oral solution and 5mg in 5ml oral solution is also approved. unlicensed
20mg/5ml oral solution
Approved for use in patients requiring high dose to reduce pill burden

Methylprednisolone sodium succinate 2mg, 4mg, and 16mg tablets

Formulary

Dexamethasone 3.3mg in 1ml and 6.6mg in 2ml

Formulary

Note: there are two different strength preparations of dexamethasone injection available in the UK (3.8mg/ml and 3.3mg/ml) where traditionaly a 4mg/ml preparation was available and prescribed as such. To avoid confusion the 3.3mg/ml strength is the preparation of choice in the acute Trusts. Where previously a 4mg dose would have prescribed it is appropriate to prescribe a 3.3mg dose (or multiples thereof). This is because the range of doses given in clinical practice varies widely and subsequent doses tend to be adjusted to reflect clinical response. If 4mg is required please ensure that the appropriate volume of 3.3mg/ml is (e.g. 1.2ml) prescribed (or mulitples thereof).

Hydrocortisone

Formulary

10mg and 20mg tablets
5mg, 10mg and 20mg dispersible tablets
5mg/5ml and 10mg/5ml oral solution (Colonis®)
In patients who are unable to swallow or have swallowing difficulties the most cost effective product should be used
0.5mg, 1mg, 2mg & 5mg granules (in capsules for opening)
- Approved for treatment of adrenal insufficiency in infants, children and adolescents
- Patients should be transitioned onto tablets once they are able to take them

Methylprednisolone Acetate 40mgin 1ml and 120mg in 3ml (depot)

Formulary

Methylprednisolone sodium succinate 40mg, 125mg, 500mg & 1000mg injection

Formulary

Betamethasone 4mg in 1ml

Formulary