Corticosteroid Equivalent Doses and Conversions

Standard Dose Equivalencies

• The American College of Physicians and other medical societies consider prednisone 5 mg to be equivalent to prednisolone 5 mg, based on FDA-approved drug labeling and established clinical practice 1, 2
• The National Comprehensive Cancer Network recommends that prednisone 5 mg is equivalent to methylprednisolone 4 mg, as confirmed by FDA labeling 3
• The Journal for ImmunoTherapy of Cancer states that prednisone 5 mg is equivalent to dexamethasone 0.75 mg, with dexamethasone being approximately 6-7 times more potent than prednisone 4, 5

Practical Dosing Conversions

• For moderate-to-severe conditions requiring 1 mg/kg prednisone, the Journal for ImmunoTherapy of Cancer recommends using 0.8 mg/kg methylprednisolone, 1 mg/kg prednisolone, 4 mg/kg hydrocortisone, or 0.15 mg/kg dexamethasone 4, 5
• The National Comprehensive Cancer Network advises that for high-dose therapy (2 mg/kg prednisone), maximum doses should not exceed prednisone 60-80 mg equivalent, regardless of indication 3

Important Clinical Considerations

• The Gastroenterology society notes that doses above prednisone 60-80 mg equivalent (or methylprednisolone 2 mg/kg) provide no additional benefit and increase adverse effects 3, 6