Hydrocortisone
Brand names Colifoam, Corlan, Dioderm, Efcorteian, Efcortesol, Hydrocortistab, Hydrocortisyl, Hydrocortone, Solu-Cortef
Used in the following combined preparations Alphaderm, Tarcortin, Xyloproct, and many others
GENERAL INFORMATION
Hydrocortisone is chemically identical to the hormone Cortisol, which is produced by the adrenal glands. For this reason, the drug is prescribed to replace natural hormones in adrenal insufficiency (Addison’s disease).
The main use of hydrocortisone is in the treatment of a variety of allergic and inflammatory conditions. Used in topical preparations, it provides prompt relief from inflammation of the skin, eye, and outer ear. Hydrocortisone is used in oral form to relieve asthma, inflammatory bowel disease, and many rheumatic and allergic disorders. Injected directly into the joints, the drug relieves pain and stiffness. Injections may also be given to relieve severe attacks of asthma.
Overuse of skin preparations with hydrocortisone can lead to permanent thinning of the skin. Taken by mouth, long-term treatment with high doses may cause serious side effects.
INFORMATION FOR USERS
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
How taken
Tablets, lozenges, injection, rectal foam, cream, ointment, eye ointment/drops.
Frequency and timing of doses
Varies according to condition.
Dosage range
Varies according to condition.
Onset of effect
Within 1-4 days.
Duration of action
Up to 12 hours.
Diet advice
Salt intake may need to be restricted when the drug is taken by mouth. It may also be necessary to take potassium supplements.
Quick Reference
Drug group Corticosteroid
Overdose danger rating Low
Dependence rating Low
Prescription needed Yes (except for some topical preparations)
Available as generic Yes
Storage
Keep in a closed container in a cool, dry place out of the reach of children.
Missed dose
Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.
Stopping the drug
Do not stop taking the drug without consulting your doctor. A gradual reduction in dosage is required following prolonged treatment with oral hydrocortisone.
Exceeding the dose
An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.
POSSIBLE ADVERSE EFFECTS
The most serious adverse effects only occur when hydrocortisone is taken by mouth in
high doses for long periods of time. These are carefully monitored during treatment.
INTERACTIONS (by mouth only)
Barbiturates, anticonvulsants, and rifampicin Those drugs reduce the effectiveness of hydrocortisone.
Antidiabetic drugs
Hydrocortisone reduces the action of these drugs.
Antihypertensive drugs
Hydrocortisone reduces the effects of these drugs.
Vaccines
Severe reactions can occur if this drug is taken with certain vaccines.
SPECIAL PRECAUTIONS
Be sure to tell your doctor if:
You have had a peptic ulcer.
You have suffered from depression or a mental illness, or epilepsy.
You have glaucoma.
You have had tuberculosis.
You have diabetes.
You are taking other medications.
Avoid exposure to chickenpox or shingles if you are on systemic treatment.
Pregnancy
No evidence of risk with topical preparations. Oral doses may adversely affect the developing baby. Discuss with your doctor.
Breast-feeding
The drug passes into the breast milk and may affect the baby. Discuss with your doctor.
Infants and children
Reduced dose necessary.
Over 60
Reduced dose may be necessary.
Driving and hazardous work
No special problems.
Alcohol
Avoid. Alcohol may increase the risk of peptic ulcer when this drug is taken by mouth.
PROLONGED USE
Depending on method of administration, prolonged high dosage may cause diabetes, glaucoma, fragile bones, and thin skin, and may retard growth in children. People on long-term treatment are advised to carry a treatment card.
Monitoring
Periodic checks on blood pressure are usually required when the drug is taken by mouth.
