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Table 3 Properties, dosing equivalents and therapeutic indications of systemic corticosteroids, relative to hydrocortisone

From: A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy

  Approximate equivalent dose* (mg) Relative glucocorticoid activity Relative mineralocorticoid activity Duration of action (hours) General therapeutic indications
Glucocorticoids
Short-acting      
 Hydrocortisone 20 1 1 8-12 • Relatively high mineralocorticoid activity makes it suitable for use in adrenal insufficiency
 Cortisone 25 0.8 0.8 8-12 • Similar to hydrocortisone
Intermediate-acting      
 Prednisone 5 4 0.8 12-36 • High glucocorticoid activity makes it useful for long-term treatment, and as an anti-inflammatory/ immunosuppressant
 Prednisolone 5 4 0.8 12-36 • Similar to prednisone
Methylprednisolone 4 5 Minimal 12-36 • Anti-inflammatory/immunosuppressant
 Triamcinolone 4 5 0 12-36 • Anti-inflammatory/immunosuppressant
Long-acting
 Dexamethasone 0.75 30 Minimal 36-72 • Anti-inflammatory/immunosuppressant; used especially when water retention is undesirable given its minimal mineralocorticoid activity
• Usually reserved for short-term use in severe, acute conditions given its high potency and long-duration of action
 Betamethasone 0.6 30 Negligible 36-72 • Similar to dexamethasone
Mineralocorticoids
 Fludrocortisone ** 10-15 125-150 12-36 • Used for aldosterone replacement
  1. Table adapted from NICE, 2012 [1]; Furst et al., 2012 [8].
  2. *Equivalent dose shown is for oral or IV administration. Relative potency for intra-ocular or intramuscular administration may vary considerably.
  3. **Glucocorticoid doses which provide a mineralocorticoid effect that is approximately equivalent to 0.1 mg of fludrocortisone are: prednisone or prednisolone 50 mg, or hydrocortisone 20 mg.