Use this calculator when switching a patient from one systemic glucocorticoid to another. It provides an equivalent dose of the target steroid.

Common indications:

• Formulation changes – oral ↔ intravenous access
• Therapy adjustments – side effects, availability, pregnancy, comorbidities
• Duration switching – short-acting ↔ long-acting for chronic disease or adrenal axis testing
• Care transitions – hospital admission, discharge, transfer

Reminder: This calculator provides equivalent dosing only. For acute illness/procedure in chronic steroid users → consider stress dosing.

⏱️ Duration of action – clinical relevance

• Short-acting (8–12h): cortisone, hydrocortisone → 2–3 divided doses/day
• Medium-acting (12–36h): methylprednisolone, prednisolone, prednisone, triamcinolone → once daily
• Long-acting (36–72h): betamethasone, dexamethasone → once daily

💧 Mineralocorticoid activity (adrenal insufficiency)

• Negligible: betamethasone, dexamethasone, triamcinolone, methylprednisolone
• Modest: hydrocortisone, cortisone, prednisolone, prednisone

Other: CYP inducers/inhibitors, severe liver/kidney disease can alter metabolism. Use only listed steroids.

Steroids differ in potency, duration, and mineralocorticoid effects. Unstandardized conversions risk serious harm:

• Under-treatment → adrenal insufficiency, hypotension, crisis
• Over-treatment → osteoporosis, hyperglycemia, immunosuppression, Cushingoid features

This calculator uses evidence-based glucocorticoid equivalency ratios (hydrocortisone=1, prednisone=4, dexamethasone=25) to minimize errors and improve safety during hospital transitions, shortages, or steroid changes.

Clinical context: For chronic supraphysiologic doses, educate about adrenal suppression and stress-dosing (2–3x usual dose during acute illness/surgery).