Steroid Conversion Calculator: Corticosteroid Equivalent Doses

Use the Steroid Conversion Calculator: Corticosteroid Equivalent Doses

How to Use Steroid Conversion Calculator: Corticosteroid Equivalent Doses

1. Step 1: Select the source steroid

   Choose the corticosteroid you are converting from (e.g., prednisone, hydrocortisone).

2. Step 2: Enter the daily dose (mg)

   Type the current daily dose in milligrams. Use decimals if needed.

3. Step 3: Pick a rounding option (optional)

   Select how you want results rounded (e.g., 0.5 mg, 1 mg) to match available tablets.

4. Step 4: Highlight a target steroid

   Optionally choose a specific target steroid to focus on, or leave “Show all”.

5. Step 5: Calculate and review results

   Press Calculate to see the prednisone‑equivalent and equivalent doses across other steroids.

Key Features

• Equivalent dose conversion factors
• Common corticosteroid mappings
• Practical dose rounding guidance
• Tapering notes (education-only)

Understanding Results

Formula

We convert every input into a common yardstick: prednisone‑equivalent (PEQ) mg/day. If a steroid requires X mg to equal 5 mg prednisone (its equivalence factor), then PEQ = SourceDose × (5 ÷ X). To get a target dose, invert the step: Target mg = PEQ × (X ÷ 5). We display both the unrounded result and, if you choose a rounding option, a tablet‑friendly number.

Reference Ranges & Interpretation

PEQ bands provide a quick feel for intensity. As a general description for adults: low ≤7.5 mg/day, moderate 7.5–30 mg/day, high 30–100 mg/day, and very high >100 mg/day. Use these as orientation only—the right dose depends on indication, duration, and patient‑specific risk.

Equivalence examples (systemic oral): hydrocortisone 20 mg ≈ cortisone acetate 25 mg ≈ prednisone 5 mg ≈ prednisolone 5 mg ≈ methylprednisolone 4 mg ≈ triamcinolone 4 mg ≈ dexamethasone 0.75 mg ≈ betamethasone 0.6 mg. Deflazacort is commonly approximated as 6 mg per 5 mg prednisone.

Assumptions & Limitations

Conversions are approximations for systemic oral steroids. Potency equivalence does not ensure identical mineralocorticoid effects, kinetics, or side‑effect profiles. Inhaled, topical, intra‑articular, and some parenteral products follow different rules. Always verify against local guidance and clinical context.

This tool is educational and not a prescribing system. Do not start, stop, or change medicines based on this page without a licensed clinician.

Complete Guide: Steroid Conversion Calculator: Corticosteroid Equivalent Doses

Use our steroid conversion calculator to convert prednisone, hydrocortisone, methylprednisolone, dexamethasone, and betamethasone doses, with rounding tips.

This guide explains how dose equivalence works across commonly used systemic corticosteroids, how our calculator derives prednisone‑equivalent dosing, and when rounding is reasonable. It is for education only and does not replace clinical judgment or local protocols.

What is a steroid conversion calculator?

A steroid conversion calculator helps you translate a dose of one systemic corticosteroid (for example, prednisone) into the equivalent anti‑inflammatory dose of another steroid (for example, dexamethasone). Clinicians often need this when changing drug availability, matching a formulary, or converting a patient's regimen to a different molecule for specific side‑effect profiles. The underlying idea is potency: how much of drug A produces the same glucocorticoid effect as a reference dose of prednisone.

Our calculator uses widely taught equivalence factors (e.g., hydrocortisone 20 mg ≈ prednisone 5 mg ≈ methylprednisolone 4 mg ≈ dexamethasone 0.75 mg). You enter a daily dose and source steroid, optionally pick a rounding preference, and it returns a prednisone‑equivalent (mg/day) plus conversions across other common steroids.

Quick start: using the tool

Start by choosing the source steroid, type the daily dose in milligrams, and select a rounding option that fits available tablet strengths. Tap Calculate to see your prednisone‑equivalent and a grid of equivalent doses for the other corticosteroids. You can highlight a single target steroid to focus on a likely substitute.

For pediatric or weight‑based scenarios, consider pairing this with our pediatric dose calculator and our mg/mL dose calculator if you are working with liquid formulations. If you are converting other drug classes, see the opioid conversion calculator or our general dosage calculator.

Equivalence basics and factors

Equivalence tables line up drugs by the dose that matches the anti‑inflammatory effect of a reference dose (commonly prednisone 5 mg). A simplified systemic oral equivalence set looks like this (≈ indicates approximate equivalence): hydrocortisone 20 mg ≈ cortisone acetate 25 mg ≈ prednisone 5 mg ≈ prednisolone 5 mg ≈ methylprednisolone 4 mg ≈ triamcinolone 4 mg ≈ dexamethasone 0.75 mg ≈ betamethasone 0.6 mg. Deflazacort is often taken as ≈ 6 mg for each 5 mg prednisone.

