About Synthetic Steroids

Which synthetic steroids have mineralocorticoid activity

  • Hydrocortisone - inactivated by HSD-1
  • Prednisolone - some activity
  • Dexamethasone - no mineralocorticoid activity

Cross-reactivity of assays

  • Prednisolone - 12% cross-reactivity by Abbott Architect assay (at St J and in future at RIE/WGH). Will produce significantly elevated spurious results
  • Fludrocortisone - 37% cross-reactivity by Abbot Architect assay. Will produce very slightly elevated results (max 17 nmol/L) after a dose of 100mcg

Dose equivalence

According to the BNF, prednisolone 5mg is equivalent to:

  • Hydrocortisone 20mg
  • Dexamethasone 750mcg
  • Betamethasone 750mcg
  • Methylprednisolone 4mg