What is the recommended hydrocortisone (cortisol) dose per kilogram?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 30, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The recommended hydrocortisone dose per kg is 2–6 mg/kg intravenously, as indicated by the most recent and highest quality study available 1.

Key Considerations

  • The dose of hydrocortisone can vary depending on the specific condition being treated and the patient's response to the medication.
  • In pediatric patients, the dose is typically higher than in adults, with a range of 2–6 mg/kg intravenously 1.
  • It is essential to adjust the dose based on clinical response and to monitor for potential side effects, such as gastrointestinal issues.

Administration and Monitoring

  • Hydrocortisone should be administered intravenously in a controlled medical setting, with close monitoring of the patient's vital signs and response to the medication.
  • The medication can be given in divided doses, with the exact schedule depending on the specific condition being treated and the patient's individual needs.
  • Patients should be educated on the importance of taking the medication as directed and not abruptly discontinuing use, as this can lead to adrenal crisis.

Comparison with Other Studies

  • While other studies, such as 1, provide dosing information for hydrocortisone, the study by 1 is the most relevant and highest quality, providing a clear recommendation for the dose per kg.
  • The dose range of 2–6 mg/kg intravenously is consistent with the principles of minimizing morbidity, mortality, and improving quality of life, and is therefore the recommended dose.

From the Research

Hydrocortisone Dose per kg

  • The provided studies do not directly address the hydrocortisone dose per kg, but rather discuss the risks of adrenal insufficiency associated with corticosteroid use 2, 3, 4, 5, 6.
  • Study 6 mentions the correlation between morning serum cortisol and OCS exposure (mg/kg prednisolone) as well as ICS exposure (mg/kg fluticasone propionate), but does not provide a specific dose per kg.
  • The studies focus on the management of corticosteroid-related comorbidities, adrenal insufficiency, and the need for steroid-sparing treatment in adult severe asthma 3, 4.
  • They also discuss the risk of adrenal insufficiency associated with inhaled corticosteroids and the importance of screening for adrenal insufficiency in select patient groups 5, 6.
  • However, none of the studies provide a specific hydrocortisone dose per kg, highlighting the need for further research on this topic.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.