Solu-Cortef

Adult Dosing .

Dosage forms:  INJ

corticosteroid-responsive conditions

[20-240 mg/day IV/IM divided bid-qid]

Alt: 100-500 mg IV/IM q2-6h; Info: dose, frequency varies by condition; taper dose gradually to D/C if long-term use

adrenal insufficiency, acute

[50 mg IV/IM q6h]

Start: 100 mg IV/IM x1; Alt: start 100 mg IV x1, then 200 mg/day IV infusion; Info: taper to maintenance dose after adequate response

asthma, acute

[200-300 mg/day IV divided q6-8h x5-7 days]

Info: switch to PO regimen ASAP to complete course

congenital adrenal hyperplasia, major illness/trauma stress tx

[50-100 mg/m^2/day IV/IM divided q6h]

Start: 100 mg IV/IM x1; Info: individualize dose based on dz severity and tx response; resume maintenance PO tx once stable

septic shock (off-label)

[200-300 mg/day IV infusion or divided q6h x5-7 days or until ICU discharge]

Max: 400 mg/day

community-acquired pneumonia, severe bacterial (off-label)

[200 mg IV x1, then 10 mg/h IV x7 days]

Alt: 200 mg IV qd x4-8 days, then taper dose gradually to complete 8-14 days total; Info: D/C upon ICU discharge

renal dosing

[see below]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

corticosteroid-responsive conditions

[<12 yo]

Dose: 1-5 mg/kg/day IV/IM divided q12-24h; Info: dose, frequency varies by condition; taper dose gradually to D/C if long-term use

[12 yo and older]

Dose: 15-240 mg IV/IM q12h; Info: dose, frequency varies by condition; taper dose gradually to D/C if long-term use

adrenal insufficiency, acute

[<3 yo]

Dose: 25 mg/day IV/IM/IO divided q6h; Start: 25 mg IV/IM/IO x1; Alt: start 2 mg/kg/dose up to 100 mg/dose IV/IM/IO x1, then 25 mg/day IV/IM/IO divided q6h; Info: taper to maintenance dose after adequate response

[3-11 yo]

Dose: 50 mg/day IV/IM/IO divided q6h; Start: 50 mg IV/IM/IO x1; Alt: start 2 mg/kg/dose up to 100 mg/dose IV/IM/IO x1, then 50 mg/day IV/IM/IO divided q6h; Info: taper to maintenance dose after adequate response

[12 yo and older]

Dose: 100 mg/day IV/IM/IO divided q6h; Start: 100 mg IV/IM/IO x1; Alt: start 2 mg/kg/dose up to 100 mg/dose IV/IM/IO x1, then 100 mg/day IV/IM/IO divided q6h Info: taper to maintenance dose after adequate response

asthma, acute

[6-11 yo]

Dose: 4 mg/kg/dose IV q6h x3-5 days; Max: 100 mg/dose; Info: switch to PO regimen ASAP to complete course

[12 yo and older]

Dose: 200 mg/day IV divided q6h x3-5 days; Info: switch to PO regimen ASAP to complete course

congenital adrenal hyperplasia, major illness/trauma stress tx

[1 mo-2 yo]

Dose: 50-100 mg/m^2/day IV/IM divided q6h; Start: 25 mg IV/IM x1; Info: individualize dose based on dz severity and tx response; resume maintenance PO tx once stable

[3-11 yo]

Dose: 50-100 mg/m^2/day IV/IM divided q6h; Start: 50 mg IV/IM x1; Info: individualize dose based on dz severity and tx response; resume maintenance PO tx once stable

[12 yo and older]

Dose: 50-100 mg/m^2/day IV/IM divided q6h; Start: 100 mg IV/IM x1; Info: individualize dose based on dz severity and tx response; resume maintenance PO tx once stable

chronic lung dz prevention (off-label)

[0-7 days old, <1 kg]

Dose: 0.5 mg/kg/dose IV q12h x7 days, then 0.5 mg/kg/dose IV qd x3 days; Info: for chorioamnionitis-exposed extremely low birth wt neonates

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[not defined]