Corticosteroids Equivalent Dose

Equivalent anti-inflammatory doses of different oral corticosteroids

Prednisolone 5mg
is equivalent to betamethasone 750 mcg
is equivalent to cortisone acetate 25 mg
is equivalent to dexamethasone 750 mcg
is equivalent to deflazacort 6mg
is equivalent to hydrocortisone 20mg
is equivalent to methylprednisolone 4mg
is equivalent to traimacinolone 4mg


Note that mineralocorticoid side effects are most marked with fludrocortisone, but are significant with cortisone, hydrocortisone, corticotropin, and tetracosactide (tetracosacrtin). Minerlacorticoid actions are negligible with the high potency glucocorticoids, betamethasone and dexamethasone, and occur only slightly with methylprednisolone, prednisolone, triamcinolone.


Topical corticosteroids:
The potency of topical corticosteroids is determined by

• the extent to which it inhibits inflammation
• the specific modification (esterification) of the steroid molecule e.g. - hydrocortisone (acetate) 1% is mild but hydrocortisone butyrate 0.1% is a potent preparation 
• the formulation
• presence of other ingredients such as urea or salicylic acid which may increase the absorption of the drug 
• occlusive dressings or increasing hydration of the stratum corneum (increases steroid absorption)

POTENCY EXAMPLES

• mild
  • hydrocortisone 0.1-1%

• moderate
  • clobetasone butyrate 0.05%

• potent
  • hydrocortisone butyrate
  • betamethasone valerate 0.1%
    
    
• very potent
  • clobetasol propionate 0.05%