Dose of Hydrocortisone for Acute Allergy / Severe Acute Asthma in Paediatric Patients

Most allergies involve the release of histamine and other pro-inflammatory substances (substances that produce inflammation)

Reference	Dosage Recommended
BNFC 2018-19	Acute hypersensitivity reactions | Angioedema By IM / IV injection ·  Child 1-5 months: Initially 25 mg TDS, adjusted according to response ·  Child 6 months - 5 years: Initially 50 mg TDS, adjusted according to response ·  Child 6-11 years: Initially 100 mg TDS, adjusted according to response ·  Child 12-17 years: Initially 200 mg TDS, adjusted according to response Severe acute asthma | Life-threatening acute asthma By IV injection 1 month – 1 year 4 mg/kg (max. 25 mg per dose) q6h, alternatively 25 mg q6h until conversion to oral predni-solone is possible 2 – 4 years 4 mg/kg (max. 50 mg per dose) q6h, alternatively 50 mg q6h 5 – 11 years 4 mg/kg (max. 100 mg per dose) q6h, alternatively 100 mg q6h 12 – 17 years 4 mg/kg (max. 100 mg per dose) q6h, alternatively 100 mg q6h
Paediatric Formulary apps [Guy’s and St. Thomas’s NHS Foundation Trust]	Asthma, acute adrenal insufficiency and emergencies By IM / IV injection § Neonates: 2.5 mg/kg bolus, then 2.5 mg/kg q6h § All others: 4 mg/kg q6h Doses may need to be increased depending on the condition being treated and the patient’s response OR Up to 2 years 2 mg/kg (max. 25 mg) 3-4 times a day 2-5 years 50 mg 3-4 times a day Over 5 years 100 mg 3-4 times a day