Prednisone and Prednisolone Equivalence
Prednisone 30-40 mg is equivalent to prednisolone 30-40 mg—these medications are pharmacologically equivalent and used interchangeably at the same dose. 1, 2, 3
Direct Equivalence
- Prednisone and prednisolone are considered equivalent medications that are used in the same dosage, as explicitly stated by KDIGO (Kidney Disease: Improving Global Outcomes) guidelines 1
- The FDA drug label confirms this 1:1 equivalence, stating that 15 mg prednisolone base equals 15 mg prednisone 3
- Both drugs have been used successfully in randomized controlled trials depending on country of origin, with no clinical superiority of one over the other 2
Practical Application
- For a prednisolone dose of 30-40 mg, simply use prednisone 30-40 mg 1, 2, 3
- The choice between these two medications depends primarily on geographic prescribing patterns rather than clinical differences: prednisone is more commonly used in the United States, while prednisolone is preferred in Europe and other regions 2
- Both medications should be administered as a single daily morning dose when possible, as this causes less adrenal suppression than divided dosing 4
Important Caveats
- This 1:1 equivalence applies specifically to oral or intravenous administration only—when these substances are injected intramuscularly or into joint spaces, their relative properties may be greatly altered 3
- The conversion is straightforward because prednisone is a prodrug that is rapidly converted to prednisolone (the active form) in the liver, making them functionally identical for most clinical purposes 1, 2