How does the conversion work?

Each steroid has a standard dose that equals 20 mg of hydrocortisone in anti-inflammatory potency. The target dose equals the source dose times the ratio of the target's equivalent to the source's equivalent, so the anti-inflammatory effect stays the same.

What are the standard equivalent doses?

Roughly equal anti-inflammatory doses are hydrocortisone 20 mg, cortisone 25 mg, prednisone and prednisolone 5 mg, methylprednisolone and triamcinolone 4 mg, dexamethasone 0.75 mg, and betamethasone 0.6 mg. Each equals about 20 mg hydrocortisone.

Does the conversion account for mineralocorticoid effect?

No. The table reflects glucocorticoid anti-inflammatory potency only. Hydrocortisone and cortisone have strong salt-retaining activity, prednisolone has mild activity, and dexamethasone and betamethasone have almost none, which matters when treating adrenal insufficiency.

Does it account for duration of action?

No. Short-acting hydrocortisone, intermediate prednisolone, and long-acting dexamethasone differ markedly in half-life and HPA-axis suppression. Factor the duration in when switching, especially around once-daily versus divided dosing.

Why is budesonide not included?

Budesonide is used topically or enterically and undergoes extensive first-pass metabolism, so there is no reliable single systemic equivalence figure. Publishing one would be misleading, so it is intentionally omitted from this systemic converter.

Corticosteroid Equivalence Converter

The corticosteroid equivalence converter translates a dose of one glucocorticoid into the equivalent dose of another, based on their relative anti-inflammatory potency. It is the everyday tool for switching steroids, planning a taper, or converting an IV regimen to oral.

How it works

Every glucocorticoid is anchored to hydrocortisone (cortisol). The table lists the dose of each drug that equals 20 mg of hydrocortisone in anti-inflammatory effect:

Steroid	Equivalent dose
Hydrocortisone	20 mg
Cortisone acetate	25 mg
Prednisone	5 mg
Prednisolone	5 mg
Methylprednisolone	4 mg
Triamcinolone	4 mg
Deflazacort	7.5 mg
Dexamethasone	0.75 mg
Betamethasone	0.6 mg

To convert, the tool applies:

Target dose = source dose × (target equivalent ÷ source equivalent)

So 40 mg prednisolone × (0.75 ÷ 5) = 6 mg dexamethasone.

Important caveats

These figures cover anti-inflammatory potency only. They do not match:

Mineralocorticoid (salt-retaining) effect — strong for hydrocortisone and cortisone, mild for prednisolone, negligible for dexamethasone. This matters when replacing physiological steroids in adrenal insufficiency.
Duration of action — hydrocortisone is short-acting, prednisolone intermediate, dexamethasone long-acting, which changes dosing frequency and HPA-axis suppression.

Budesonide is deliberately excluded because its high first-pass metabolism means no reliable systemic equivalence exists. Never stop chronic steroids abruptly — taper to avoid adrenal crisis. All calculation runs locally in your browser.