Corticosteroid Dose Equivalents

Equivalent Dose	Steroid
1.2 mg	Betamethasone (long-acting)
1.5 mg	Dexamethasone (long-acting)
8 mg	Methylprednisolone (intermediate-acting)
8 mg	Triamcinolone (intermediate-acting)

Aug 14 2022

Full
Answer

What is corticosteroid equivalence and how is it calculated?

The corticosteroid equivalence calculations are based on old studies comparing the degree of ACTH suppression following a single dose of corticosteroid. The degree of suppression depends on the dose of steroid given as well as the timing of that dose in relation to the drug’s half-life.

How many mg of cortisone in a dose?

About This Calculator Compound Equivalent Dose Anti-inflammatory Potency Mineralocorticoid Potency Biological Half-life Cortisone 25 mg 0.8 0.8 Short Hydrocortisone 20 mg 1 1 Short Prednisone 5 mg 4 0.6 Intermediate Prednisolone 5 mg 4 0.6 Intermediate 5 more rows …

What is the equivalent of hydrocortisone in MG?

Corticosteroid Equivalency Table (Oral or IV) Equivalent Dose (mg) Glucocorticoid (Anti-inflammatory) Mineralocorticoid (Na+-Retaining) Short Acting. Hydrocortisone (Cortisol) 20 1 2 Cortisone 25 0.8 2. Intermediate Acting.

What is a steroid conversion calculator?

This steroid conversion calculator is able to convert from one corticosteroid medication dosage to another for oral and IV administration. There is more information on the possible substance transformations and their available dosage forms below the converter. Steroid to convert from:

How much prednisone is equivalent to hydrocortisone?

Corticosteroid Dose EquivalentsEquivalent DoseSteroid10 mgPrednisone (intermediate-acting)10 mgPrednisolone (intermediate-acting) [4, 5]40 mgHydrocortisone (short-acting)50 mgCortisone (short-acting)4 more rows•Apr 18, 2019

What is steroid equivalence?

The corticosteroid equivalence calculations are based on old studies comparing the degree of ACTH suppression following a single dose of corticosteroid. The degree of suppression depends on the dose of steroid given as well as the timing of that dose in relation to the drug’s half-life.

What is the equivalent of prednisone to dexamethasone?

Dexamethasone is sixfold as potent as prednisone and prednisolone as an antiinflammatory; thus, 6 mg of prednisone/prednisolone is equivalent to 1 mg of dexamethasone.

What is equivalent to dexamethasone?

About This CalculatorCompoundEquivalent DoseAnti-inflammatory PotencyTriamcinolone4 mg5Methylprednisolone4 mg5Betamethasone0.8 mg25Dexamethasone0.8 mg255 more rows•Oct 24, 2015

How much dexamethasone is equivalent to hydrocortisone?

Table 1.DrugDose equivalent to 5 mg of prednisoloneDexamethasone750 microgramsHydrocortisone20 mgMethylprednisolone4 mgPrednisone5 mg6 more rows

How much prednisone is 4 mg dexamethasone?

Corticosteroid conversion of dosesDrugEquivalent doseAnti-inflammatory potencyPrednisolone5 mg4Triamcinolone4 mg5Methylprednisolone4 mg5Dexamethasone0.75 mg304 more rows•Jul 17, 2022

Which corticosteroid is the strongest?

The highest potency topical steroids include: Temovate (clobetasol propionate) 0.05% ointment. Ultravate (halobetasol propionate) 0.05% cream, ointment, or lotion. Psorcon (diflorasone diacetate) 0.05% ointment.

What is the most potent systemic corticosteroid?

Prednisone and methylprednisolone, which are intermediate-acting products, are four to five times more potent than hydrocortisone. Dexamethasone is a long-acting, systemic corticosteroid; its potency is about 25 times greater than the short-acting products.

What is stronger dexamethasone or prednisone?

Dexamethasone is a long-acting glucocorticoid with a half-life of 36 to 72 hours, and is 6 times more potent than prednisone. Prednisone is shorter acting, with a half-life of 18 to 36 hours.

How much prednisone is equivalent to prednisolone?

What is equivalent to prednisone? Prednisolone and prednisone doses are equivalent in a milligram to milligram comparison. In other words, 5 mg of prednisolone is as strong as 5 mg of prednisone.

How much budesonide is equivalent to prednisone?

Based on pharmacokinetic and bioavailability studies, 3 mg of budesonide is equivalent to 10 mg of prednisone [14]. Starting dose of budesonide will be 9 mg by mouth daily which will be equivalent to 30-40 mg of prednisone used as standard of care.

Can you switch from prednisone to dexamethasone?

