π Corticosteroid Dose Converter
Equivalent anti-inflammatory doses across steroids.
Equivalent doses
For informational purposes only, not medical advice.
Corticosteroid equivalents compare anti-inflammatory potency: 5 mg of prednisone equals 0.75 mg of dexamethasone, 20 mg of hydrocortisone, or 4 mg of methylprednisolone. So 40 mg of prednisone converts to 6.00 mg of dexamethasone. This calculator converts any dose among the six common systemic steroids, using the standard equivalence table every formulary prints.
Equivalence is about glucocorticoid effect, not the whole drug. Hydrocortisone retains salt and water strongly; dexamethasone barely does. Two equivalent doses can feel quite different, which is why switches are clinical decisions, not arithmetic.
How to Use This Converter
Enter the dose and the steroid you are converting from. The tool shows the equivalent dose in each of the other five, for reference when reviewing orders or formularies.
Enter the dose in milligrams.
Select the steroid the dose is written in.
Read the equivalents. Confirm any real switch or taper change with the prescriber or pharmacist.
The Equivalence Table
| Steroid | Equivalent mg | Duration |
|---|---|---|
| Hydrocortisone | 20 | Short (8-12h) |
| Prednisone / Prednisolone | 5 | Intermediate (12-36h) |
| Methylprednisolone | 4 | Intermediate (12-36h) |
| Dexamethasone | 0.75 | Long (36-72h) |
| Betamethasone | 0.6 | Long (36-72h) |
Duration matters as much as potency: dexamethasone's long half-life suppresses the adrenal axis longer, while hydrocortisone's short action suits stress dosing. Mineralocorticoid activity runs opposite to what many expect: hydrocortisone and fludrocortisone retain sodium strongly; dexamethasone and betamethasone essentially do not.
Worked Example
A prescription reads prednisone 40 mg daily, and the question is the dexamethasone equivalent: 40 divided by 5 is 8 equivalent units, times 0.75 gives 6.00 mg of dexamethasone. The hydrocortisone equivalent is 8 times 20, or 160 mg.
In practice nobody swaps 40 mg prednisone for 6 mg dexamethasone casually: the longer duration and different side-effect profile make it a prescriber's call. The conversion answers how potent the doses are relative to each other, which is one input to that call.
Reading Your Result
Use equivalents to compare potency across orders, formularies, and literature, not to self-adjust. Tapering schedules depend on duration of use and dose, not just the current day's equivalent. And remember the table equates anti-inflammatory effect; it does not equate side effects, which follow each drug's own profile.
My take: the most common real-world use is sanity-checking a switch the doctor already ordered. If the equivalent looks wildly different from what you expected, that is a pharmacist phone call, not a reason to adjust it yourself.
Limits
Equivalences are approximate and derived from anti-inflammatory assays, not head-to-head trials at every dose. Topical, inhaled, and injected steroids follow different potency scales entirely. Adrenal suppression risk, taper needs, and mineralocorticoid effects all sit outside this table.
Related Tools
Steroids affect weight and pressure: the BMI calculator and blood pressure checker track both. For pain-med context, the acetaminophen dosage reference covers the non-steroid option.
For informational purposes only, not medical advice. Consult a healthcare professional.
Frequently Asked Questions
How do you convert prednisone to dexamethasone?
Divide the prednisone dose by 5 and multiply by 0.75. Prednisone 40 mg equals dexamethasone 6 mg in anti-inflammatory effect. Confirm any real switch with the prescriber.
What are corticosteroid equivalent doses?
The standard table: hydrocortisone 20 mg = prednisone 5 mg = prednisolone 5 mg = methylprednisolone 4 mg = dexamethasone 0.75 mg = betamethasone 0.6 mg, all approximately equal in glucocorticoid effect.
Is dexamethasone stronger than prednisone?
Per milligram, yes: 0.75 mg dexamethasone matches 5 mg prednisone, making it about 6-7 times more potent by weight. It also lasts much longer (36-72 hours vs 12-36).
Do equivalent doses have the same side effects?
No. The table equates anti-inflammatory potency only. Mineralocorticoid effects (salt/water retention), duration of adrenal suppression, and metabolic effects differ by drug.
Which steroid causes the least fluid retention?
Dexamethasone and betamethasone have negligible mineralocorticoid activity. Hydrocortisone retains the most salt and water among common systemic steroids.
Can I switch steroids using this table myself?
No. Switches and tapers need prescriber supervision because duration, side effects, and the reason for treatment all matter beyond the potency math. Use the table to understand orders, not to change them.
What is the difference between prednisone and prednisolone?
Prednisone is a prodrug converted by the liver to active prednisolone; they are milligram-equivalent in most patients. Prednisolone is preferred in severe liver disease where conversion is impaired.
How long do steroids suppress the adrenal glands?
It depends on dose and duration: brief courses recover quickly, while weeks of therapy need tapering. Longer-acting agents like dexamethasone suppress longer than their daily dose suggests.
Are inhaled steroids on this table?
No. Inhaled, topical, and injected steroids use separate potency scales and mostly act locally. This converter covers systemic oral and IV corticosteroids only.
Does this cover anabolic steroids?
No. This page is about corticosteroids (anti-inflammatory, e.g. prednisone). Anabolic steroids are entirely different drugs with different effects and risks.