What is the equivalent dose of Dexamethasone (Decadron) to 125mg of Methylprednisolone (Solumedrol)?

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Last updated: April 4, 2025 • View editorial policy

From the Guidelines

The equivalent dose of Decadron (dexamethasone) to 125mg of Solu-Medrol (methylprednisolone) is approximately 20-25mg, considering the potency ratios provided in the clinical practice guideline for sudden hearing loss 1. When converting between these medications, it's crucial to consider their relative potencies. According to the guideline, prednisone is 4 times, methylprednisolone is 5 times, and dexamethasone is 25 times more powerful than hydrocortisone 1.

  • The potency ratio between methylprednisolone and dexamethasone can be derived from their relative potencies compared to hydrocortisone, suggesting that dexamethasone is about 5 times more potent than methylprednisolone.
  • Given this ratio, 125mg of methylprednisolone would convert to approximately 20-25mg of dexamethasone.
  • This conversion is important when switching between corticosteroids to maintain the same anti-inflammatory and immunosuppressive effects, especially in conditions like idiopathic sudden sensorineural hearing loss (ISSNHL), where early institution of high enough dosages of treatment is critical 1.
  • The guideline emphasizes the importance of early treatment and adequate dosing, highlighting that underdosage is a possibility if attention is not given to these ratios 1.
  • Therefore, when administering Decadron shots, it is essential to be aware of the potential for a longer duration of action compared to the equivalent Solu-Medrol dose, which could affect the dosing frequency and monitoring for side effects.

From the Research

Equivalent Dosage of Decadrom Shot to 125mg Solumedrol

To determine the equivalent dosage of Decadrom shot to 125mg Solumedrol, we need to consider the potency and dosage of each medication.

  • Solumedrol (methylprednisolone) is a corticosteroid with a potency of 5 times that of hydrocortisone 2.
  • Decadrom (dexamethasone) is a corticosteroid with a potency of 25-30 times that of hydrocortisone 3.

Conversion Factors

The conversion factor from methylprednisolone to dexamethasone is approximately 1:6 to 1:7, meaning that 1mg of dexamethasone is equivalent to 6-7mg of methylprednisolone 3, 4. Using this conversion factor, we can estimate the equivalent dosage of Decadrom shot to 125mg Solumedrol.

Estimated Equivalent Dosage

Based on the conversion factor, the estimated equivalent dosage of Decadrom shot to 125mg Solumedrol would be: 125mg Solumedrol / 6-7 = approximately 18-20mg Decadrom shot

Note that this is an estimate and the actual equivalent dosage may vary depending on individual patient factors and the specific clinical context. It is essential to consult with a healthcare professional to determine the appropriate dosage and treatment plan.

References

Guideline

clinical practice guideline: sudden hearing loss.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2012

Research

Different oral corticosteroid regimens for acute asthma.

The Cochrane database of systematic reviews, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.