Corticosteroids provide symptomatic relief from a reversal (type 1) reaction frequently within 1 week. Prednisone 1 mg/kg up to 80 mg/day tapered over several months can be used. The dose may be increased by 20 mg/day if symptoms persist after initiation of therapy. Prednisolone is available as an oral solution that may be used in place of prednisone. Long-term use of high-dose corticosteroids certainly has complications associated with adrenocortical atrophy and hypoalbuminemia. Myopathy, osteoporosis, ocular effects, hyperglycemia, and skin reactions are just a few of the major adverse effects that must be monitored and addressed throughout the treatment. Some practitioners will also prescribe a bisphosphonate, such as alendronate, to prevent osteoporosis.
Pharmacotherapy. 2012;32(1):27-37. © 2012 Pharmacotherapy Publications