Dosage must be decreased or therapy discontinued gradually when administration has been continued for more than a few days. Continued supervision of the patient after cessation of corticosteroids is essential, since there may be a sudden reappearance of severe manifestations of the disease for which the patient was treated. In acute conditions where immediate relief is urgent, large doses are permissible and may be mandatory for a short period. In chronic conditions requiring long-term therapy, the lowest dosage that provides adequate, but not necessarily complete, relief should be used. If a high dosage for prolonged periods is considered essential, patients must be observed closely for signs that might necessitate a reduction in dosage or discontinuance of the hormone.
Chronic conditions are subject to periods of spontaneous remission.
When such periods occur, corticosteroids should be discontinued gradually. Periodic determinations of serum potassium are advisable if large doses are being used. Upper gastrointestinal x-rays should be taken when treatment is prolonged, in patients with history of ulcer or when there is gastric distress. The daily requirement should be divided into 4 doses. When symptoms have been suppressed adequately, dosage should be maintained at the minimum amount capable of providing sufficient relief without excessive hormonal effects.