21
Examples Suggested regimen
• Illness requiring
bed rest
• Illness with fever (out
of hospital)
• Illness requiring
treatment with
antibiotics (out of
hospital)
• Significant
emotional stress (e.g.,
bereavement)
If not on daily glucocorticoids: Give hydrocortisone 40 mg
total daily dose, to be given in three divided doses (e.g., 20 mg
on rising, 10 mg 12 midday, 10 mg 5pm). Continue for 2–5
days until well (or for the duration of antibiotic treatment).
If on hydrocortisone <40 mg total daily dose: Increase to 40
mg total daily dose, to be given in three divided doses (e.g.,
20 mg on rising, 10 mg 12 midday, 10 mg 5pm). Continue
for 2–5 days until well (or for the duration of antibiotic
treatment).
If on prednisone <10 mg total daily dose: Increase to 10
mg total daily dose, to be given in one or two divided doses.
Continue for 2–5 days until well (or for the duration of
antibiotic treatment).
If on dexamethasone <1 mg total daily dose: Increase to 1 mg
once daily. Continue for 2–5 days until well.
Minor surgery
including any
procedure requiring
local anesthesia
If not on daily glucocorticoids: Give oral hydrocortisone 40
mg total daily dose, to be given in three divided doses (e.g.,
20 mg one hour prior to the procedure, 10 mg six hours aer
the procedure, 10 mg aer a further six hours). Continue
glucocorticoids in patients who remain unwell aer the
procedure until clinically stable.
If on hydrocortisone <40 mg total daily dose: Increase to 40
mg total daily dose, to be given in three divided doses (e.g.,
20 mg one hour prior to the procedure, 10 mg six hours aer
the procedure, 10 mg aer a further six hours). Continue
increased dose in patients who remain unwell aer the
procedure until clinically stable.
If on prednisone <10 mg total daily dose: Increase to 10 mg
total daily dose, to be given one hour prior to the procedure.
Continue increased dose in patients who remain unwell aer
the procedure until clinically stable.
If on dexamethasone <1 mg total daily dose: Increase to 1 mg
total daily dose, to be given one hour prior to the procedure.
Continue increased dose in patients who remain unwell aer
the procedure until clinically stable.
Bowel procedures
not carried out under
general anesthesia
If not on daily glucocorticoids: Give hydrocortisone 20 mg
total daily dose, to be given in three divided doses (e.g., 10
mg one hour prior to the procedure, 5 mg six hours aer the
procedure, 5 mg aer a further six hours).
If on daily glucocorticoids: Continue normal glucocorticoid
dose. Give an equivalent I.V. dose if prolonged nil by mouth.
