Endocrinology Book

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Systemic CorticosteroidAka: Corticosteroid, Betamethasone, Dexamethasone, Cortisone, Hydrocortisone, Methylprednisolone, Prednisolone

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  1. See Also
    1. Topical Corticosteroid
    2. Inhaled Corticosteroid
    3. Intranasal Steroid
    4. Intra-articular Corticosteroid
    5. Corticosteroid Associated Osteoporosis
  2. Dosing: Adult
    1. Betamethasone (Celestone) 0.5 to 0.9 mg IM/PO qd
    2. Cortisone (Cortone) 25-300 mg PO qd
    3. Dexamethasone (Decadron) 0.75-9 mg PO/IM/IV divided q6h
    4. Hydrocortisone (Cortef)
      1. Parenteral: 100 to 150 mg IV/IM q2-6 hours prn
      2. Oral: 20 to 240 mg/day PO in divided dosing
    5. Methylprednisolone
      1. Parenteral (Solu-Medrol) 10 to 125 mg IV/IM
      2. Oral (Medrol) 4 to 48 mg PO qd
      3. Medrol Dose pack: tapers from 24 to 0 PO over 7 days
    6. Prednisolone (Prelone) 5-60 mg PO/IV/IM qd
    7. Prednisone (Deltasone) 5-60 mg PO qd
    8. Triamcinolone (Aristocort, Kenalog) 4 to 48 mg PO/IM qd
  3. Dosing: Child
    1. Methylprednisolone (Solu-Medrol)
      1. Dose: 1-2 mg/kg/dose PO/IV/IM q6h up to 125 mg/dose
    2. Prednisolone (Prelone)
      1. Dose: 1-2 mg/kg/dose PO qd to bid up to 60 mg/day
      2. Maximum: 60 mg per day
      3. Preparations
        1. Syrup: 15 mg/5 ml
        2. Liquid: 5 mg/5 ml
  4. Agents: Overall potency (equivalent dosages)
    1. High potency
      1. Betamethasone 0.6 to 0.75 mg
      2. Dexamethasone 0.75 mg
    2. Medium potency
      1. Methylprednisolone 4 mg
      2. Triamcinolone 4 mg
      3. Prednisolone 5 mg
      4. Prednisone 5 mg
    3. Low potency
      1. Hydrocortisone 20 mg
      2. Cortisone 25 mg
  5. Agents: Relative anti-inflammatory potency
    1. High anti-inflammatory potency
      1. Betamethasone 20-30
      2. Dexamethasone 20-30
    2. Medium anti-inflammatory potency
      1. Methylprednisolone 5
      2. Triamcinolone 5
      3. Prednisolone 4
      4. Prednisone 4
    3. Low anti-inflammatory potency
      1. Hydrocortisone 1
      2. Cortisone 0.8
  6. Agents: Relative Mineralocorticoid Potency
    1. Mineralocorticoid Activity
      1. Cortisone 2
      2. Hydrocortisone 2
      3. Prednisolone 1
      4. Prednisone 1
    2. No Mineralocorticoid Activity
      1. Betamethasone
      2. Dexamethasone
      3. Methylprednisolone
      4. Triamcinolone
  7. Agents: Half Life
    1. Long half-life (36-54 hours)
      1. Betamethasone
      2. Dexamethasone
    2. Medium half-life (18-36 hours)
      1. Methylprednisolone
      2. Prednisolone
      3. Prednisone
      4. Triamcinolone
    3. Short half-life (8-12 hours)
      1. Cortisone
      2. Hydrocortisone
  8. Adverse Effects: Long-term Corticosteroids
    1. Corticosteroid Associated Osteoporosis
    2. Corticosteroid Myopathy
    3. Emotional lability (depression or hypomania)
    4. Motor restlessness
    5. Insomnia
    6. Hypertension
    7. Iatrogenic Diabetes Mellitus
    8. Hyperlipidemia
    9. Fluid retention
    10. Osteonecrosis of the hip
  9. Prevention of corticosteroid complications
    1. See Corticosteroid Associated Osteoporosis
  10. References
    1. Lane (1998) Endocrinol Metab Clin North Am 27:465

Adrenal Cortex Hormones (C0001617)

