Convert between corticosteroids using equipotent anti-inflammatory dose equivalency. Compares 8 steroids with relative potency, mineralocorticoid activity, half-life, and exposure context.
Corticosteroid dose conversion is one of the most common clinical calculations in medicine, required whenever switching between steroid formulations, converting from IV to oral, adjusting for pharmacokinetic differences, or assessing cumulative steroid exposure. Since different corticosteroids have dramatically different potencies — dexamethasone is 25-30 times more potent than hydrocortisone — accurate conversion is essential to maintain therapeutic efficacy while avoiding over- or under-treatment.
This calculator converts between eight commonly used systemic corticosteroids based on their anti-inflammatory (glucocorticoid) equipotent doses. It calculates the hydrocortisone equivalent to assess physiologic vs supraphysiologic dosing, provides prednisone-equivalent doses for standardized communication, estimates HPA axis suppression risk, and includes mineralocorticoid activity and biologic half-life for each agent.
Beyond simple conversion, the tool also gives broader exposure context. The hydrocortisone-equivalent and prednisone-equivalent outputs make it easier to compare regimens, while the tapering section is intentionally general and should not be treated as a patient-specific steroid plan.
Corticosteroid conversions are easy to misremember because each drug combines different potency, half-life, and mineralocorticoid effects. This calculator keeps the equivalency math visible, standardizes the hydrocortisone and prednisone reference points, and provides general taper context without pretending to replace the actual clinical plan.
Target Dose = Source Dose × (Source Equivalent / Target Equivalent) Hydrocortisone Equivalent = Total Daily Dose × (20 / Source Equivalent Dose) Physiologic replacement ≈ 20 mg hydrocortisone/day (≈ 5 mg prednisone) Relative potency referenced to hydrocortisone = 1×
Result: 6.0 mg dexamethasone daily = 40 mg prednisone daily
Prednisone equivalent dose is 5 mg, dexamethasone is 0.75 mg. Ratio: 5/0.75 = 6.67. So 40 mg prednisone = 40/6.67 = 6.0 mg dexamethasone. Hydrocortisone equivalent = 40 × (20/5) = 160 mg/day — 8× physiologic. At this level, HPA suppression is likely if used > 5 days.
The conversion on this page is based on anti-inflammatory equipotent dosing. That makes it useful for comparing relative glucocorticoid exposure, but it does not automatically answer questions about mineralocorticoid replacement, taper speed, or the best drug for a specific diagnosis.
Using hydrocortisone and prednisone equivalents makes very different regimens easier to compare on one scale. It also gives the user a better sense of whether the total exposure is near physiologic replacement or far above it.
The tapering section is intentionally broad. Real taper decisions depend on duration, prior exposure, adrenal-suppression risk, disease activity, and the reason the steroid was started in the first place.
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This page converts one systemic corticosteroid to another by comparing the entered daily dose with a standard anti-inflammatory equivalency table. It also expresses the regimen as hydrocortisone-equivalent and prednisone-equivalent exposure so the user can compare total glucocorticoid burden, biologic half-life, and mineralocorticoid activity on one worksheet.
The result is a reference conversion, not a patient-specific taper or replacement plan. Clinical equivalence still depends on indication, route, timing, mineralocorticoid needs, adrenal-suppression risk, and the disease being treated.
No. Equipotent doses reflect average anti-inflammatory potency ratios and are approximations. Individual patients may respond differently. Clinical response, not just dose conversion, should guide therapy. Mineralocorticoid effects, half-life, and formulation bioavailability also affect clinical equivalence.
Dexamethasone has the longest biologic half-life (36-54 hours), zero mineralocorticoid activity (no salt/water retention), highest potency (smallest volume), and excellent CNS penetration. It is preferred for cerebral edema, chemotherapy antiemesis, and when sodium retention must be avoided.
Taper is needed after: >5-7 days of supraphysiologic doses, any duration >3 weeks, or any dose if the patient has features of adrenal suppression. The longer the duration and higher the dose, the slower the taper must be. Below physiologic replacement (5 mg prednisone), taper very slowly and check AM cortisol.
Prednisone is a prodrug that must be converted to prednisolone (the active form) by the liver. In patients with severe liver disease, prednisolone is preferred because it does not require hepatic activation. Otherwise, they are clinically interchangeable at the same dose.
No. The conversion is based on anti-inflammatory (glucocorticoid) potency only. Hydrocortisone has significant mineralocorticoid activity (salt retention, hypokalemia), while dexamethasone has none. When replacing adrenal function, fludrocortisone may be needed separately for mineralocorticoid coverage.
Prednisone ≥ 7.5 mg/day (or equivalent) for more than 3 weeks commonly causes moon face, weight gain, and other Cushingoid features. Even 5 mg/day long-term can cause osteoporosis. Cumulative dose matters — tracking lifetime steroid exposure is emerging as a best practice.