Steroid Conversion Calculator
Calculate equivalent doses between different corticosteroids based on their anti-inflammatory potency and duration of action
Steroid Equivalency Table
| Corticosteroid | Equivalent Dose (mg) | Anti-inflammatory Potency | Duration of Action | Mineralocorticoid Activity |
|---|---|---|---|---|
| Hydrocortisone | 20 | 1 | 8-12 hours | High |
| Cortisone | 25 | 0.8 | 8-12 hours | High |
| Prednisone | 5 | 4 | 12-36 hours | Low |
| Prednisolone | 5 | 4 | 12-36 hours | Low |
| Methylprednisolone | 4 | 5 | 12-36 hours | Minimal |
| Triamcinolone | 4 | 5 | 12-36 hours | None |
| Dexamethasone | 0.75 | 25-30 | 36-72 hours | None |
| Betamethasone | 0.6 | 25-30 | 36-72 hours | None |
How to Use This Calculator
This steroid conversion calculator helps healthcare professionals convert between different corticosteroids based on their anti-inflammatory potency. The conversions are based on established medical literature and are intended for oral or intravenous administration.
Step-by-Step Instructions
- Select the corticosteroid you are converting from in the first dropdown menu
- Choose the target corticosteroid you want to convert to in the second dropdown
- Enter the current dose in milligrams
- Select the daily dosing frequency
- Click “Calculate Conversion” to get the equivalent dose
Understanding Corticosteroid Categories
Short-Acting Corticosteroids (8-12 hours)
Hydrocortisone and cortisone are natural corticosteroids with significant mineralocorticoid activity. They are often used for replacement therapy in adrenal insufficiency and acute situations requiring immediate glucocorticoid effects.
Intermediate-Acting Corticosteroids (12-36 hours)
Prednisone, prednisolone, methylprednisolone, and triamcinolone are synthetic corticosteroids with enhanced anti-inflammatory activity and reduced mineralocorticoid effects. They are commonly used for inflammatory conditions and immunosuppression.
Long-Acting Corticosteroids (36-72 hours)
Dexamethasone and betamethasone have the highest anti-inflammatory potency and longest duration of action. They have no mineralocorticoid activity, making them suitable for conditions requiring potent anti-inflammatory effects without fluid retention.
Clinical Considerations
Factors Affecting Conversion
- Route of administration: Oral, intravenous, intramuscular, and topical routes may have different bioavailability
- Individual patient factors: Age, hepatic function, and concurrent medications can affect steroid metabolism
- Clinical condition: Some conditions may require adjustment of standard conversion ratios
- Duration of therapy: Long-term use requires consideration of cumulative effects and withdrawal schedules
Monitoring Parameters
When switching between corticosteroids, monitor patients for:
- Signs of inadequate glucocorticoid replacement (fatigue, hypotension, electrolyte imbalances)
- Excessive glucocorticoid effects (hyperglycaemia, hypertension, mood changes)
- Mineralocorticoid effects when switching to or from hydrocortisone or cortisone
- Withdrawal symptoms if reducing overall glucocorticoid exposure
Frequently Asked Questions
Why do steroid conversion ratios vary in the literature?
Conversion ratios can vary due to differences in study populations, routes of administration, and clinical endpoints measured. This calculator uses widely accepted ratios based on anti-inflammatory potency from authoritative medical sources.
Can I use these conversions for topical steroids?
No, this calculator is designed for systemic (oral or intravenous) corticosteroids only. Topical steroid potency classifications use different criteria and are not directly comparable to systemic formulations.
What about intramuscular or intra-articular injections?
The relative potency for intramuscular or intra-articular administration may differ significantly from oral or intravenous routes. Consult specific literature for these administration routes.
How do I handle fractions in dosing?
When calculated doses result in fractions, round to the nearest practical tablet strength or use available liquid formulations for more precise dosing, particularly in paediatric patients.
References
- National Adrenal Diseases Foundation. Corticosteroid Comparison Chart. Available at: https://www.nadf.us/uploads/1/3/0/1/130191972/corticosteroid_comparison_chart.pdf
- Chrousos GP, Kino T, Charmandari E. Glucocorticoids and their actions: an introduction. Ann N Y Acad Sci. 2004;1024:1-8.
- Furst DE, Saag KG. Glucocorticoid withdrawal. In: UpToDate, Romain PL (Ed), UpToDate, Waltham, MA, 2023.
- Liu D, Ahmet A, Ward L, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013;9(1):30.
- Buttgereit F, Straub RH, Wehling M, Burmester GR. Glucocorticoids in the treatment of rheumatic diseases: an update on the mechanisms of action. Arthritis Rheum. 2004;50(11):3408-17.