Skip to main content

Immunosuppression and Steroid Conversion Tool

About this Calculator

Welcome to the Transplant Medication Converter - a precision tool designed for healthcare professionals to calculate equivalent doses across critical immunosuppressive medications.

Mycophenolate

  • CellCept/MMF to Myfortic/MPA
  • IV to PO conversions

Calcineurin Inhibitors

  • Tacrolimus formulations
  • Cyclosporine IV/PO
  • CNI cross-conversions

Corticosteroids

  • Prednisone to Methylprednisolone
  • Hydrocortisone to Dexamethasone
  • All steroid equivalencies
View Conversion Matrix
Daily Dose Entry: Enter the total daily dose for accurate conversion. Results show equivalent daily doses that can be divided according to standard schedules.
Safety Alert: When converting between cyclosporine and tacrolimus formulations, therapeutic drug monitoring within 3-7 days is essential, especially when using IV.

Drug Conversion Matrix

Multiply the source drug amount by the conversion factor to get the target drug amount

From ↓ / To → MMF PO
(CellCept)		 MMF IV
(CellCept)		 Myfortic PO CSA PO CSA IV
(SMH ×25 protocol)		 Envarsus Advagraf Prograf
(total daily)		 Prednisone PO MePred IV HCort IV Dexameth
MMF PO 1 1.0 0.72
MMF IV 1.0 1 0.72
Myfortic PO 1.389 1.389 1
CSA PO 1 0.333
CSA IV 3.0 1
Envarsus 35.714 1 1.43 1.43
Advagraf 30 25 0.7 1 1.0
Prograf
(total daily)		 30 25 0.7 1.0 1
Prednisone PO 1 0.8 4.0 0.15
MePred IV 1.25 1 5.0 0.1875
HCort IV 0.25 0.2 1 0.0375
Dexameth 6.67 4.8–5.3 25–30 1

Legend:

  • MMF = Mycophenolate Mofetil (CellCept)
  • CSA = Cyclosporine
  • Pred = Prednisone
  • MePred IV = Methylprednisolone IV
  • HCort IV = Hydrocortisone IV
  • Dex = Dexamethasone
mg
Total daily dose: 0 mg/day

References

Immunosuppression Guidelines

  • Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. "KDIGO clinical practice guideline for the care of kidney transplant recipients." American Journal of Transplantation 9 (2009): S1-S155.
  • The International Society for Heart and Lung Transplantation Guidelines. "The International Society for Heart and Lung Transplantation Guidelines for the care of heart transplant recipients." The Journal of Heart and Lung Transplantation 29.8 (2010): 914-956.

Mycophenolate Conversions

  • Staatz, C.E., and S.E. Tett. "Clinical pharmacokinetics and pharmacodynamics of mycophenolate in solid organ transplant recipients." Clinical Pharmacokinetics 46.1 (2007): 13-58.
  • van Gelder, T., et al. "Comparison of the effects of tacrolimus and cyclosporine on the pharmacokinetics of mycophenolic acid." Therapeutic Drug Monitoring 23.2 (2001): 119-128.

Calcineurin Inhibitor Conversions

  • Alloway, R., et al. "Conversion of stable kidney transplant recipients from a twice daily Prograf-based regimen to a once daily modified release tacrolimus-based regimen." Transplantation Proceedings 37.2 (2005): 867-870.
  • Gaber, A.O., et al. "Conversion from twice-daily tacrolimus capsules to once-daily extended-release tacrolimus (LCPT): a phase 2 trial of stable renal transplant recipients." Transplantation 96.2 (2013): 191-197.

Corticosteroid Equivalencies

  • Liu, D., et al. "A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy." Allergy, Asthma & Clinical Immunology 9.1 (2013): 1-25.
  • Meikle, A.W., and F.H. Tyler. "Potency and duration of action of glucocorticoids: effects of hydrocortisone, prednisone and dexamethasone on human pituitary-adrenal function." The American Journal of Medicine 63.2 (1977): 200-207.

Supporting References

Drug Monitoring Guidelines

  • Wallemacq, P., et al. "Opportunities to optimize tacrolimus therapy in solid organ transplantation: report of the European consensus conference." Therapeutic Drug Monitoring 31.2 (2009): 139-152.
  • Brunet, M., et al. "Therapeutic drug monitoring of tacrolimus-personalized therapy: second consensus report." Therapeutic Drug Monitoring 41.3 (2019): 261-307.

Clinical Practice Guidelines

  • European Association for the Study of the Liver. "EASL Clinical Practice Guidelines: Liver transplantation." Journal of Hepatology 64.2 (2016): 433-485.
  • Baker, R.J., et al. "Renal Association Clinical Practice Guideline in Post-Operative Care in the Kidney Transplant Recipient." BMC Nephrology 18.1 (2017): 174.

Safety Considerations

  • Harrison, J.J., et al. "A systematic review of immunosuppressant medication errors in solid organ transplant recipients." Canadian Journal of Hospital Pharmacy 65.5 (2012): 381.
  • Staatz, C.E., and S.E. Tett. "Clinical pharmacokinetics of once-daily tacrolimus in solid-organ transplant patients." Clinical Pharmacokinetics 54.10 (2015): 993-1025.

Pharmacokinetic Studies

  • van Gelder, T. "Drug interactions with tacrolimus." Drug Safety 25.10 (2002): 707-712.
  • Vanhove, T., et al. "Clinical determinants of calcineurin inhibitor disposition: a mechanistic review." Drug Metabolism Reviews 48.1 (2016): 88-112.
ukidneyisup