These values come from decades of clinical use and pharmacology texts. They are not exact for every indication, route, or patient. Mineralocorticoid activity differs (for example, hydrocortisone has more salt‑retaining effects than dexamethasone), and clinical goals vary across rheumatologic, pulmonary, and neurologic diseases. Use conversions as a starting point, not an automated order.

Prednisone‑equivalent: the common language

Conversions are easier when you translate everything into a single yardstick: prednisone‑equivalent (PEQ) mg/day. Our calculator does this in two steps. First, it computes PEQ from your source: PEQ = SourceDose × (5 ÷ mg‑for‑pred‑5). Second, it calculates the target dose: Target mg = PEQ × (mg‑for‑pred‑5 ÷ 5). The result is also shown unrounded and, if you pick a rounding option, rounded to tablet‑friendly numbers.

As a rough orientation for adults, PEQ ≤7.5 mg/day is often described as low dose, 7.5–30 mg/day moderate, 30–100 mg/day high, and >100 mg/day very high. These are descriptive bands rather than rules. Context matters: short bursts, chronic maintenance, and disease activity all influence risk and benefit.

Rounding, tablets, and practicality

Real‑world prescribing depends on what tablet strengths are on the shelf. We include rounding options (0.5 mg, 1 mg, 2.5 mg, 5 mg) to help you quickly match a practical dose. For dexamethasone, 0.5 mg increments are common; for prednisone, 1 mg or 2.5 mg steps are typical in many formularies. When the exact number is not available, clinicians may round toward a safer side depending on indication and duration.

If you need weight‑based calculations first, try our dosage calculator and for chemotherapy or other mg/m² workflows, the BSA calculator can be helpful in upstream planning.

Mineralocorticoid effects matter

Not all corticosteroids share the same mineralocorticoid (salt‑retaining) activity. Hydrocortisone and cortisone acetate have more mineralocorticoid effect compared with dexamethasone and betamethasone, which are almost purely glucocorticoid. That is why dose‑for‑ dose swaps can change edema, blood pressure, or potassium effects even when the anti‑inflammatory potency is matched. Keep this in mind for heart failure, cirrhosis, and other sodium‑sensitive conditions.

Route and formulation differences

The equivalence factors here are for systemic oral use. Parenteral formulations may have different bioavailability or clinical considerations. Inhaled, topical, and intra‑articular steroids follow completely different potency and exposure rules and should not be converted using systemic tables. When switching between immediate‑release and modified‑release or enteric‑coated products, consider absorption timing and local guidance.

If dose timing or biologic half‑life affects your plan (for example, once‑daily versus divided dosing), you can review general kinetics with the drug half‑life calculator and adjust schedules accordingly.

When to use (and when not to)

Use conversions when drug supply dictates a different molecule, when aligning with a protocol that specifies a particular steroid, or when harmonizing complex regimens across care settings. Avoid mechanical conversions for diseases that have protocol‑specific guidance (e.g., certain oncology or transplant pathways) without verifying the recommended agent and schedule.

For children and older adults, dosing windows tend to be narrower, and adverse effects can emerge earlier. Consider the pediatric dose calculator and the geriatric dose calculator to check reasonable ranges before thinking about conversions.

About tapering and conversions

Tapering aims to reduce cumulative exposure and allow hypothalamic‑pituitary‑adrenal (HPA) axis recovery. Conversions can help you pick an equipotent starting point before tapering, but the taper schedule is not dictated by equivalence alone. Duration of prior therapy, cumulative dose, comorbidities, and relapse risk all matter. Many clinicians taper faster at higher doses and slower once around physiologic replacement (≈5 mg prednisone/day equivalent), but plans vary widely.

Because practice varies, always follow a protocol endorsed by your team or institution. If you are designing patient‑friendly handouts, ensure language is clear and emphasizes warning symptoms of adrenal suppression and disease flare.

Safety notes, limits, and sources

This tool is informational and does not provide medical advice. Do not use it to start, stop, or change medicines without a licensed clinician. The equivalence factors above are widely used approximations; they vary by source, population, and indication. When in doubt, consult your local formulary, a pharmacist, or an institutional guideline.

Useful overviews include the NCBI Bookshelf chapter on glucocorticoid therapy and tapering and reviews of corticosteroid adverse effects. See: NCBI Bookshelf entries such as “Glucocorticoid Therapy and Cushing’s Syndrome” and “Adrenal Suppression”. For disease‑specific targets, consult specialty society guidelines (e.g., rheumatology, pulmonology).

Steroid conversions are a helpful bridge between theory and practice. Used thoughtfully—with attention to indication, formulation, and patient‑specific risks—they can simplify transitions while keeping potency consistent. Pair the numbers with clinical judgment, and when possible, with a second check from a pharmacist or protocol.

Frequently Asked Questions