Hydrocortisone

What is Hydrocortisone?

• Hydrocortisone (Cortef; Cortril; Hydrocortone) is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract.
• It is similar to a natural hormone produced by your adrenal glands.
• It is often used to replace this chemical when your body does not make enough of it.

Cortisol2

Cortisol-3D-balls

What are the uses of this medicine?

• Hydrocortisone (Cortef; Cortril; Hydrocortone) tablets are used in the following conditions:

Endocrine Disorders:

• Primary or secondary adrenocortical insufficiency
• Congenital adrenal hyperplasia
• Non suppurative thyroiditis
• Hypercalcemia associated with cancer

Rheumatic Disorders: As adjunctive therapy for short-term administration in:

• Psoriatic arthritis
• Rheumatoid arthritis, including juvenile rheumatoid arthritis
• Ankylosing spondylitis
• Acute and subacute bursitis
• Acute nonspecific tenosynovitis
• Acute gouty arthritis
• Post-traumatic osteoarthritis
• Synovitis of osteoarthritis
• Epicondylitis

Collagen Diseases:

• Systemic lupus erythematosus
• Systemic dermatomyositis (polymyositis)
• Acute rheumatic carditis

Dermatologic Diseases:

• Pemphigus
• Bullous dermatitis herpetiformis
• Severe erythema multiforme (Stevens-Johnson syndrome)
• Exfoliative dermatitis
• Mycosis fungoides
• Severe psoriasis
• Severe seborrheic dermatitis

Allergic States:

• Seasonal or perennial allergic rhinitis
• Serum sickness
• Bronchial asthma
• Contact dermatitis
• Atopic dermatitis
• Drug hypersensitivity reactions

Ophthalmic Diseases:

• Allergic conjunctivitis
• Keratitis
• Allergic corneal marginal ulcers
• Herpes zoster ophthalmicus
• Iritis and iridocyclitis
• Chorioretinitis
• Anterior segment inflammation
• Diffuse posterior uveitis and choroiditis
• Optic neuritis
• Sympathetic ophthalmia

Respiratory Diseases:

• Symptomatic sarcoidosis
• Loeffler's syndrome not manageable by other means
• Berylliosis
• Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
• Aspiration pneumonitis

Hematologic Disorders:

• Idiopathic thrombocytopenic purpura in adults
• Secondary thrombocytopenia in adults
• Acquired (autoimmune) hemolytic anemia
• Erythroblastopenia (RBC anemia)
• Congenital hypoplastic anemia

Neoplastic Diseases: For palliative management of:

• Leukemias and lymphomas in adults
• Acute leukemia of childhood

• To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.

Gastrointestinal Diseases: To tide the patient over a critical period of the disease in:

• Ulcerative colitis
• Regional enteritis

Miscellaneous:

• Tuberculous meningitis with subarachnoid block or impending block.
• Trichinosis with neurologic or myocardial involvement.

How does this medicine work?

• Hydrocortisone has both glucocorticoid and mineralocorticoid properties.
• Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states.
• Their synthetic analogs are primarily used for their potent anti-inflammatory effects in disorders of many organ systems.
• Glucocorticoids cause profound and varied metabolic effects.
• In addition, they modify the body's immune responses to diverse stimuli.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• Systemic fungal infections
• known hypersensitivity to components

What drug interactions can this medicine cause?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention any of the following:

• anticoagulants ('blood thinners') such as warfarin (Coumadin)
• arthritis medication
• aspirin
• cyclosporine (Neoral, Sandimmune)
• digoxin (Lanoxin)
• diuretics ('water pills')
• estrogen (Premarin)
• ketoconazole (Nizoral)
• oral contraceptives
• phenobarbital
• phenytoin (Dilantin)
• rifampin (Rifadin)
• theophylline (Theo-Dur)

Is this medicine FDA approved?

• Hydrocortisone was patented in 1936 and approved for medical use in 1941.

How should this medicine be used?

Recommended dosage:

• The initial dosage of hydrocortisone tablets may vary from 20 mg to 240 mg of hydrocortisone per day depending on the specific disease entity being treated.
• The initial dosage should be maintained or adjusted until a satisfactory response is noted.

Administration:

• Hydrocortisone comes as a tablet and suspension to be taken by mouth.
• Take hydrocortisone exactly as directed.
• Do not take more or less of it or take it more often than prescribed by your doctor.
• Do not stop taking hydrocortisone without talking to your doctor.
• Stopping the drug abruptly can cause loss of appetite, an upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss.
• If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As a tablet and suspension

This medicine is available in fallowing brand namesː

• Cortef; Cortril; Hydrocortone

What side effects can this medication cause?

The most common side effects of this medicine include:

• upset stomach
• stomach irritation
• vomiting
• headache
• dizziness
• insomnia
• easy bruising
• irregular or absent menstrual periods
• anxiety
• acne
• restlessness
• depression
• increased hair growth

What special precautions should I follow?

• In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is required.
• Corticosteroids may mask some signs of infection, and new infections may appear during their use.
• Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.
• Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.
• There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
• Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
• The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
• Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations.
• Steroids should be used with caution in nonspecific ulcerative colitis.
• Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
• Kaposi's sarcoma has been reported to occur in patients receiving corticosteroid therapy. Discontinuation of corticosteroids may result in clinical remission.
• Pheochromocytoma crisis, which can be fatal, has been reported after administration of systemic corticosteroids. In patients with suspected pheochromocytoma, consider the risk of pheochromocytoma crisis prior to administering corticosteroids.
• Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay.
• Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered to patients receiving immunosuppressive doses of corticosteroids.

What to do in case of emergency/overdose?

In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.

Can this medicine be used in children?

• Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.

What are the active and inactive ingredients in this medicine?

Active ingredients:

• HYDROCORTISONE

Inactive Ingredients:

• SILICON DIOXIDE
• LACTOSE MONOHYDRATE
• MAGNESIUM STEARATE
• MICROCRYSTALLINE CELLULOSE

Who manufactures and distributes this medicine?

Distributed by:

• American Health Packaging
• Columbus, OH

What should I know about storage and disposal of this medication?

• Store at 20° to 25°C (68° to 77°F).

• Dailymed label info on Hydrocortisone
• FDA Hydrocortisone

Hydrocortisone Resources
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