Conversion of Cortef 0.2 mg to Micrograms
Cortef (hydrocortisone) 0.2 mg is equivalent to 200 micrograms (mcg).
Conversion Calculation
The conversion from milligrams (mg) to micrograms (mcg) follows a simple mathematical formula:
- 1 mg = 1000 mcg
- Therefore: 0.2 mg × 1000 = 200 mcg
Clinical Context of Hydrocortisone Dosing
Hydrocortisone (Cortef) is commonly prescribed in various dosages depending on the clinical indication:
- Standard oral replacement therapy for adrenal insufficiency typically ranges from 15-20 mg daily in divided doses
- For septic shock, higher doses may be used (200 mg/day) when hemodynamic stability cannot be achieved with fluid resuscitation and vasopressors 1
- Weight-based dosing has been shown to reduce interpatient variability in cortisol concentration and improve therapeutic outcomes 2
Dosing Considerations
When administering hydrocortisone, several factors should be considered:
- Weight-adjusted dosing decreases interpatient variability in maximum cortisol concentration from 31% to 7% 2
- Food intake delays hydrocortisone absorption, so administration before meals is recommended 2
- Thrice daily dosing better mimics the natural cortisol circadian rhythm 3
Common Pitfalls in Hydrocortisone Dosing
- Failure to adjust dose during times of stress (illness, surgery) can lead to adrenal crisis
- Overtreatment can result in cushingoid features, hypertension, and metabolic complications
- Undertreatment may result in persistent symptoms of adrenal insufficiency
Special Circumstances Requiring Dose Adjustment
- During major surgery: 100 mg hydrocortisone IM just before anesthesia, then 100 mg every 6 hours until able to take oral medication 1
- During labor and delivery: 100 mg hydrocortisone IM at onset of labor, then double oral dose for 24-48 hours after delivery 1
- For minor procedures: Extra morning dose 1 hour prior to procedure 1
Remember that while 0.2 mg of hydrocortisone equals 200 mcg, this is a relatively small dose compared to typical therapeutic doses used in clinical practice, which often start at 20 mg daily 4.