Conclusions. A corticosteroid switch from prednisone to dexamethasone is effective for mCRPC which progressed on A + P treatment. Patients with lower PSA at corticosteroid switch and/or longer mCRPC-free survival may gain more benefits by the corticosteroid switch.

Are prednisone and prednisolone equivalent?

What is equivalent to prednisone? Prednisolone and prednisone doses are equivalent in a milligram to milligram comparison. In other words, 5 mg of prednisolone is as strong as 5 mg of prednisone. Prednisolone and prednisone are five times more potent than hydrocortisone, but only one-sixth the potency of dexamethasone.

Is hydrocortisone IV and PO equivalent?

What is the equivalent dose of oral prednisolone to intravenous (IV) hydrocortisone? Prednisolone 5mg orally is equivalent to hydrocortisone 20mg intravenously (equivalent anti-inflammatory dose).

When do you need to taper steroids?

Generally, dose tapering is required for patients who have: received more than 40 mg of prednisone per day for more than one week. been given repeat prednisone doses in the evening. received prednisone for more than 3 weeks.

Is oral and IV dexamethasone equivalent?

Some centres, however, continue to use a 1:1 conversion between dexamethasone oral and subcutaneous doses. *will need to be given via 2 sites as the maximum recommended volume for a single SC bolus injection is 2ml….Dose Conversions.CorticosteroidDoseDuration of action (hours)Dexamethasone0.75mg36-542 more rows•Sep 4, 2018

What are some other corticosteroids than dexamethasone?

Corticosteroids Other Than Dexamethasone. If dexamethasone is not available, alternative glucocorticoids such as prednisone, methylprednisolone, or hydrocortisone can be used. Half-life, duration of action, and frequency of administration vary among corticosteroids.

How long does hydrocortisone last?

Short-acting corticosteroid: hydrocortisone; half-life: 8 to 12 hours, administer in two to four divided doses daily. Hydrocortisone is commonly used to manage septic shock in patients with COVID-19; see Care of Critically Ill Patients With COVID-19 for more information.

Why were the corticosteroids stopped early?

16-20 Some of these trials were stopped early due to under enrollment following the release of the results from the RECOVERY trial. Given that the sample size of many these …

How long does dexamethasone last?

Long-acting corticosteroid: dexamethasone; half-life: 36 to 72 hours, administer once daily. Intermediate-acting corticosteroids: prednisone and methylprednisolone; half-life: 12 to 36 hours, administer once daily or in two divided doses daily.

What is the purpose of a short course of betamethasone?

A short course of betamethasone or dexamethasone, which are known to cross the placenta, is routinely used to decrease neonatal complications of prematurity in women with threatened preterm delivery. 40,41

Is Budesonide a glucocorticoid?

Budesonide is a synth etic, inhaled corticosteroid with potent glucocorticoid activity and weak mineralocorticoid activity. It has broad anti-inflammatory properties and has Food and Drug Administration-labeled indications for the management of chronic respiratory diseases including asthma and chronic obstructive pulmonary disease. Certain inhaled corticosteroids have been shown to impair viral replication of SARS-CoV-2 25 and downregulate expression of the receptors used for cell entry. 26,27 These mechanisms support the potential of inhaled corticosteroids as therapeutic agents for COVID-19. However, observational studies have found that long-term use of inhaled corticosteroids prescribed for non-COVID-19 respiratory diseases either had no effect on COVID-19 outcomes or increased the risk of hospitalization. 28,29 More recently, two open-label randomized controlled trials provided additional insights regarding the role of inhaled budesonide in outpatients with COVID-19, as described below and in Table 4b.

Can corticosteroids cause secondary infections?

Combining systemic corticosteroids with other immunosuppressants, such as tocilizumab or baricitinib, could theoretically increase the risk of secondary infections. However, this adverse effect has not been reported in clinical trials to date.

Why is oral glucocorticoid less potent than parenteral?

Oral potency may be less than parenteral potency because significant amounts (up to 50% in some cases) may not reach the circulation. Cortisol is the standard of comparison for glucocorticoid potency.

Is cortisol a glucocorticoid?

Cortisol is the standard of comparison for glucocorticoid potency. Select a steroid to convert cortisone hydrocortisone prednisone prednisolone triamcinolone methylprednisolone dexamethasone betamethasone. Dose (mg):

What is corticosteroid therapy?

Corticosteroids are drugs used in the management and treatment of almost all areas of medicine. This activity outlines the indications, action, and contraindications for corticosteroids as a valuable agent in managing numerous disorders. This activity will highlight the mechanism of action, adverse side effects profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) of corticosteroid usage.

What is the route of administration of corticosteroids?

