Table 3.

Possible lower dosages of immunomodulators

Agent	Elimination half‐life	Possible lower dose
Azathioprine	5 h	Reduce to ≤0.5 mg/kg/day
Ciclosporin	5–18 h	Reduce to ≤1 mg/kg/day
Methotrexate	25–30 h	Reduce to ≤10 mg/week
Mycophenolate mofetil	8–16 h	Reduce to ≤1 g/day (mycophenolic acid to <720 mg/day)
Systemic corticosteroids	Predniso(lo)ne 3–4 h	Reduce to 10 mg/day prednisone equivalent in a graduated manner.
Retinoids	Isotretinoin 10–20 h Acitretin 49 h Alitretinoin 2–10 h	No dose adjustment required.
Biologics	Variable	Dose reduction often not possible but consider extending the time between dosages. Temporary discontinuation should be evaluated on a case‐by‐case basis.