Prednisolone Pediatric Dose Calculator
Calculate weight-based prednisolone doses for children for common indications including croup, asthma, and allergic reactions. Always confirm with your prescribing doctor.
Prednisolone in pediatric care
Prednisolone is one of the most widely used corticosteroids in pediatric medicine. Unlike some drugs that work over days or weeks, prednisolone begins reducing inflammation within hours — which makes it valuable in acute situations like croup and asthma attacks, where airway swelling can escalate quickly.
In croup — a viral infection causing inflammation of the upper airway, producing the characteristic barking cough and stridor — a single dose of prednisolone (or dexamethasone) reduces both severity and the likelihood of emergency department return visits. Studies consistently show that even mild to moderate croup benefits from oral corticosteroid treatment.
For asthma exacerbations, prednisolone forms part of the standard acute treatment pathway alongside bronchodilators. It reduces airway inflammation, accelerates recovery, and decreases the chance of relapse in the days following an attack. Short courses (3–5 days) are typically sufficient for acute events.
Dosing is always weight-based in children. The therapeutic range for most acute indications is 1–2 mg/kg/day, with indication-specific maximums to prevent excessive corticosteroid effects from a single course.
Reference: NICE guideline NG80 — Asthma: diagnosis, monitoring and chronic asthma management (UK).
Dosing formula
Frequently asked questions
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Prednisolone is a corticosteroid used in children for several conditions: croup (laryngotracheobronchitis) — a single dose or short course to reduce airway swelling; asthma exacerbations — to reduce airway inflammation; allergic reactions — for moderate to severe reactions not responding to antihistamines; nephrotic syndrome — longer courses under specialist supervision; inflammatory bowel disease; and various autoimmune conditions. The dose varies significantly by indication.
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For croup, the standard prednisolone dose is 1 mg/kg as a single dose (maximum 20 mg). Some guidelines use dexamethasone instead (0.15–0.6 mg/kg) as it lasts longer. Prednisolone works within 2–4 hours and significantly reduces croup severity, hospital admission rates, and the need for nebulized epinephrine. It is safe and effective for moderate to severe croup.
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For an acute asthma exacerbation, the standard prednisolone dose is 1–2 mg/kg/day, given once daily or in divided doses, for 3–5 days. Maximum dose is typically 40 mg/day for older children. For mild exacerbations, 1 mg/kg may be sufficient. Courses longer than 5 days are generally not needed for acute exacerbations but may require tapering. Always follow your hospital's asthma protocol.
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Prednisolone and prednisone are closely related corticosteroids. Prednisone is a prodrug that the liver converts to prednisolone (its active form). In children, prednisolone is generally preferred because children's liver metabolism may be less reliable for converting prednisone, and prednisolone is available in liquid formulations (better for young children who cannot swallow tablets). They have equivalent potency when properly dosed.
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Short courses of prednisolone (3–5 days) are generally well tolerated with minimal side effects. Possible temporary effects include increased appetite and energy, mild mood changes (particularly in toddlers), and some fluid retention. These resolve when the course is finished. Long-term or repeated courses carry more significant risks (growth effects, adrenal suppression, bone density effects), which is why short courses are preferred and longer courses require specialist oversight.
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Yes, prednisolone should ideally be taken with food or milk to reduce the chance of stomach irritation. This is especially important for children who are already unwell or who are prone to nausea. If your child vomits within 30 minutes of a dose, most guidelines suggest repeating the dose since absorption will be incomplete.
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No — prednisolone and other corticosteroids should not be given to children who are actively infected with chickenpox (varicella) or who have been recently exposed. Corticosteroids suppress immune function and can allow the chickenpox infection to spread severely, including internally. If your child needs prednisolone for another condition and has been exposed to chickenpox, contact your doctor immediately.
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If you miss a dose and remember the same day, give it as soon as possible. If it is close to the time of the next dose, skip the missed dose and continue normally. Do not double up. For short 3–5 day courses for acute conditions, missing one dose is generally not critical. For longer prescribed courses (e.g., for nephrotic syndrome), contact your prescribing doctor for guidance as the medication should not be stopped abruptly.