The route of administration for corticosteroids depends on many factors, primarily being the disorder treated. The route can be parenteral, oral, inhaled, topical , injected (intramuscular, intraarticular, intralesional, intradermal, etc.), and rectal. The clinician must keep many factors in mind upon deciding to initiate corticosteroid therapy, including the route of administration, preparation, dosing, frequency, and duration of treatment.

How do corticosteroids work?

Corticosteroids produce their effect through multiple pathways. In general, they produce anti-inflammatory and immunosuppressive effects, protein and carbohydrate metabolic effects, water and electrolyte effects, central nervous system effects, and blood cell effects. [1][2][7] They have both genomic and nongenomic mechanisms of action. The genomic mechanism of action is mediated through the glucocorticoid receptor, leading to most anti-inflammatory and immunosuppressive effects. [2][5][8]

What are the adverse effects of corticosteroid?

9. Cardiovascular adverse effects: Corticosteroid use is associated with hypertension, hyperglycemia, obesity , and conflicting evidence exists regarding hyperlipidemia.[2]  Mineralocorticoid activity, which varies by corticosteroid, leads to the retention of free water and sodium with potassium excretion.[2]  Studies have found that corticosteroid use is associated with higher rates of cardiovascular events, new-onset atrial fibrillation and flutter, heart failure, and ischemic heart disease. [2][17]

Can corticosteroids cause optic nerve atrophy?

Glaucoma and cataracts: There is a dose-dependent risk for both glaucoma and cataracts for patients on corticosteroids.[2]  Glaucoma is the more serious complication of the two. Systemic corticosteroids can lead to a painless increase in intraocular pressure, which can cause optic nerve atrophy and visual field loss .  This increased pressure will resolve within a few weeks of discontinuing the corticosteroid therapy; however, the optic nerve damage and vision loss can be permanent. [2]

Where is the glucocorticoid receptor located?

The glucocorticoid receptor is located intracellularly within the cytoplasm and, upon binding, trans-locates rapidly into the nucleus, where it affects gene transcription and causes inhibition of gene expression and translation for inflammatory leukocytes and structural cells such as epithelium. [1][2][7] This action leads to a reduction in proinflammatory cytokines, chemokines, cell adhesion molecules, and other enzymes involved in the inflammatory response.[2]  The non-genomic mechanism occurs more rapidly and is mediated through interactions between the intracellular glucocorticoid receptor or a membrane-bound glucocorticoid receptor.[1]  Within seconds to minutes of receptor activation, a cascade of effects is set off, including inhibition of phospholipase A2, which is critical for producing inflammatory cytokines, impairing release of arachidonic acid, and regulation of apoptosis in thymocytes. [1][7] Corticosteroids at high concentrations will also inhibit the production of B cells and T cells. [1][2]

Can corticosteroids cause euphoria?

Psychiatric disturbance: Corticosteroids can cause a range of psychiatric disorders, including psychosis, agitation, insomnia, irritability, hypomania, anxiety, and mood lability.[2] Short courses of corticosteroids can produce euphoria in many individuals and progress to depressive symptoms with extended courses.[15]  Psychosis is typically only seen with high doses (over 20 mg prednisone/day or equivalent) at prolonged periods.[16]  These psychotic features may require antipsychotic treatment if they persist. [2]

How does the steroid conversion calculator work?

This health tool transforms one steroid medication dosage to another steroid dosage based on equivalent dose. The list of corticosteroid medication available to convert is:

Why are steroids used in clinical settings?

Steroid conversions are often used in the clinical setting due to medication shortages or required formulation for treatment i.e. IV or oral. Medical specialists are also required to consider potency and the duration of the effect not only the steroid conversion in mg.

Recommendations

Systemic Corticosteroids in Patients with Covid-19

Systemic Corticosteroids Other Than Dexamethasone

• For Nonhospitalized Adults With COVID-19
  1. See Therapeutic Management of Nonhospitalized Adults With COVID-19for the Panel’s recommendations on the use of dexamethasone or other systemic corticosteroids in certain nonhospitalized patients. 2. There is insufficient evidence for the Panel to recommend either for …
• For Hospitalized Adults With COVID-19
  1. See Therapeutic Management of Hospitalized Adults With COVID-19for the Panel’s recommendations on the use of dexamethasone or other systemic corticosteroids in certain hospitalized patients. 2. There is insufficient evidence for the Panel to recommend either for or …

See more on covid19treatmentguidelines.nih.gov

Inhaled Corticosteroids in Patients with Covid-19

Monitoring, Adverse Effects, and Drug-Drug Interactions

Considerations in Pregnancy

Considerations in Children

Clinical Trials