When starting prednisolone for a lupus flare, write the planned taper and a target dose — ideally 5 mg a day or less — into the first prescription and the clinic letter. Patients and other doctors then see the endpoint from the start, and it is much harder for a patient to drift for months on 15 mg because nobody wrote down what should come next.
- Write a planned taper and target dose at the first steroid prescription.
- Aim for 5 mg prednisolone a day or less for maintenance where possible.
- Review the steroid dose at every lupus visit, not only disease activity.
Why it matters
Cumulative steroid exposure drives infection and damage in lupus.
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