Definition (CSP)any of the 21-carbon steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to adrenocorticotropic hormone (ACTH) released by the pituitary gland or to angiotensin II; called also adrenocorticoid, corticoid, adrenal cortical or adrenocortical steroid, and adrenocortical or cortical hormone.
Definition (NCI)Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment.
Definition (NCI)Hormones synthesized in the cortex of the adrenal gland and consist of two subclasses, glucocorticoids (carbohydrate regulation) and mineralocorticoids (electrolyte regulation).
ConceptsSteroid (T110) , Pharmacologic Substance (T121) , Hormone (T125)
Englishadrenal cortex hormone, Adrenal Cortex Hormones, Adrenal cortical hormone, Adrenocorticosteroids, Corticoid preparation, Corticoids, corticosteroid, Corticosteroids, Therapeutic Corticosteroid
Spanishadrenocorticoesteroide, hormona de la corteza suprarrenal, hormona suprarrenal cortical, preparado con corticoides, preparado de corticoides
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Betamethasone (C0005308)

Definition (MSH)A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. Its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p724)
Definition (PDQ)A synthetic glucocorticoid with metabolic, immunosuppressive and anti-inflammatory activities. Betamethasone binds to specific intracellular glucocorticoid receptors and subsequently binds to DNA to modify gene expression. The synthesis of certain anti-inflammatory proteins is induced while the synthesis of certain inflammatory mediators is inhibited. As a result, there is an overall reduction in chronic inflammation and autoimmune reactions. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39273&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39273&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C303" NCI Thesaurus)
Definition (NCI)A synthetic glucocorticoid with metabolic, immunosuppressive and anti-inflammatory activities. Betamethasone binds to specific intracellular glucocorticoid receptors and subsequently binds to DNA to modify gene expression. The synthesis of certain anti-inflammatory proteins is induced while the synthesis of certain inflammatory mediators is inhibited. As a result, there is an overall reduction in chronic inflammation and autoimmune reactions.
ConceptsSteroid (T110) , Pharmacologic Substance (T121) , Hormone (T125)
EnglishBetadexamethasone, Betamethasone, Betamethasone preparation, Flubenisolone, Flubenisolone preparation
Spanishbetametasona, preparado de betametasona, preparado de flubenisolona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Cortisone (C0010137)

Definition (MSH)A naturally occurring glucocorticoid. It has been used in replacement therapy for adrenal insufficiency and as an anti-inflammatory agent. Cortisone itself is inactive. It is converted in the liver to the active metabolite HYDROCORTISONE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p726)
Definition (CSP)naturally occurring glucocorticoid used in replacement therapy for adrenal insufficiency and as an anti-inflammatory agent; cortisone itself is inactive and is converted in the liver to the active metabolite cortisol.
Definition (NCI)A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses.
Definition (NCI)A steroid hormone synthesized and secreted by the adrenal gland and necessary for life. It is involved with maintaining cardiovascular function, blood glucose balance, regulating the inflammatory response and metabolism of proteins, carbohydrates, and fat.
Definition (NCI)A corticosteroid with potent glucocorticoid activity. Therapeutic cortisone is the inactive precursor molecule of the active hormone cortisol, which is the hydroxylation product of cortisone by 11-beta-steroid dehydrogenase. Cortisol increases blood pressure, blood sugar levels, and suppresses the immune system, thereby cortisone is used to treat allergies or inflammation.
ConceptsSteroid (T110) , Pharmacologic Substance (T121) , Hormone (T125)
EnglishCompound E, CORT, Cortisone, Cortisone preparation, Cortisone product, Therapeutic Cortisone
Spanishcortisona, preparado con cortisona, preparado de cortisona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Dexamethasone (C0011777)

