• High-dose “pulse” steroids, given for 7 days: no weaning necessary if patient not recently treated with steroids.
• High-dose steroids, given for 1-4 weeks: cut by ~25% every 4-7 days.
• High-dose steroids given for 1 month: wean rapidly to “stress doses”, then cut by ~10-25% every 1-2 weeks, until dose is <50% of physiologic replacement. Probably should then be tested for suppression.
• On long treatment/weaning schedules, can try to get all of dose to once in the morning, or once every other day, to allow HPA axis to recover and minimize growth-retarding effects.

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You can find more details on: Adrenal Steroid Therapy and Weaning – BC Children’s Hospital