What is the equivalent dose of prednisone (corticosteroid) to 100 mg of methylprednisolone (corticosteroid)?

Methylprednisolone to Prednisone Conversion

100 mg of methylprednisolone is equivalent to 125 mg of prednisone, using the standard 1.25:1 conversion ratio (prednisone:methylprednisolone). 1

Conversion Ratio

The conversion between these two corticosteroids is based on their relative anti-inflammatory potencies:

• Prednisone is 4 times more potent than hydrocortisone 1
• Methylprednisolone is 5 times more potent than hydrocortisone 1
• This yields a 1.25:1 ratio (prednisone:methylprednisolone) 1

Practical Clinical Application

For 100 mg methylprednisolone, you would use 125 mg prednisone. 1

This conversion ratio is consistently applied across multiple clinical guidelines:

• The Society for Immunotherapy of Cancer recommends prednisone 1 mg/kg/day (or equivalent dose of methylprednisolone) for immune checkpoint inhibitor toxicities, using this 1.25:1 conversion 2, 1
• The European Society of Cardiology states that prednisone 25 mg is equivalent to methylprednisolone 20 mg, which confirms the 1.25:1 ratio 2

Important Clinical Considerations

Methylprednisolone has more predictable pharmacokinetics than prednisone because it shows linear dose-response without dose-dependent protein binding, making dosing calculations more straightforward. 3

When converting between formulations, maintain equivalent anti-inflammatory potency to ensure consistent therapeutic effect, particularly in conditions requiring precise corticosteroid dosing. 4

The conversion applies to both oral and intravenous formulations, as demonstrated in pediatric asthma studies where oral prednisone 2 mg/kg twice daily was equivalent to intravenous methylprednisolone 1 mg/kg four times daily (both totaling 4 mg/kg/day). 5