Steroid Conversion Calculator
Converts steroid dosages using dosing equivalencies.
- Please enter the steroid you wish to convert from, the dose of that steroid, and the steroid you wish to convert to.
- Only the listed steroids and formulations (PO, IV) are available for conversion.
Advice
- For steroids that are listed as having both IV and PO formulations, their dose is equivalent by either route.
- Given differences in steroid duration of action, it is simplest to use the cumulative 24-hour steroid dose when making conversions.
- For those on chronic supraphysiologic doses, consider need for steroid tapering and patient education regarding adrenal suppression or stress-dosing. Adult physiologic glucocorticoid replacement is approximately 15-25 mg/day of hydrocortisone (or equivalent).
- For patients with primary adrenal insufficiency, ensure adequate mineralocorticoid coverage if switching to a steroid with low mineralocorticoid activity. Glucocorticoid doses which provide a mineralocorticoid effect that is approximately equivalent to 0.1 mg of fludrocortisone are: hydrocortisone 20 mg, cortisone 25 mg, and prednisone or prednisolone 50 mg.
Management
- Prescribe the new steroid at the calculated equivalent dose (if converting to a short-acting steroid, e.g., cortisone and hydrocortisone, then give in 2-3 divided doses per day).
- Monitor for signs of glucocorticoid excess or for adrenal insufficiency.
Critical Actions
- As always, apply clinical context.
- In acutely ill patients, stress-dose steroids may be appropriate (e.g., 2-3x usual steroid doses, or high-dose hydrocortisone 50 mg every 6-8 hours).
- Always consider the need for dose tapering, especially after prolonged (>2-3 weeks) steroid therapy. Abrupt steroid discontinuation after chronic use can precipitate an adrenal crisis and should be avoided.