corticosteroid (potency)

Last reviewed 09/2021

Corticosteroids in general:

Equivalent anti-inflammatory doses of different oral corticosteroids

This table takes no account of mineralocorticoid effects, nor does it take account of variations in duration of action

Prednisolone 5mg

is equivalent to betamethasone 750 mcg

is equivalent to cortisone acetate 25 mg

is equivalent to dexamethasone 750 mcg

is equivalent to deflazacort 6mg

is equivalent to hydrocortisone 20mg

is equivalent to methylprednisolone 4mg

is equivalent to traimacinolone 4mg

Note that mineralocorticoid side effects are most marked with fludrocortisone, but are significant with cortisone, hydrocortisone, corticotropin, and tetracosactide (tetracosacrtin). Minerlacorticoid actions are negligible with the high potency glucocorticoids, betamethasone and dexamethasone, and occur only slightly with methylprednisolone, prednisolone, triamcinolone.

Topical corticosteroids:

The potency of topical corticosteroids is determined by

  • the extent to which it inhibits inflammation (2)
  • the specific modification (esterification) of the steroid molecule e.g. - hydrocortisone (acetate) 1% is mild but hydrocortisone butyrate 0.1% is a potent preparation (3)
  • the formulation
  • presence of other ingredients such as urea or salicylic acid which may increase the absorption of the drug (4)
  • occlusive dressings or increasing hydration of the stratum corneum (increases steroid absorption) (5)

POTENCY EXAMPLES

  • mild
    • hydrocortisone 0.1-1%

  • moderate
    • clobetasone butyrate 0.05%

  • potent
    • hydrocortisone butyrate
    • betamethasone valerate 0.1%

  • very potent
    • clobetasol propionate 0.05%

The respective summary of product characteristics must be checked before prescribing any of the drugs described.

Reference:

Related pages:

hydrocortisone

aldosterone

beclometasone (beclomethasone) dipropionate

cortisone

dexamethasone

fludrocortisone

budesonide

triamcinolone

prednisolone

mometasone furoate