Enter a dose to see the equivalent.
Equivalent dose
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- Conversion ratio
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| Corticosteroid | Equivalent dose (mg) | Potency vs hydrocortisone |
|---|
Equivalence reflects oral anti-inflammatory potency only. Confirm with the BNF and your local guidance before changing a patient’s steroid.
Steroid Conversion Calculator
This calculator converts a dose of one oral corticosteroid into the approximately equivalent dose of another — for example prednisolone to dexamethasone, or hydrocortisone to prednisolone. It shows the result for the drug you choose and a table of the equivalent dose for every steroid listed.
How the conversion works
Each corticosteroid has an equivalent anti-inflammatory dose, using the values published in the BNF. The calculator scales your dose by the ratio of the two equivalent doses:
equivalent dose = your dose × (equivalent dose of target drug ÷ equivalent dose of starting drug)
| Corticosteroid | Equivalent to prednisolone 5 mg |
|---|---|
| Cortisone acetate | 25 mg |
| Hydrocortisone | 20 mg |
| Deflazacort | 6 mg |
| Prednisolone | 5 mg |
| Prednisone | 5 mg |
| Methylprednisolone | 4 mg |
| Triamcinolone | 4 mg |
| Dexamethasone | 0.75 mg |
| Betamethasone | 0.75 mg |
The “potency vs hydrocortisone” column in the calculator is worked out from these figures (hydrocortisone 20 mg ÷ each drug’s equivalent dose).
What the numbers don’t tell you
- Glucocorticoid potency only. The table ignores mineralocorticoid activity, which is highest with fludrocortisone and significant with hydrocortisone and cortisone, and negligible with dexamethasone and betamethasone.
- Duration of action differs. Hydrocortisone is short-acting, prednisolone intermediate, and dexamethasone long-acting, which can matter for dosing frequency.
- Approximate values. Published equivalences vary slightly between sources, particularly for deflazacort.
- Not for adrenal replacement. Replacement therapy in adrenal insufficiency follows separate endocrine guidance.
- Route matters. The values apply to oral dosing; injected and depot preparations differ.
Stopping or switching long-term steroids
Anyone who has taken systemic steroids for a prolonged period can have a suppressed adrenal axis. The dose should be reduced gradually and abrupt withdrawal avoided. Our medication tapering calculator can help lay out a stepped schedule, but the pace should be set by the prescriber.
Frequently asked questions
How much prednisolone is equal to 4 mg of dexamethasone?
Dexamethasone 0.75 mg is equivalent to prednisolone 5 mg, so 4 mg of dexamethasone is roughly 26.7 mg of prednisolone. Use the calculator for other combinations.
Is prednisone the same as prednisolone?
For dose conversion they’re treated as equivalent (5 mg each). Prednisone is converted to prednisolone in the liver.
Why isn’t fludrocortisone included?
Fludrocortisone is used for its mineralocorticoid effect, so it isn’t comparable on anti-inflammatory potency and can’t be converted with this method.
Are these conversions exact?
No. They are approximate equivalents. Individual response varies, so clinical review after any switch is important.
Can I use this to convert steroid replacement in Addison’s disease?
No. Replacement regimens need specialist endocrine guidance rather than a potency conversion.
Medical disclaimer
This calculator is a reference aid for healthcare professionals. It gives approximate equivalent doses and does not replace the BNF, local guidance or clinical judgement. Do not change or stop a corticosteroid without advice from the prescriber.
Sources & references
- NICE. British National Formulary (BNF) — Corticosteroids, general use: equivalent anti-inflammatory doses. bnf.nice.org.uk
- Deflazacort: therapeutic index, relative potency and equivalent doses versus other corticosteroids. BMC Pharmacology and Toxicology, 2016. bmcpharmacoltoxicol.biomedcentral.com