Corticosteroid Equivalent Calculator
Different corticosteroids vary widely in their anti-inflammatory potency, mineralocorticoid activity, and duration of action. When switching between corticosteroids, the equivalent anti-inflammatory dose is calculated as: Equivalent dose = Input dose x (Input drug potency / Target drug potency). All potencies are expressed relative to hydrocortisone = 1.0. This calculator uses standard equipotency ratios derived from published clinical pharmacology references including the NIH and standard formulary references.
Corticosteroid equivalence formula
Equivalent dose = Input dose x (Input potency / Target potency)
Hydrocortisone equivalent = Input dose x Input potency
Potencies relative to hydrocortisone (= 1.0): Cortisone 0.8, Prednisone/Prednisolone 4, Methylprednisolone/Triamcinolone 5, Dexamethasone/Betamethasone 25. These are anti-inflammatory equivalences; mineralocorticoid activity differs significantly.
Key considerations when switching corticosteroids
- Mineralocorticoid potency is not captured by anti-inflammatory equivalence; fludrocortisone is used separately for mineralocorticoid replacement.
- Duration of action affects HPA suppression: dexamethasone causes greater suppression per anti-inflammatory dose than hydrocortisone.
- Tapering schedules are required for patients who have been on corticosteroids long enough to develop HPA axis suppression.
- Bioavailability of oral vs IV forms may differ; dose adjustments may be needed when changing route.
- Always involve a prescribing clinician when planning corticosteroid transitions in clinical practice.
Corticosteroid equivalent calculator: frequently asked questions
What is corticosteroid equivalence?
Corticosteroid equivalence compares the anti-inflammatory potency of different glucocorticoids relative to hydrocortisone (defined as 1.0). An equivalent dose is one that produces the same anti-inflammatory effect. Potency factors differ for mineralocorticoid effects, which are separate from anti-inflammatory potency.
What are the standard equipotent doses?
Relative to hydrocortisone 1.0: cortisone 0.8, prednisolone 4, prednisone 4, methylprednisolone 5, triamcinolone 5, dexamethasone 25 to 30, betamethasone 25 to 30. These are anti-inflammatory equivalences; mineralocorticoid potency differs considerably (e.g., dexamethasone has essentially no mineralocorticoid effect).
Why does duration of action matter for steroid switching?
Short-acting steroids (hydrocortisone, cortisone) have duration 8 to 12 hours and stronger mineralocorticoid effect. Intermediate-acting (prednisone, methylprednisolone) last 12 to 36 hours. Long-acting (dexamethasone, betamethasone) last 36 to 72 hours. Duration affects HPA axis suppression and dosing frequency when switching.
Does this calculator account for route of administration?
No. This calculator assumes oral or IV administration where equivalences are established. Inhaled, topical, and intra-articular corticosteroids have different potency relationships that do not directly compare to systemic doses. Always use route-specific references when switching between routes.
Can this calculator be used for clinical prescribing?
This tool is for educational and informational purposes only. Corticosteroid switching in clinical practice requires careful consideration of indication, HPA axis suppression, mineralocorticoid effects, patient factors, and professional judgment by a licensed healthcare provider.
Official sources
- NIH National Library of Medicine: Corticosteroids (StatPearls).
- U.S. Food and Drug Administration: FDA Drugs Information.
Reviewed by the CalculatorHub team, edited by James Graham, 15 June 2026. See our methodology.