Steroid Conversion

Below are approximate equivalent synthetic steroid doses, and their relative glucocorticoid and mineralocorticoid potencies. When charting the same, ensure appropriate administration intervals and check with local protocols and your pharmacist colleagues regarding the same (e.g. 5 mg daily of prednisone, would be equivalent to 5 mg 6 hourly of hydrocortisone).

AgentEquivalent dose (mg)Anti-inflammatory
potency
Mineralocorticoid
potency
DoA
Cortisone250.80.8Short
Hydrocortisone2011Short
Prednisone540.3Intermediate
Prednisolone550.3Intermediate
Triamcinolone450Intermediate
Methylprednisolone450.25Intermediate
Betamethasone0.625-400Long
Dexamethasone0.75300Long
Fludrocortisone*210*250Intermediate
*Note, Fludrocortisone is not used for its anti-inflammatory properties, as the usual dose is ~100 microgs

Duration of Action (DoA)

  • Short: 8-12 hours
  • Intermediate: 12-36 hours
  • Long: 36-72 hours

LITFL

References

  • MedCalc — Steroid Conversion Converter
  • Katzung, B., & Trevor, A. (2014). Basic & Clinical Pharmacology (13th ed., p. 686). United States of America: McGraw-Hill.

Cite this article as: Chris Nickson and James Pearlman, "Steroid Conversion," In: LITFL - Life in the FastLane, Accessed on January 30, 2023, https://litfl.com/steroid-conversion/.

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

ICU Advanced Trainee BMedSci [UoN], BMed [UoN], MMed(CritCare) [USyd] from a broadacre farm who found himself in a quaternary metropolitan ICU. Always trying to make medical education more interesting and appropriately targeted; pre-hospital and retrieval curious; passionate about equitable access to healthcare; looking forward to a future life in regional Australia. Student of LITFL.

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