Steroid Taper Calculator
Prednisone taper schedule from starting dose and duration.
About this calculator
This calculator builds a step-down prednisone taper schedule and converts the starting dose into equivalent doses of three other commonly used corticosteroids. Starting from the entered dose, it repeatedly reduces the daily dose by a fixed amount that gets smaller as the dose gets lower -- 10 mg per step above 40 mg/day, 5 mg between 20 and 40, 2.5 mg between 10 and 20, 1 mg between 5 and 10, and 0.5 mg below 5 mg/day -- holding each dose for the chosen step interval before reducing again, until the target dose is reached. This front-loaded, slow-at-the-end shape reflects a widely used general pattern for tapering chronic steroid use: larger absolute reductions are tolerated well at supraphysiologic doses, while the final few milligrams matter most because the body's own adrenal cortisol output (roughly equivalent to 5 mg of prednisone per day) needs time to recover once exogenous steroid is withdrawn, and tapering too fast below that physiologic range risks an adrenal crisis.
The calculator also reports the starting dose converted to hydrocortisone (prednisone x4), methylprednisolone (prednisone x0.8), and dexamethasone (prednisone x0.15) using standard anti-inflammatory potency equivalence ratios, useful when switching a patient between corticosteroid formulations. What it does NOT do: account for the specific medical reason steroids were started (autoimmune flares often need a slower taper than a short post-surgical course), adjust for alternate-day dosing strategies, or replace formal HPA-axis testing (cosyntropin stimulation) when a patient has been on high-dose steroids long enough that adrenal suppression is a real concern.
Medical Disclaimer
This calculator is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about your health. Never disregard professional medical advice or delay seeking it because of results from this tool.
Inputs
Results
Number of Taper Steps
23
How to Use This Calculator
- Enter the Starting Dose in mg prednisone equivalent.
- Set the Step Interval (days) between each dose reduction.
- Input the Target Dose (mg) — typically 0 mg for a full discontinuation taper.
- Review the Number of Taper Steps and Total Taper Duration (days and weeks).
- Use Cumulative Dose and steroid equivalents (hydrocortisone, methylprednisolone, dexamethasone) to counsel on HPA axis suppression risk.
How the result changes with Starting Dose (mg prednisone)
| Starting Dose (mg prednisone) | Number of Taper Steps |
|---|---|
| 20 | 19 |
| 30 | 21 |
| 60 | 25 |
| 100 | 29 |
What each input means
- Starting Dose (mg prednisone)
- Current daily prednisone dose in mg.
- Step Interval (days)
- Days to hold each dose before reducing. 7 days is common; use 14–28 for slower tapers at lower doses.
- Target Dose (mg)
- Final target dose (0 to discontinue completely, or a maintenance dose).
What each result means
- Number of Taper Steps
- Total number of dose reductions in the taper schedule.
- Total Taper Duration (days)
- Total days from start of taper to reaching target dose.
- Total Taper Duration (weeks)
- Total taper duration expressed in weeks.
- Cumulative Dose (mg)
- Total prednisone consumed over the entire taper period.
- Hydrocortisone Equiv. Start (mg)
- Starting dose expressed as hydrocortisone (prednisone × 4).
- Methylpred Equiv. Start (mg)
- Starting dose expressed as methylprednisolone (prednisone × 0.8).
- Dexamethasone Equiv. Start (mg)
- Starting dose expressed as dexamethasone (prednisone × 0.15).
How this is calculated
Worked example, using the default values
- Identify Input ParametersStarting Dose (mg prednisone) = 40, Step Interval (days) = 7, Target Dose (mg) = 0 = 3 input(s) provided
- Calculate Number of Taper Steps23 = 23
- Calculate Total Taper DurationTotal Taper Duration161 = 161
- Calculate Total Taper DurationTotal Taper Duration = totalDays / 723 = 23
Engine last updated . Checked against 2 independently-derived tests — how we verify calculators. Built by Paul Gunder, a software engineer, not a licensed financial, medical, or legal professional.
Frequently Asked Questions
Why does the dose reduction get smaller as the taper goes on instead of staying constant?
A fixed percentage or fixed absolute cut works differently at different starting points. Reducing by 10 mg when the dose is 60 mg is a modest ~17% cut, but the same 10 mg reduction at a 10 mg dose would eliminate the drug entirely in one step -- right where the body's own adrenal glands are least able to compensate. Shrinking the step size as the dose falls keeps each individual cut proportionally gentler as the patient approaches the physiologic replacement range.
Does a longer step interval change how many dose-reduction steps the taper has?
No -- the step interval only controls how many days each dose is held before the next reduction, not how many reductions are needed to get from the starting dose down to the target. A 7-day interval and a 14-day interval produce the exact same sequence of doses; the 14-day version simply takes twice as long and roughly doubles the cumulative dose consumed along the way.
How much higher is an equivalent hydrocortisone dose compared to prednisone?
About four times higher by milligram, since 5 mg of prednisone is considered anti-inflammatory-equivalent to roughly 20 mg of hydrocortisone. A patient tapering off 40 mg of prednisone daily is therefore working with a dose equivalent to about 160 mg of hydrocortisone, a conversion clinicians use when switching a patient to hydrocortisone for physiologic replacement dosing near the end of a taper.
Why is dexamethasone equivalent to such a small number of milligrams?
Dexamethasone is a far more potent glucocorticoid gram-for-gram than prednisone -- about 0.75 mg of dexamethasone matches the anti-inflammatory effect of 5 mg of prednisone, a roughly 6.7-fold potency difference. That's why dexamethasone is prescribed in much smaller milligram amounts than prednisone for an equivalent clinical effect, and why mixing up the two without converting doses correctly is a real medication-error risk.
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