Convert a steroid dose to its approximate equivalent in prednisone, dexamethasone, methylprednisolone, hydrocortisone or other corticosteroids.
Steroid Conversion Formula
The calculator compares approximate systemic glucocorticoid (anti-inflammatory) equivalents using the reference amounts below. Exact arithmetic on a reference ratio does not make clinical equivalence exact or establish route or formulation interchangeability:
D2 = D1 * (E2 / E1)
Variables:
- D2 is the equivalent dose of the target steroid, in mg
- D1 is the dose of the current steroid you enter, in mg
- E1 is the standard equivalent dose of the current steroid (for example 5 mg for prednisone)
- E2 is the standard equivalent dose of the target steroid (for example 0.75 mg for dexamethasone)
To express an entered amount as a common reference, the calculator also reports hydrocortisone-equivalent and prednisone-equivalent amounts on the same time basis as the input:
HCE = D1 * (20 / E1) PE = D1 * (5 / E1)
HCE and PE are approximate reference amounts, not automatically daily totals or measures of adverse-effect risk. Choose one-to-one conversion or all nine equivalents. The optional existing frequency must be a positive whole number of occurrences of the entered amount in 24 hours; blank means no daily interpretation. If the input is already a 24-hour total, leave frequency blank to avoid counting it again. Relative mineralocorticoid potency is a drug property; multiplying it by dose does not provide a validated prediction of fluid-retention risk.
Corticosteroid Equivalent Doses and Potency
The first eight rows use approximate Endotext reference equivalents and relative drug properties. Deflazacort 6 mg ≈ prednisone or prednisolone 5 mg is supported by the Calcort product information; the other deflazacort properties are not specified in these cited references. Relative potencies are approximate reference properties, not exact inverse conversion factors or predictions of individual fluid retention. Biologic duration is not plasma half-life. These comparisons exclude topical, inhaled, local/depot use and mineralocorticoid replacement.
| Steroid | Equivalent dose (mg) | Anti-inflammatory potency | Relative mineralocorticoid potency | Duration |
|---|---|---|---|---|
| Hydrocortisone | 20 | 1 | 1 | Short (8-12 h) |
| Cortisone acetate | 25 | 0.8 | 0.8 | Short (8-12 h) |
| Prednisone | 5 | 4 | 0.3 | Intermediate (18-36 h) |
| Prednisolone | 5 | 5 | 0.3 | Intermediate (18-36 h) |
| Methylprednisolone | 4 | 5 | 0 | Intermediate (18-36 h) |
| Triamcinolone | 4 | 5 | 0 | Intermediate (18-36 h) |
| Dexamethasone | 0.75 | 30 | 0 | Long (36-54 h) |
| Betamethasone | 0.6 | 25 to 40 | 0 | Long (36-54 h) |
| Deflazacort | 6 | Not specified | Not specified | Not specified |
Biologic duration is one reference property; it does not by itself determine administration frequency, adrenal suppression or a conversion schedule. The clinician determines timing for the indication, formulation and individual. Equivalent anti-inflammatory amounts do not establish an interchangeable regimen.
| Duration class | Examples | Biologic duration | Administration timing | Conversion limitation |
|---|---|---|---|---|
| Short | Hydrocortisone, cortisone | 8 to 12 h | Clinician determines | Duration does not determine schedule |
| Intermediate | Prednisone, methylprednisolone | 18 to 36 h | Clinician determines | Duration does not determine schedule |
| Long | Dexamethasone, betamethasone | 36 to 54 h | Clinician determines | Duration does not determine schedule |
The risk of glucocorticoid-induced adrenal insufficiency depends on dose, duration and individual factors. A reference conversion alone cannot decide whether, when or how to taper, or provide a stress-dose plan. Do not change or stop treatment using this calculator; the prescriber or pharmacist must assess the regimen.
Example Problems
Example 1: Convert prednisone to methylprednisolone.
For an entered existing 24-hour total of 40 mg prednisone, using E1 = 5 and E2 = 4 gives an approximate methylprednisolone equivalent of D2 = 40 * (4 / 5) = 32 mg on the same 24-hour basis. The hydrocortisone-equivalent amount is 40 * (20 / 5) = 160 mg on that basis. Leave optional frequency blank because the input is already a 24-hour total. This arithmetic does not choose timing or predict fluid retention.
Example 2: Convert hydrocortisone to dexamethasone.
For an entered amount of 100 mg hydrocortisone, using E1 = 20 and E2 = 0.75 gives an approximate dexamethasone equivalent of D2 = 100 * (0.75 / 20) = 3.75 mg on the same time basis. Their reference biologic duration and mineralocorticoid properties differ, but this does not establish a schedule, route change or fluid-retention risk.
Frequently Asked Questions
How do you convert one steroid dose to another?
Divide the entered amount by its drug’s reference equivalent, then multiply by the target drug’s reference equivalent. The result retains the input time basis. If you enter an existing 24-hour total, leave optional frequency blank; if you enter one amount and its existing occurrences over 24 hours, the calculator also shows arithmetic totals. These approximate anti-inflammatory comparisons do not establish a treatment regimen.
What does relative mineralocorticoid potency mean?
It is a relative drug property listed in the reference table, not a validated prediction of fluid retention or overall adverse effects for a person. A zero reference value does not establish absence of edema or other clinical risk. Do not multiply this property by dose to choose an agent or manage swelling, blood pressure or heart failure. Deflazacort’s value is not specified in the cited references.
Does converting change how often I take the dose?
An equivalent amount does not determine administration frequency. The prescriber or pharmacist must assess indication, formulation, route, response and individual risk before changing timing, dose or taper. The optional frequency field records an existing pattern only and never recommends one.
Sources
Endotext: Glucocorticoid Therapy and Adrenal Suppression, Table 1; Calcort 6 mg Summary of Product Characteristics, section 4.2; European Society of Endocrinology and Endocrine Society 2024 guideline.
