A patient maintained on prednisolone 15 mg daily needs conversion to oral hydrocortisone. The equipotent total daily dose of hydrocortisone is:
- A 15 mg
- B 30 mg
- C 60 mg ✓
- D 120 mg
Correct answer: C. 60 mg
Explanation
Prednisolone is roughly four times more potent than hydrocortisone as a glucocorticoid, so the conversion ratio is 1 mg prednisolone to 4 mg hydrocortisone. Fifteen mg of prednisolone therefore equals 60 mg of hydrocortisone. Choosing 30 mg ignores this ratio and would underdose the patient, risking adrenal insufficiency symptoms after the switch.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
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