During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
5mg a day was too much and he was having bad side effects, extreme lethargy, he stopped eating,and drinking and his diarrhea actually got worse. Half a pill ever other day was not enough his stool was normal the first day then back to diarrhea the second. Half a pill mg a day seems to be the formula that works for him. He tolerates it well,and his stool remains normal. Mischief is much more active and healthy now,and is actually gaining weight. I am very pleased. Like I said I think it saved his life. Also the drug is very inexpensive $10 bucks a month