Methylprednisolone 50 mg Oral Equivalent to Prednisone
50 mg of oral methylprednisolone is equivalent to approximately 62.5 mg of oral prednisone, using the standard 1.25:1 conversion ratio (prednisone:methylprednisolone). 1
Standard Conversion Ratio
The established anti-inflammatory potency equivalence is methylprednisolone 4 mg = prednisone 5 mg, which translates to a 1.25:1 ratio. 1 This conversion is based on:
- Methylprednisolone is 5 times more potent than hydrocortisone 1
- Prednisone is 4 times more potent than hydrocortisone 1
- Therefore, the relative potency ratio between prednisone and methylprednisolone is 5:4, or 1.25:1 1
Clinical Application of This Conversion
Using the 1.25:1 ratio for your specific dose:
- 50 mg methylprednisolone × 1.25 = 62.5 mg prednisone equivalent 1
This conversion ratio is consistently applied across multiple clinical contexts:
- For immune checkpoint inhibitor toxicities, prednisone 1 mg/kg/day converts to methylprednisolone 0.8 mg/kg/day using this 1.25:1 ratio 1
- For polymyalgia rheumatica, prednisone 12.5-25 mg daily is equivalent to methylprednisolone 10-20 mg daily 1
- For lupus nephritis pulse therapy, the conversion framework uses this same ratio when transitioning between IV methylprednisolone and oral prednisone 2, 1
Important Pharmacokinetic Considerations
Methylprednisolone has more predictable pharmacokinetics than prednisone because it demonstrates linear, dose-proportional kinetics without saturable protein binding. 3 In contrast, prednisone shows dose-dependent clearance and volume of distribution due to saturable plasma protein binding, making dose adjustments more complex. 3
Both oral formulations have excellent bioavailability, though oral methylprednisolone has approximately 69% bioavailability compared to IV administration. 4 This does not affect the prednisone:methylprednisolone conversion ratio, which applies to both oral and IV routes. 1
Critical Safety Note
Do not confuse methylprednisolone with "methylprednisone"—they are different compounds. 1 Always verify the exact medication name when prescribing or converting doses.
Route-Specific Considerations
The 1.25:1 conversion ratio applies to both oral and intravenous administration. 1 When converting from oral prednisone to IV methylprednisolone (or vice versa), use the same ratio, as bioavailability of both oral formulations is excellent. 1
For perioperative stress coverage specifically, prednisolone 5 mg oral = methylprednisolone 4 mg IV = hydrocortisone 20 mg IV. 1