Abstract

In an attempt to ascertain the minimal dose of alternate-day prednisone at which there is significant adrenal suppression, we have measured serum 17-hydroxycorticosteroids (17-OHCS) and cortisol levels in patients on long-term prednisone therapy of varied doses and in controls before and after insulin and synthetic corticotropin stimulation. One patient had frequent determinations while on varied doses over a two-year period, and two adult volunteers received single-dose daily and alternate-day prednisone in increasing increments up to 25 mg to try to correlate dose with the levels of 17-OHCS and cortisol in serum. For alternate-day treatment, prednisone was always given as a single dose before 9 AM and blood samples were always drawn before 9 AM. Results indicated that alternate-day doses of prednisone of less than 15 to 20 mg produce only minimal odrenal suppression.