Table 6

Properties and therapeutic indications of oral corticosteroids, relative to hydrocortisone

DrugGC:MC ratioGeneral therapeutic indication
Hydrocortisone (S)11Relatively high mineralocorticoid activity makes it unsuitable for long-term use
Cortisone (S)0.80.8Similar to hydrocortisone
Prednisolone (I)40.8High glucocorticoid activity makes it useful for long-term treatment, and as an anti-inflammatory and immunosuppressant
Methylprednisolone (I)5MinimalAnti-inflammatory and immunosuppressive
Dexamethasone (L)30MinimalAnti-inflammatory and immunosuppressive, used especially when water retention is undesirable as it has insignificant mineralocorticoid activity. Long duration of action makes it useful in conditions such as congenital adrenal hyperplasia
Betamethasone (L)30NegligibleAnti-inflammatory and immunosuppressive, used especially when water retention is undesirable as it has insignificant mineralocorticoid activity. Long duration of action makes it useful in conditions such as congenital adrenal hyperplasia.
  • GC, glucocorticoid; I, intermediate acting, biological half-life 18–36 hours; L, long acting, biological half-life 36–54 hours; MC, mineralocorticoid; S, short acting, biological half-life 8–12 hours.