💊 Glucocorticoid Stress Dosing & Taper
Glucocorticoid stress dosing by surgical magnitude, adrenal crisis management and long-term tapering, per the Endocrine Society and Woodcock 2020. Browser-side.
Glucocorticoid Stress Dosing & Taper
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When to use
Decide who needs stress-dose steroids, how much to give for a given surgery, and how to taper chronic steroids.
How it works
Minor: usual dose ± hydrocortisone 25 mg. Moderate: 50–75 mg/day. Major: 100 mg + 200 mg/24h. Crisis: hydrocortisone 100 mg IV then 200 mg/24h.
Key points
- Prednisone > 20 mg/day for ≥ 3 weeks implies HPA suppression.
- Hydrocortisone is preferred for its mineralocorticoid activity.
- Adrenal crisis: hydrocortisone + isotonic fluids + treat the trigger.
- HPA recovery after a taper can take weeks to months.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.