Glucocorticoids | Glucocorticoid activity relative to hydrocortisone* | Mineralocorticoid activity¶ | Plasma half-life (min)[1] |
Short-acting | |||
Hydrocortisone (cortisol) | 1 | Moderate | 60 to 90 |
Intermediate-acting | |||
Prednisone | 5 | Low | 60 |
Prednisolone | 5 | Low | 115 to 200 |
Long-acting | |||
Dexamethasone | 60 to 80 | None | 200 |
Mineralocorticoids | Dose | Mineralocorticoid activity¶ | Plasma half-life (min)[1] |
Fludrocortisone | 0.1 to 0.2 mgΔ | High | 200 |
* In this table, glucocorticoid activity refers to the relative effect as measured by growth suppression, which is thought to be the best measure of potency for patients with adrenal insufficiency[1-4]. The relative potency for antiinflammatory effects is somewhat lower.
¶ 20 mg of hydrocortisone and 25 mg of cortisone acetate each provide a mineralocorticoid effect that is approximately equivalent to 0.1 mg fludrocortisone[5].
Δ For patients with mineralocorticoid deficiency, the typical daily dose of fludrocortisone is 0.1 mg when given in conjunction with hydrocortisone (which has some mineralocorticoid activity). The dose is adjusted as needed to achieve normal plasma renin activity. It is not adjusted by weight, age, or body surface area, because the aldosterone secretion rate is nearly constant throughout the lifespan. Higher doses are occasionally needed in early infancy (eg, <4 months of age) due to physiologic resistance of the immature kidney to mineralocorticoid.Do you want to add Medilib to your home screen?