Endocrinology
Corticosteroid Dose Converter
Glucocorticoid equivalence to prednisolone.
Education and reference only. Not a substitute for clinical judgement, local policy or product labelling. Always verify before clinical use. Values are calculated in your browser and never stored.
Background
The corticosteroid dose converter expresses a dose of one glucocorticoid in terms of its prednisolone equivalent for anti-inflammatory (glucocorticoid) effect. It relies on well-established relative potencies: hydrocortisone is roughly four times weaker than prednisolone, while methylprednisolone and triamcinolone are somewhat more potent, and dexamethasone and betamethasone are markedly more potent. Using prednisolone as the reference, approximate equivalents are about 20 mg hydrocortisone, 5 mg prednisolone/prednisone, 4 mg methylprednisolone or triamcinolone, 6 mg deflazacort, and around 0.75 mg dexamethasone or betamethasone. The tool supports switching between corticosteroids without losing anti-inflammatory effect.
Interpreting the result
The output is the dose of prednisolone that delivers an equivalent anti-inflammatory effect to the entered drug and dose. A higher equivalent indicates a more potent steroid or a larger dose. Equivalence is only approximate and reflects glucocorticoid potency alone — it deliberately ignores mineralocorticoid (salt-retaining) effect, which is significant for hydrocortisone, and the differing durations of action, which are short for hydrocortisone and very long for dexamethasone and betamethasone.
Worked example
A patient is switching from 4 mg of dexamethasone. Since roughly 0.75 mg of dexamethasone equates to 5 mg of prednisolone, 4 mg of dexamethasone corresponds to about 27 mg of prednisolone in anti-inflammatory terms (4 ÷ 0.75 × 5 ≈ 27 mg).
Critical actions
Equivalence reflects ANTI-INFLAMMATORY (glucocorticoid) potency only — it ignores mineralocorticoid effect and differing durations of action. Not a guide to tapering; do not use for adrenal-replacement dosing.
Pearls / pitfalls
- Equivalence reflects anti-inflammatory potency only — it ignores mineralocorticoid activity, so it is not appropriate for adrenal-replacement or salt-balance decisions.
- Durations of action differ widely (hydrocortisone short, dexamethasone/betamethasone long), so an equivalent dose is not biologically interchangeable hour-to-hour.
- It is not a tapering guide; withdrawal of long-term steroids must be gradual to avoid adrenal insufficiency.
- Equivalences are approximate and vary slightly between sources, so treat the result as a guide, not a precise prescription.
Evidence & validation
The relative potency figures are long-standing pharmacological constants found in standard formularies and references such as the British National Formulary; the converter applies these established equivalences rather than any single trial-derived formula.
Frequently asked questions
What does the converter actually calculate?
It converts a dose of one glucocorticoid into the prednisolone dose that has an equivalent anti-inflammatory effect. This helps when switching between different corticosteroids.
Does it account for mineralocorticoid (salt-retaining) effects?
No. The converter reflects glucocorticoid (anti-inflammatory) potency only. Mineralocorticoid effects, which matter for drugs like hydrocortisone, are not represented.
Can I use it to taper or stop steroids?
No. It only converts between equivalent doses and does not provide a tapering schedule. Long-term steroids must be reduced gradually under clinical supervision to avoid adrenal insufficiency.
Why is dexamethasone such a small equivalent dose?
Dexamethasone is far more potent than prednisolone (roughly 0.75 mg dexamethasone equals 5 mg prednisolone), so a small number of milligrams represents a large anti-inflammatory effect. It also has a much longer duration of action.
Are the equivalences exact?
No, they are approximate and can vary slightly between reference sources. The converter gives a clinically useful estimate, not a precise dose, and prescribing should always be checked against a current formulary.
References
- Standard glucocorticoid equivalence — relative anti-inflammatory potency of corticosteroids referenced to prednisolone.
- British National Formulary (BNF). Corticosteroids: equivalent anti-inflammatory doses. Joint Formulary Committee.
Related calculators
Need a calculator we don't have — or a custom tool?
We build evidence-led clinical calculators, dashboards and reference tools for teams.