I just found this on a web site that covers the different potebncies of corticosteroids and it more or less proves what we have been talking about with the dex potency being miscalculated by some doctors:

Steroids vary in terms of their antiinflammatory potency. Equivalent doses are shown below:

Steroid	Equivalent Dose
Cortisone	25
Hydrocortisone	20
Prednisone	5
Prednisolone	5
Methylprednisolone	4
Triamcinolone	4
Dexamethasone	0.75
Betamethasone	0.70

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However, I note that the equivalent dose for 20mg of HCT is noted as 0.75 which I dont think is right.  Dex is said to be 80 times more potent and some information may say it is 30 times more potent.  Thats why some kids have been over dosed on the dex and why it has never had a fair hearing where CAH is concerned.  Once they get the conversion correct and give the right dose it is as effective as HCT.  I was kind of wondering if some of the other conversions therefore could be inaccurate.

I would say that whatever your kids doses are that once they are tuned to their needs (and as we know they do that by checking the blood tests) they should work just the same.  I think that different meds are probably needed under different circumstances.  But as is illustrated above, they had the dexamethasone potency wrong from the start, and therefore whenever they have had to consider it since as an realistic treatment for children with CAH, they have been avoiding it because it was used at that potency above and therfore deemed unsuitable.  Rather a big boo boo really I think.   A HCT dose of 15mg is more like a dex dose of 00.18mg and so therefore a HCT dose of 20mg will not be anywhere near to a dex dose of 00.75mg which it states above.

 

JH