Glucocorticoid Equivalents
Safely and accurately transitioning between different glucocorticoid agents.
Conversion uses standard equivalent doses: hydrocortisone 20 mg, cortisone 25 mg, prednisone/prednisolone 5 mg, methylprednisolone/triamcinolone 4 mg, dexamethasone 0.75 mg, and betamethasone 0.75 mg.
A steroid conversion calculator helps clinicians transition between glucocorticoids with different potencies and durations of action. Inaccurate conversions may cause under- or over-treatment, increasing the risk of adrenal insufficiency or glucocorticoid toxicity. Standardized conversions can reduce errors during steroid transitions and support safer patient care.
When to use
This steroid conversion calculator should be used when a patient needs to switch from one systemic glucocorticoid to another. The result provides an equivalent dose for the selected target steroid.
- Transitioning between formulations, such as changes in oral or intravenous access.
- Adjusting therapy because of drug availability, side effect profile, or patient-specific factors such as comorbidities or pregnancy.
- Converting between short-acting and long-acting steroids for chronic disease management or adrenal axis assessment.
- Supporting transitions between care settings, including hospital admission, discharge, or transfer.
Advice
- Because steroid duration of action differs, it is usually simplest to use the cumulative 24-hour steroid dose when converting.
- For patients on chronic supraphysiologic doses, consider whether tapering is needed and provide education about adrenal suppression or stress dosing.
- Adult physiologic glucocorticoid replacement is approximately 15-25 mg/day of hydrocortisone, or an equivalent dose.
Management
- If converting to a short-acting steroid such as cortisone or hydrocortisone, give the total daily dose in 2-3 divided doses.
- Monitor for signs of glucocorticoid excess or adrenal insufficiency.