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Calcimator

Adrenal Insufficiency Stress Dosing Calculator

Hydrocortisone stress dose from procedure severity.

Inputs

Results

Stress Dose (mg/day)

40

IV Bolus (mg)0
Dose q8h (mg)13
Day-1 Total (mg)40
Total Over Period (mg)80
Prednisone Equivalent (mg/day)10
Dexamethasone Equivalent (mg/day)1.5
How to Use This Calculator
  1. Enter the patient's Maintenance Dose (mg/day) of hydrocortisone or equivalent.
  2. Select Stress Level (1 = minor illness, 2 = moderate surgery, 3 = major surgery/ICU).
  3. Enter Duration (days) for the stress dosing period.
  4. Review Stress Dose (mg/day), IV Bolus (mg), and dose every 8 hours.
  5. Taper back to the maintenance dose over 1-3 days once the stressor resolves.

How the result changes with Maintenance Dose (mg/day)

Maintenance Dose (mg/day)Stress Dose (mg/day)
1122
2448
4182
55110

What each input means

Maintenance Dose (mg/day)
Current daily hydrocortisone maintenance dose in mg. Typical: 15–25 mg/day.
Stress Level (1–3)
1 = Minor (dental, mild illness). 2 = Moderate (moderate surgery, pneumonia). 3 = Major (major surgery, sepsis, trauma).
Duration (days)
Expected duration of physiological stress in days before taper to maintenance.

What each result means

Stress Dose (mg/day)
Total hydrocortisone dose per day during the stress period.
IV Bolus (mg)
Initial IV hydrocortisone bolus dose (moderate/major stress only).
Dose q8h (mg)
Hydrocortisone dose given every 8 hours.
Day-1 Total (mg)
Total hydrocortisone on first day including IV bolus.
Total Over Period (mg)
Cumulative hydrocortisone over the entire stress dosing period.
Prednisone Equivalent (mg/day)
Daily stress dose expressed as prednisone equivalent (HC ÷ 4).
Dexamethasone Equivalent (mg/day)
Daily stress dose expressed as dexamethasone equivalent (HC ÷ 26.67).

How this is calculated

Worked example, using the default values

  1. Identify Input Parameters
    Maintenance Dose (mg/day) = 20, Stress Level (1–3) = 1, Duration (days) = 2 = 3 input(s) provided
  2. Calculate Stress Dose
    Stress Dose
    40 = 40
  3. Calculate IV Bolus
    IV Bolus
    0 = 0
  4. Calculate Dose q8h
    Dose q8h
    13 = 13

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