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%

Delay Your Menstruation Period

Some female may wish to delay their menses cycle due to various reasons, such as wedding, holiday trip, taking exam etc. This can be easily achieved.

For female who are NOT taking oral contraceptive pills, you can take a pill called "norethisterone" which is a progesterone hormone. It is taken 3 days before the expected first day of the next menstrual cycle. The dose is 5mg three times a day. Just stop the hormone when you want the menses flow to start. Usually the menses will start 2-3 days after stop taking norethisterone. Side effects are not common, as it is only taken short term. Some known side effects include stomach upset and breast changes. If your menses cycle is irregular and you are not sure when will be the start of next cycle, then it's a problem. In this case you may want to start norethisterone many days earlier before the day of your trip. Don't take norethisterone continuously for more than 2 weeks.

          Example of Norethisterone. Not expensive.

For female who are taking oral contraceptive pills (OCP), you have to continue to take the pills with hormone in order to delay the menses. In a typical OCP, the first 21 pills are with hormone while the last 7 pills are "empty" without hormone. Normally when you take the pills without hormone, menses flow will start. If the period of time you don't want your menses to come falls between Day 1 to Day 21 of the pills, then just continue the OCP as usual. However, if it falls after Day 21, then after the Day 21 pill, you have to start a new strip of OCP from Day 1, without taking the "empty" Day 21-28 pills. When you want your menses flow back at anytime, just take the "empty" pills for 7 days.

     Example of OCP: Note the 7 empty pills in white