ELMMB logo
Facebook logo Twitter logo
Menu
6.3 Corticosteroids

6.3 Corticosteroids

Equivalent anti-inflammatory doses of corticosteroids:

Prednisolone 5mg
Betamethasone 750 microgram
Cortisone Acetate 25mg
Deflazacort 6mg
Dexamethasone 750 microgram
Hydrocortisone 20mg
Methylprednisolone 4mg
Triamcinolone 4mg
 

6.3.1 Replacement therapy

A combination of hydrocortisone and the mineralocorticoid fludrocortisone are needed in primary adrenal deficiency states.
 
GREEN        Fludrocortisone tablets 100 microgram
 

Glucocorticoid therapy

The proportions of glucocorticoid to mineralocorticoid activity determine the uses of these corticosteroids:
 
Glucocorticoid and mineralocorticoid activity 
These are suitable for adrenal replacement therapy and as injection for emergency management of some conditions.
 
GREEN        Hydrocortisone, tablets 10mg, 20mg
AMBER       Hydrocortisone sodium succinate injection 100mg
RED             Hydrocortisone Emergency  Injection Kit
 
Glucocorticoid activity mainly 
Most common corticosteroid for long term disease suppression.
 
GREEN      Prednisolone, tablets 1mg, 5mg, 25mg
       (NB - the 5mg tablets will disperse in water.)
                   tablets e/c 2.5mg
 
High glucocorticoid activity with insignificant mineralocorticoid activity 
Suitable for high dose therapy when water retention would be a disadvantage.
 
GREEN      Betamethasone tablets 500 microgram 
RED           Betamethasone injection 4mg/mL 
GREEN      Dexamethasone
                   tablets 500 microgram, 2mg
                   oral solution 2mg/5mL
RED           Dexamethasone injection 8mg/2mL
 
Other corticosteroid preparations 
RED           Methylprednisolone injection 500mg, 1g (Solu-Medrone®) 
GREEN      Methylprednisolone acetate injection 40mg/mL (Depo-Medrone®) 
GREEN       Triamcinolone injection 40mg/mL  [NOT receommended for use in hayfever]
 
Deflazacort
Deflazacort may only be initiated by a paediatrician for the management of Duchenne Muscular Dystrophy.  Deflazacort
should only be used for patients in whom oral prednisolone is not tolerated due to cushingoid side effects. Treatment
is likely to be long term and prescribers should continue to monitor patients for side effects routinely (especially asymptomatic
cataracts and weight gain).  Therapy may be transferred to the primary care prescriber (following prior agreement) once therapy
has been initiated by the specialist.  Duration of treatment and dose adjustments should be clearly communicated at regular
intervals.
 
AMBER     Deflazacort tablets 1mg, 6mg, 30mg
 
 
 
 
 
 
 

All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the  
public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service. 
  Email: info.elmmb@nhs.net
 Copyright© 2016 East Lancashire Medicines Management Board. 
 All rights reserved.  Disclaimer/Terms and conditions