Definition (MSH)An anti-inflammatory 9-fluoro-glucocorticoid.
Definition (CSP)anti-inflammatory 9-fluoro-glucocorticoid.
Definition (NCI)A synthetic steroid (similar to steroid hormones produced naturally in the adrenal gland). Dexamethasone is used to treat leukemia and lymphoma and may be used to treat some of the problems caused by other cancers and their treatment.
Definition (PDQ)A synthetic adrenal corticosteroid with potent anti-inflammatory properties. In addition to binding to specific nuclear steroid receptors, dexamethasone also interferes with NF-kB activation and apoptotic pathways. This agent lacks the salt-retaining properties of other related adrenal hormones. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39789&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39789&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C422" NCI Thesaurus)
Definition (NCI)A synthetic adrenal corticosteroid with potent anti-inflammatory properties. In addition to binding to specific nuclear steroid receptors, dexamethasone also interferes with NF-kB activation and apoptotic pathways. This agent lacks the salt-retaining properties of other related adrenal hormones. (NCI04)
ConceptsSteroid (T110) , Pharmacologic Substance (T121)
EnglishDesamethasone, Dexamethasone, Dexamethasone preparation, Dexamethasonum, DM, DXM, Hexadecadrol, Methylfluorprednisolone
Spanishdexametasona, preparado con dexametasona, preparado de dexametasona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Hydrocortisone (C0020268)

Definition (MSH)The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.
Definition (CSP)main glucocorticoid secreted by the adrenal cortex; its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.
Definition (NCI)A drug used to relieve the symptoms of certain hormone shortages and to suppress an immune response.
Definition (PDQ)A synthetic or semisynthetic analog of natural hydrocortisone hormone produced by the adrenal glands with primary glucocorticoid and minor mineralocorticoid effects. As a glucocorticoid receptor agonist, hydrocortisone promotes protein catabolism, gluconeogenesis, capillary wall stability, renal excretion of calcium, and suppresses immune and inflammatory responses. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39274&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39274&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C555" NCI Thesaurus)
Definition (NCI)A synthetic or semisynthetic analog of natural hydrocortisone hormone produced by the adrenal glands with primary glucocorticoid and minor mineralocorticoid effects. As a glucocorticoid receptor agonist, hydrocortisone promotes protein catabolism, gluconeogenesis, capillary wall stability, renal excretion of calcium, and suppresses immune and inflammatory responses. (NCI04)
ConceptsSteroid (T110) , Pharmacologic Substance (T121) , Hormone (T125)
EnglishCompound F, Compound F preparation, Cortisol, Cortisol preparation, Cortisol product, Dihydrocortisone, Domolene, HC, Hydrocortisone, Hydrocortisone preparation, Hydrocortisone product, Therapeutic Hydrocortisone
Spanishcortisol, hidrocortisona, preparado con hidrocortisona, preparado de hidrocortisona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Methylprednisolone (C0025815)

Definition (MSH)A PREDNISOLONE derivative with similar anti-inflammatory action.
Definition (CSP)synthetic glucocorticoid derived from progesterone, used in replacement therapy for adrenal insufficiency and as an anti-inflammatory and immunosuppressant.
Definition (NCI)A corticosteroid hormone replacement.
Definition (PDQ)A synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41528&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41528&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C647" NCI Thesaurus)
Definition (NCI)A synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations.
ConceptsSteroid (T110) , Pharmacologic Substance (T121) , Hormone (T125)
English6 Methylprednisolone, MePRDL, Methylprednisolone, Methylprednisolone preparation, Methylprednisolonum, Metipred
Spanishmetilprednisolona, preparado con metilprednisolona, preparado de metilprednisolona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


prednisolone (C0032950)

Definition (MSH)A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.
Definition (CSP)synthetic glucocorticoid with the general properties of the corticosteroids.
Definition (NCI)A synthetic corticosteroid used in the treatment of blood cell cancers (leukemias) and lymph system cancers (lymphomas).
Definition (PDQ)A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisolone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cells populations. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43296&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43296&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C769" NCI Thesaurus)
Definition (NCI)A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisolone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cells populations. (NCI04)
ConceptsSteroid (T110) , Pharmacologic Substance (T121)
EnglishDeltahydrocortisone, Deltahydrocortisone preparation, Metacortandralone, Metacortandralone preparation, PRDL, prednisolone, Prednisolone preparation, Prednisolone product, Prednisolonum
Spanishprednisolona, preparado con deltahidrocortisona, preparado con metacortandralona, preparado con prednisolona, preparado de deltahidrocortisona, preparado de metacortandralona, preparado de prednisolona
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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