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NEVER stop or change steroid doses without medical supervision. Abrupt discontinuation can cause life-threatening adrenal crisis. This calculator is for educational reference only—always follow your doctor's prescribed taper schedule.
Educational reference for understanding steroid tapering
| Steroid | Equivalent Dose | Half-Life | Relative Potency |
|---|---|---|---|
| Hydrocortisone | 20 mg | 8-12 hours (short) | 1x |
| Prednisone / Prednisolone | 5 mg | 12-36 hours (intermediate) | 4x |
| Methylprednisolone | 4 mg | 18-36 hours (intermediate) | 5x |
| Dexamethasone | 0.75 mg | 36-54 hours (long) | 25-30x |
| Betamethasone | 0.6 mg | 36-54 hours (long) | 25-30x |
Physiologic dose: The body naturally produces approximately 5-7.5mg prednisone equivalent daily (20mg hydrocortisone). When tapering below this, monitor closely for adrenal insufficiency.
When you take corticosteroids, your body's natural cortisol production decreases. The HPA (hypothalamic-pituitary-adrenal) axis becomes suppressed and may take weeks to months to recover after stopping steroids.
Less than 3 weeks at any dose, or <10mg prednisone daily
3-12 weeks therapy at moderate doses
>3 months therapy, or >20mg prednisone daily for weeks
Call 911 immediately. Patient may need emergency hydrocortisone.
Contact your doctor if these occur during taper. May need to slow down or pause taper.
Important: During and after long-term steroid use, your body may not produce enough cortisol to handle physical stress (illness, surgery, injury). You may need temporary "stress doses."
Cold, minor infection
Double your current dose for 2-3 days
Dental procedure, minor surgery
50mg hydrocortisone (or equivalent) day of procedure
Major surgery, severe illness, trauma
100mg hydrocortisone IV, then taper per protocol
Always carry a medical alert card or bracelet if on chronic steroids or within 1 year of stopping.
It varies widely based on the dose, duration of therapy, and individual response. A short course (1-2 weeks) may taper over a few days to a week. Long-term high-dose therapy may require a taper lasting several months with very gradual dose reductions.
Don't adjust your dose yourself. Contact your doctor—they may pause the taper, increase the dose temporarily, or slow the taper rate. For autoimmune conditions, a flare during taper is common and may require adjustments to your treatment plan.
Generally, courses under 2-3 weeks at moderate doses don't require a taper because HPA suppression hasn't occurred yet. However, some doctors still use a brief taper to prevent symptom rebound. Always follow your prescriber's instructions.
Your doctor can test this with a morning cortisol blood test or an ACTH (Cortrosyn) stimulation test. A normal morning cortisol (above ~10 mcg/dL) suggests adequate recovery. Testing is usually done after completing the taper if there's concern about recovery.
Corticosteroids affect nearly every organ system. Side effects include weight gain, fluid retention, high blood sugar, mood changes, insomnia, osteoporosis, thin skin, cataracts, and increased infection risk. Most are reversible with dose reduction and discontinuation, but bone loss and cataracts may persist.