Dexamethasone to Prednisone Dose Equivalency
0.5 mg of dexamethasone is equivalent to approximately 3 mg of prednisone.
Conversion Ratio
The standard conversion ratio is based on relative glucocorticoid potency:
- Dexamethasone is 25 times more potent than hydrocortisone 1
- Prednisone is 4 times more potent than hydrocortisone 1
- Therefore, dexamethasone is approximately 6-6.25 times more potent than prednisone 1
Using this ratio: 0.5 mg dexamethasone × 6 = 3 mg prednisone equivalent 1
Clinical Context from Guidelines
The American Academy of Otolaryngology-Head and Neck Surgery explicitly states these equivalencies for sudden sensorineural hearing loss treatment 1:
- Prednisone 60 mg = Dexamethasone 10 mg = Methylprednisolone 48 mg 1
This confirms the 6:1 ratio (60 mg prednisone ÷ 10 mg dexamethasone = 6:1 ratio) 1.
Important Caveats
Bioequivalence varies by clinical endpoint: While the 6:1 ratio is standard for anti-inflammatory effects, research demonstrates that dose equivalency can differ based on the specific pharmacodynamic endpoint measured 2. Studies using mechanistic models for cell trafficking and cortisol suppression show reasonable correlation with traditional dosing tables, though some variation exists across different biomarkers 2.
Methylprednisolone reference: Multiple NCCN guidelines confirm that methylprednisolone and prednisone are used interchangeably at approximately 0.8:1 ratio (methylprednisolone being slightly more potent), which helps validate the overall corticosteroid equivalency framework 1.
Practical Application
For your specific calculation:
- 0.5 mg dexamethasone = 3 mg prednisone (using 6:1 ratio) 1
- Alternative calculation: 0.5 mg dexamethasone = 3.125 mg prednisone (using precise 6.25:1 ratio) 1
In clinical practice, 3 mg prednisone is the appropriate equivalent dose 1.