Generic
Hydrocortisone
18 brands available in the market
At a glance
Hydrocortisone is a corticosteroid used for severe allergic reactions, allergic conditions, cancer, skin and eye disorders, and adrenal insufficiency.
Description
Hydrocortisone belongs to a group of medicines called corticosteroids. It works by blocking the production of certain chemical messengers in the body that cause inflammation (redness and swelling) and allergies. It is used for primary or secondary adrenocortical insufficiency, acute adrenocortical insufficiency, shock, congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis, rheumatic disorders, dermatologic diseases, severe allergic conditions, ophthalmic diseases, gastrointestinal diseases, hematologic disorders, and neoplastic diseases.
Indications
- Primary or secondary adrenocortical insufficiency
- Acute adrenocortical insufficiency
- Shock unresponsive to conventional therapy
- Congenital adrenal hyperplasia
- Hypercalcemia associated with cancer
- Nonsuppurative thyroiditis
- Rheumatic Disorders
- Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
- Severe allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Allergic rhinitis, Drug hypersensitivity, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
- Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, Iridocyclitis, Chorioretinitis, Diffuse posterior uveitis, Optic neuritis)
- Gastrointestinal Diseases
- Hematologic Disorders (Autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura, Secondary thrombocytopenia, Erythroblastopenia)
- Neoplastic Diseases (Leukemias and lymphomas, Acute leukemia of childhood)
- Edematous States
- Acute exacerbations of multiple sclerosis
Therapeutic class
Glucocorticoids
Pharmacological class
Corticosteroid
Pharmacology
Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. It reduces various vasoactive agents released during inflammation and controls the rate of protein synthesis. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability.
Mechanism of action
Hydrocortisone suppresses migration of polymorphonuclear leukocytes and reverses increased capillary permeability to reduce inflammation and provide immunosuppressive effects.
Dosage
Adult Dose (Oral):
- Initial dosage: 20-240 mg daily depending on disease
- Replacement therapy in adrenocortical insufficiency: 20-30 mg daily in 2 divided doses
Adult Dose (Injection):
- Acute adrenocortical insufficiency: 100-500 mg 3-4 times/24 hr
- Supplement during anesthesia: 25-50 mg at induction
- Status Asthmaticus: 1-2 mg/kg IV q6hr for 24 hr; maintenance: 0.5-1 mg/kg q6hr
- Intra-articular: 5-50 mg depending on joint size
Child Dose (Injection):
- Acute adrenocortical insufficiency: <1 yr: 25 mg; 1-5 yr: 50 mg; 6-12 yr: 100 mg
- Status Asthmaticus: 1-2 mg/kg IV q6hr for 24 hr; not to exceed 250 mg IV; maintenance: 2 mg/kg/day IV divided q6hr
Administration
Take with food (to avoid upset stomach); swallow the whole tablet; administered as IM injection or slow IV injection/infusion.
Missed dose
If you miss a dose, take it as soon as possible; if it is almost time for your next dose, skip the missed dose and follow regular schedule; do not double the dose.
Side effects
Common Side Effects:
- Ankle swelling
- Dizziness
- Headache
- Weakness
With prolonged high doses:
- Cardiac arrhythmia
- Esophageal candidiasis
- Menstrual irregularity
- Decreased carbohydrate & glucose tolerance
- Fluid retention
- Weight gain
- Euphoria, mood swings, depression, insomnia, acne
Precautions & warnings
Precautions:
- Caution in history of peptic ulceration (increases incidence of peptic ulceration)
- Caution in congestive heart failure, hypertension, glaucoma, diabetes mellitus and epilepsy
- Tell doctor if you have signs of infection (fever or sore throat)
- Do not stop suddenly without talking to your doctor (may worsen symptoms)
- Withdraw gradually after long-term therapy
Contraindications
Contraindications:
- Severe systemic fungal infections
- Hypersensitivity to any component
- Viral/fungal infections, tubercular or syphilitic lesions (unless with appropriate chemotherapy)
Drug interactions
Drug Interactions:
- Thiazides: May enhance hyperglycaemia and hypokalaemia
- NSAIDs: Increased incidence of peptic ulcer or GI bleeding
- Anticoagulants: Response altered
- Antidiabetics and antihypertensives: Dose needs to be increased
- Carbamazepine, phenytoin, primidone, barbiturates, rifampicin: Reduced efficacy of corticosteroids
- Ciclosporin: Increased plasma concentration of both drugs
- Oestrogens or oral contraceptives: Enhanced effect
Food interactions
Food Interactions: Caution is advised when consuming alcohol with Hydrocortisone; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies have shown harmful effects; use only if absolutely required.
Use in lactation
Use in Lactation: Safe during breastfeeding; does not pass into breastmilk in significant amount and is not harmful to baby.
Pediatric use
Pediatric Use: Replacement therapy: 400-800 mcg/kg/day in 2-3 divided doses. Acute adrenocortical insufficiency: <1 yr: 25 mg; 1-5 yr: 50 mg; 6-12 yr: 100 mg.
Geriatric use
No specific dosage adjustment needed for elderly; however caution is advised.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment recommended.
Hepatic Impairment: Limited information available; consult your doctor.
Overdose effects
Overdose: Acute toxicity from corticosteroid overdose is rare; chronic overdose may cause Cushing's syndrome; symptomatic treatment.
Storage conditions
Store below 30°C temperature, away from light & moisture; keep out of reach of children.
Chemical structure
Hydrocortisone