Corticosteroids are medicines that have varying strengths of action. Some of them are indistinguishable while others are ten times more powerful. What is steroid dose conversion? How to calculate it using web tools?
Steroid Conversion Chart – What Does it Mean?
Let’s speak a bit about corticosteroids. According to the corticosteroid definition, these hormones imply substances produced by the adrenal cortex. These hormonal substances regulate the mineral metabolism (the so-called mineralocorticoids, like aldosterone and cortexone) and the metabolism of carbohydrates, proteins, and fats (the so-called glucocorticoids). In addition, on the basis of synthetic versions of these medicines, prodigiously impactful drugs are produced, which are used to fight against many inflammatory and allergic diseases. These medications are gettable in the following forms:
- Steroid injections.
- Oral steroid pills.
- Steroid creams.
- Gels, eg, ophthalmic gel
- Lotions, eg, Desowen lotion for skin diseases.
Depending on the duration of the remedial effect, all glucocorticoids are divided into 3 groups, so a term “glucocorticoid” has a ternary structure. Understanding equipollent doses of corticosteroids allow, if needed, to replace one drug with another. The precept: “pill per pill” (if a healthcare professional had to switch one to another glucocorticoid, they were given an identical quantity of tablets of the new drug as they administered before the replacement) is inherently amiss. This is explained by the introduction into the medical practice of medicinal forms of glucocorticoids with different contents of the active substance. These steroids have differing effects, for instance, 1 portion of betamethasone (marketed as Diprolene, Diprosone, Celestone, Menstripen, Propiochrone, etc.) is equal to thirty doses of hydrocortisone (Xebcort, Bactine, Balneol, Transderma, Suniderma, Retef, etc.) in the context of glucocorticoid activity.
The dose of substances with glucocorticoidal activity, prescribed at the commencement of the therapy, is contingent on the kind and severeness of the illness. It is also affected by the age of the patient, presence/absence of comorbidities (additional co-occurring conditions), simultaneous administration of other meds, and other circumstances.
Steroid Conversion Table — Insight Into Corticosteroids’ Strength
Endogenous glucocorticoids have mineralocorticoid influence, although weaker than real mineralocorticoids. As reported by Ruben Vardanyan and Victor Hruby (2016), normally, aldosterone is the only functioning natural mineralocorticoid in human bodies. Non-fluorinated semi-synthetic glucocorticoids also possess mineralocorticoid effects (which in turn are inferior to those of natural glucocorticoids). There is no mineralocorticoid activity in fluoridated meds*.
*FYI: Fluoride (an inorganic, monatomic anion) is a substance that is commonly added to pharmaceuticals because it can increase their selectivity, fat dissolubility, and decrease the rate of their metabolization, allowing them more time to act.
Glucocorticoid activity of semi-synthetic meds surpasses that of cortisone and hydrocortisone, which is explained by a lower binding to protein compared to naturally occurring glucocorticoid agents. A feature of fluoridated preparations is a slower metabolism in the body, which entails an increase in the duration of action.
Here is a description of the strength and conversion of corticosteroids from 3 classes.
1) Short-term action corticosteroids.
|Name||Glucocorticoid activity||Mineralocorticoid activity|
2) Medium-term action corticosteroids. This group includes triamcinolone, which is marketed under such names as Dermasorb TA, Kenalog, Kenonel, Trianex, and Pediaderm TA (in the US). Its glucocorticoid activity is 5. It does not have mineralocorticoid activity.
3) Long-term action hormones. Dexamethasone & betamethasone belong to this group of medicines. They have potent glucocorticoid activity and have no mineralocorticoid activity.
This steroid conversion table is used by physicians to prescribe the optimal dosage of steroids to patients.
When dosing, doctor and patient also need to consider the strength and the duration of the action, not only the steroid conversion in milligrams. For instance, drugs such as Dexamethasone have prolonged half-life, therefore, they don’t require frequent consumption.
Steroid Conversion Calculator — What is it?
If you don’t wanna look for a steroid conversion chart and study it, we recommend a useful tool called steroid conversion calculator. For instance, such a calculator can be found on the MDApp website. This “digital arithmometer” consists of three main fields:
Steroid to convert from. We have typed “cortisone” there. You can choose another medicament.
Dosage to convert (in mg). We have typed “1” there. You can type another number (it will denote the number of grams of the drug).
Steroid to convert to. We’ve selected “hydrocortisone” there. You have the possibility to choose another medication that belongs to the group of corticosteroids.
After you have filled in all the fields in this excellent online calculator, you need to click on the “Calculate” button. In this case, we obtained the following result: “A dose of 1 mg of Cortisone is approximately equivalent to 0.8 mg of Hydrocortisone. Please note that medical specialists are also required to consider potency and the duration of the effect not only the steroid conversion in mg. Click the “Reset” button to clear all fields and start the calculation again.
You can also download the result in PDF (can be opened by Adobe Acrobat Reader / Foxit / Javelin) format and print it on the printer. It is noteworthy that this portable document file contains a disclaimer: “This pdf or any of the information contained in it should NOT be considered as a substitute for any professional medical service, NOR as a substitute for clinical judgment. People are responsible for the way they use the information provided.”
A similar steroid conversion calculator is accessible on the Mdcalc website. This calculator was coded by a medical specialist named Bryan D. Hayes. We decided to test this calculator. We selected triamcinolone in the “Converting from” section and cortisone in the “Converting to” section. The dosage was chosen in the amount of 1 mg. Here’s what we got: “6 mg: Approximate Cortisone Equivalence to 1mg of Triamcinolone”.
Other calculators for corticosteroids are available on Medcalc, Clincalc, and QxMD websites.
We have seen the information that several portals offer anabolic steroid conversion calculators. Unfortunately, we could not find any normal tools that could unerringly calculate conversions of these drugs. Maybe you will be fortunate.