Steroid Taper Teaching

Prednisone provides an exogenous glucocorticoid signal. With sustained exposure, feedback lowers hypothalamic CRH and pituitary ACTH, so the adrenal cortex reduces its own cortisol production. Abruptly stopping the medication can therefore leave the client without enough cortisol, particularly during infection, injury, surgery, or another physiologic stress. Use this risk flag: glucocorticoid therapy lasting 3 weeks or longer, or any course with a daily prednisone equivalent above 5 mg, should be tapered rather than abruptly stopped. The taper protects against adrenal insufficiency while the prescriber balances recovery of the HPA axis with control of the illness being treated.