Glucocorticoid or Steroid Conversion
The equivalent anti-inflammatory dose shown is for oral or intravenous (IV) administration. Relative potency for intra-articular or IM administration may vary significantly.
Potency is relative to hydrocortisone.
| Steroid Agent | Equivalent Dose (mg) | Anti-inflammatory Potency | Mineralocorticoid Potency (Salt-Retaining) |
Duration of action (hours) |
|
Short-acting
|
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| Hydrocortisone (cortisol) | 20 | 1 | 1 |
8 to 12
|
| Cortisone | 25 | 0.8 | 0.8 |
8 to 12
|
|
Intermediate-acting
|
||||
| Prednisone | 5 | 4 | 0.6 |
12 to 36
|
| Prednisolone | 5 | 4 | 0.6 |
12 to 36
|
| Methylprednisolone | 4 | 5 | 0.25 |
12 to 36
|
| Triamcinolone | 4 | 5 | 0 |
12 to 36
|
|
Long-acting
|
||||
| Betamethasone | 0.6 | 30 | 0 |
36 to 72
|
| Dexamethasone | 0.75 | 30 | 0 |
36 to 72
|
| Fludrocortisone | – | 0 | 125 |
12 to 36
|
The Anti-inflammatory potency is responsible for anti-inflammatory and immunosuppressive properties as well as the metabolism of carbohydrates, proteins, and fats.
The mineralocorticoid potency is used sodium (salt) retention and potassium and hydrogen excretion. It basically does what aldosterone normally does. Clinically speaking, it helps to expand the plasma volume.
Glucocorticoid doses which provide a mineralocorticoid effect that is approximately equivalent to 0.1 mg fludrocortisone are prednisone or prednisolone 50 mg or hydrocortisone 20 mg.
Online Steroid Conversion Calculator (clincalc.com)
Another online calculator is the Steroid Equivalence calculator on medcalc.com
References
George P. Chrousos, MD. Adrenocorticosteroids & Adrenocortical Antagonists. Chapter 39. Bertram G. Katzung BG: Basic & Clinical Pharmacology, 9e.
Anesth Prog. 2013 Spring; 60(1): 25–32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601727