From the Guidelines
Hydrocortisone is a steroid hormone medication that mimics the effects of cortisol, a natural hormone produced by the adrenal glands, and is commonly used to treat adrenal insufficiency, with a recommended daily dose of 15–25 mg in split doses for most patients with primary adrenal insufficiency 1.
Definition and Uses
Hydrocortisone is used to treat various conditions, including inflammatory conditions, allergic reactions, autoimmune disorders, and adrenal insufficiency. It comes in various forms, including oral tablets, topical creams and ointments, injectable solutions, and rectal preparations.
Dosage
For patients with primary adrenal insufficiency, the recommended dose is 15–25 mg of hydrocortisone daily in split doses, with the first dose immediately after waking and the last dose not less than 6 hours before bedtime 1. In children, the dose is 6–10 mg/m2 of body surface area.
Administration and Monitoring
Patients with adrenal insufficiency should wear Medic Alert identification jewelry and carry a steroid/alert card, and should receive sufficient education to manage daily medications and situations of minor to moderate concurrent illnesses 1. They should also be reviewed at least annually, with assessment of health and well-being, measurement of weight, blood pressure, and serum electrolytes.
Treatment of Adrenal Crisis
In cases of adrenal crisis, hydrocortisone should be administered immediately, with an initial dose of 100 mg iv or im, followed by 100 mg 6–8 hourly until recovered 1. Isotonic sodium chloride solution should also be administered, at an initial rate of 1 L/h until haemodynamic improvement.
From the FDA Drug Label
ACTIONS Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states. DESCRIPTION Hydrocortisone Tablets, USP contain hydrocortisone which is a glucocorticoid. Hydrocortisone is a glucocorticoid, which is a type of adrenocortical steroid. It is a naturally occurring steroid with anti-inflammatory effects and is used for replacement therapy in adrenocortical deficiency states 2. The chemical name for hydrocortisone is pregn-4-ene-3,20-dione,11,17,21-trihydroxy-,(11β)- 2.
- Key points:
- Hydrocortisone is a glucocorticoid
- It is used for replacement therapy in adrenocortical deficiency states
- It has anti-inflammatory effects
- Chemical name: pregn-4-ene-3,20-dione,11,17,21-trihydroxy-,(11β)-
From the Research
Definition of Hydrocortisone
- Hydrocortisone is a type of corticosteroid, which is a class of medications that are used to treat various conditions, including allergic reactions and inflammatory diseases 3.
- It is one of the most commonly implicated corticosteroids in allergic-type reactions, along with methylprednisolone 3.
Uses of Hydrocortisone
- Hydrocortisone is used to treat a range of conditions, including eczema, asthma, and allergic reactions 4, 5, 6.
- It can be administered topically, orally, or via injection, and is often used to reduce inflammation and suppress the immune system 5, 3.
Hypersensitivity Reactions to Hydrocortisone
- Hypersensitivity reactions to hydrocortisone can occur, and can range from mild to severe 5, 3, 7.
- These reactions can be immediate or delayed, and can manifest as symptoms such as rash, sneezing, dyspnea, edema, bronchospasm, or anaphylaxis 5, 3, 7.
- The prevalence of hypersensitivity reactions to hydrocortisone is estimated to be around 0.3-0.5% 5.
Diagnosis and Treatment of Hypersensitivity Reactions
- Diagnosis of hypersensitivity reactions to hydrocortisone can be challenging, and requires a high index of suspicion 7.
- Prick and intradermal skin tests can be used to diagnose immediate hypersensitivity reactions, while patch tests can be used to diagnose delayed hypersensitivity reactions 7.
- Treatment of hypersensitivity reactions to hydrocortisone typically involves discontinuing the use of the medication and administering an alternative corticosteroid agent 7.