What is the equivalent dose of hydrocortisone (cortisol) for prednisolone 20mg?

From the Guidelines

Prednisolone 20mg is equivalent to approximately 80mg of hydrocortisone, based on the relative potency of these two corticosteroids. This is supported by the study 1, which states that hydrocortisone 20 mg is equivalent to prednisone 5 mg, implying a 4:1 ratio between hydrocortisone and prednisone. Given that prednisolone is similar to prednisone, we can apply this ratio to estimate the equivalence between prednisolone and hydrocortisone. However, it's essential to note that the exact equivalence may vary depending on the specific context and individual patient factors. The study 1 also supports this ratio, stating that prednisolone 5 mg is equivalent to hydrocortisone 20 mg. When converting between these medications, this 4:1 ratio is commonly used in clinical practice, and understanding this equivalence is crucial for maintaining the same therapeutic effect and minimizing adverse effects. Key points to consider when converting between prednisolone and hydrocortisone include:

• The 4:1 ratio between hydrocortisone and prednisolone/prednisone
• The potential for side effects to occur at lower doses of prednisolone due to its increased potency
• The importance of gradual adjustments when transitioning between these medications to ensure proper disease control and minimize adverse effects.

From the FDA Drug Label

20 mg of hydrocortisone is equivalent to 5 mg of prednisolone For the purpose of comparison, ... Hydrocortisone, 60

• To find the equivalent dose of hydrocortisone for 20mg of prednisolone, we can set up a proportion based on the given information.
• Since 20 mg of hydrocortisone is equivalent to 5 mg of prednisolone, and we are looking for the equivalent of 20mg of prednisolone, we can calculate it as follows:
• (20 mg hydrocortisone / 5 mg prednisolone) = x mg hydrocortisone / 20 mg prednisolone
• Solving for x gives us: x = (20 mg hydrocortisone * 20 mg prednisolone) / 5 mg prednisolone
• x = 80 mg hydrocortisone
• Alternatively, we can use the information that 60 mg of hydrocortisone is equivalent to 15 mg of prednisolone (from the second drug label) to set up a proportion:
• (60 mg hydrocortisone / 15 mg prednisolone) = x mg hydrocortisone / 20 mg prednisolone
• Solving for x gives us: x = (60 mg hydrocortisone * 20 mg prednisolone) / 15 mg prednisolone
• x = 80 mg hydrocortisone
• 20mg of prednisolone is equivalent to 80mg of hydrocortisone 2

From the Research

Corticosteroid Equivalency

• The equivalency of prednisolone to hydrocortisone is not directly stated in the provided studies, but we can look at the general equivalency of corticosteroids.
• According to 3, the study investigated the dose equivalency of major corticosteroids, including hydrocortisone, methylprednisolone, dexamethasone, and oral prednisolone.
• However, the study does not provide a direct conversion factor between prednisolone and hydrocortisone.

Pharmacokinetics and Pharmacodynamics

• 4 discusses the pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids, including hydrocortisone, prednisolone, methylprednisolone, and dexamethasone.
• The study mentions that the effects of glucocorticoids are mediated by genomic and possibly nongenomic mechanisms, but does not provide information on the equivalency of prednisolone to hydrocortisone.

Clinical Studies

• 5 and 6 compare the efficacy of different corticosteroids, including hydrocortisone, methylprednisolone, and dexamethasone, in the treatment of acute severe asthma.
• However, these studies do not provide information on the equivalency of prednisolone to hydrocortisone.
• 7 compares the effects of different corticosteroids, including hydrocortisone, dexamethasone, prednisolone, and methylprednisolone, in the treatment of severe community-acquired pneumonia.
• The study finds that hydrocortisone is significantly more effective at reducing mortality than placebo, but does not provide information on the equivalency of prednisolone to hydrocortisone.

Equivalent Dosing

• Unfortunately, there is no direct information available in the provided studies to determine the equivalent dosing of prednisolone to hydrocortisone.
• Further research or consultation of a medical professional may be necessary to determine the equivalent dosing of these corticosteroids, as referenced in 3, 5, 7, 6, 4.