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Corticosteroid Conversion Calculator

Convert between corticosteroids using potency equivalencies. Hydrocortisone 20mg = Prednisone 5mg = Methylprednisolone 4mg = Dexamethasone 0.75mg. Anti-inflammatory and mineralocorticoid potencies differ significantly.

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Why: This page explains what the Corticosteroid Conversion calculator does, what to enter, and how to read the results—without repeating the overview above.

How: Enter your values in the calculator fields below, keep units consistent, then run the calculation to see results and any step-by-step work shown on this page.

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For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.

Corticosteroids are potent anti-inflammatory medications. Different steroids have varying potencies, so "equivalent doses" refer to amounts producing similar glucocorticoid effects. Hydrocortisone 20mg = Prednisone 5mg = Methylprednisolone 4mg = Dexamethasone 0.75mg. Anti-inflammatory and mineralocorticoid potencies differ significantly—dexamethasone has no mineralocorticoid activity.

5mg
Prednisone reference
25×
Dex glucocorticoid
8-54h
Half-life range
3+ wks
Taper if chronic

Sources: UpToDate, Lexicomp, AHFS Drug Information.

Key Takeaways

  • • Convert via prednisone equivalent: (Dose ÷ From Equiv) × 5
  • • Target dose = (Pred Equiv ÷ 5) × Target Equiv
  • • Consider duration (short/intermediate/long) when switching
  • • Mineralocorticoid activity matters in heart failure, hypertension

Did You Know?

🔢 Hydrocortisone is the reference (potency = 1) for glucocorticoid comparison.
📊 Dexamethasone 6mg became standard for hypoxic COVID-19 (RECOVERY trial).
💡 Prednisone is a prodrug—use prednisolone in severe liver disease.
🌍 Holliday-Segar method: physiologic replacement ~15-25mg hydrocortisone/day.
📈 >20mg prednisone equivalent for >3 weeks requires tapering.
🎯 Blood products require 10 gtt/mL tubing; microdrip is 60 gtt/mL.

How Does Corticosteroid Conversion Work?

Step 1: Prednisone Equivalent

Convert current steroid to prednisone equivalent: (Current Dose ÷ From Equivalent) × 5. Example: 40mg prednisone = 40; 8mg dex = (8÷0.75)×5 ≈ 53mg pred.

Step 2: Target Steroid Dose

Convert prednisone equivalent to target: (Pred Equiv ÷ 5) × Target Equivalent. Example: 40mg pred to methylpred = (40÷5)×4 = 32mg.

Clinical Considerations

Consider half-life (dosing frequency), mineralocorticoid effects (edema, hypokalemia), and indication-specific preferences.

Expert Tips

Give single morning dose when possible to minimize HPA suppression and insomnia.
Consider PPI for high-dose or prolonged steroids, especially with NSAIDs.
Start calcium/vitamin D for all; consider bisphosphonates for >5mg/day >3 months.
Stress dosing: chronic steroid users need supplemental doses during surgery, illness, or trauma.

Corticosteroid Equivalence Table

SteroidEquivalent (mg)Half-LifeDuration
Prednisone5 mg12-36 hrsIntermediate
Prednisolone5 mg12-36 hrsIntermediate
Methylprednisolone4 mg12-36 hrsIntermediate
Hydrocortisone20 mg8-12 hrsShort
Cortisone25 mg8-12 hrsShort
Dexamethasone0.75 mg36-54 hrsLong
Betamethasone0.6 mg36-54 hrsLong
Triamcinolone4 mg12-36 hrsIntermediate

Frequently Asked Questions

What is corticosteroid equivalence?

Corticosteroid equivalence refers to doses of different steroids that produce similar anti-inflammatory (glucocorticoid) effects. Hydrocortisone 20mg = Prednisone 5mg = Methylprednisolone 4mg = Dexamethasone 0.75mg. Equivalence is approximate and varies by indication.

How is steroid conversion calculated?

Convert to prednisone equivalent first: (Current Dose ÷ From Equivalent) × 5. Then convert to target: (Prednisone Equiv ÷ 5) × Target Equivalent. Example: 40mg prednisone to methylprednisolone = (40÷5)×4 = 32mg.

Why do mineralocorticoid and glucocorticoid potencies differ?

Glucocorticoid effect (anti-inflammatory) and mineralocorticoid effect (salt/water retention) are separate. Dexamethasone has high glucocorticoid but zero mineralocorticoid activity. Hydrocortisone has both. This affects steroid selection for heart failure or hypertension.

When should I taper corticosteroids?

Taper when on ≥20mg prednisone equivalent for ≥3 weeks. Reduce by 10-20% every 3-5 days for short courses. Slower tapers (5-10% every 2-4 weeks) for long-term use. Never stop abruptly—risk of adrenal crisis.

Can I substitute prednisone for prednisolone?

Yes—they are equipotent (both 5mg equivalent). Prednisone is a prodrug converted to prednisolone in the liver. Use prednisolone in severe liver disease when conversion may be impaired.

What is physiologic replacement dosing?

For adrenal insufficiency: hydrocortisone 15-25mg/day or prednisone 5-7.5mg/day. Give in divided doses mimicking diurnal rhythm (2/3 AM, 1/3 PM). May need fludrocortisone for mineralocorticoid replacement.

Key Statistics

5mg
Pred reference
20mg
Hydrocortisone
0.75mg
Dex equivalent
4mg
Methylpred

Official Data Sources

⚠️ Disclaimer: This calculator is for educational purposes only. Steroid equivalence is approximate; clinical response varies. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for clinical decisions.

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