From the Guidelines
Hydrocortisone can cause several serious side effects, including hypertension, hyperglycemia, sleep and mood disturbances, gastric irritation or ulcer formation, glaucoma, myopathy, and osteoporosis, which can significantly impact a patient's quality of life and increase morbidity and mortality risk. When used as a medication, hydrocortisone can lead to various side effects due to its corticosteroid properties, which mimic the effects of cortisol, a natural hormone regulating metabolism, immune response, and stress reaction. Common side effects include:
- Increased appetite
- Weight gain
- Fluid retention
- Mood changes
- Insomnia
- Elevated blood sugar levels
- Skin thinning
- Easy bruising
- Acne
- Delayed wound healing As noted in the American Society of Hematology 2019 guidelines for immune thrombocytopenia 1, it is essential to monitor patients closely for these potential side effects, regardless of the duration or type of corticosteroid selected. Additionally, a study published in Otolaryngology--head and neck surgery 1 highlights the importance of being aware of the potential side effects of systemic corticosteroid therapy, including acne, blurred vision, cataracts or glaucoma, easy bruising, insomnia, hypertension, increased appetite, weight gain, and osteoporosis. Given the potential impact of corticosteroids on mental health, a thorough assessment of health-related quality of life (HRQoL) is crucial while patients are receiving corticosteroids 1.
From the FDA Drug Label
WARNINGS General Rare instances of anaphylactoid reactions have occurred in patients receiving corticosteroid therapy Cardio-Renal Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. Endocrine Corticosteroids can produce reversible hypothalamic-pituitary adrenal (HPA) axis suppression with the potential for corticosteroid insufficiency after withdrawal of treatment. Immunosuppression and Increased Risk of Infection Corticosteroids, including prednisone tablets, suppress the immune system and increase the risk of infection with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic pathogens Corticosteroids can: • Reduce resistance to new infections • Exacerbate existing infections • Increase the risk of disseminated infections • Increase the risk of reactivation or exacerbation of latent infections • Mask some signs of infection
The side effects of hydrocortisone (corticosteroid) include:
- Anaphylactoid reactions
- Elevation of blood pressure
- Salt and water retention
- Increased excretion of potassium
- Reversible hypothalamic-pituitary adrenal (HPA) axis suppression
- Immunosuppression and increased risk of infection 2
From the Research
Side Effects of Hydrocortisone (Corticosteroid)
- Common side effects of long-term treatment with corticosteroids include:
- Psychiatric and cognitive changes during corticosteroid therapy, such as:
- Other possible side effects of systemic glucocorticoid treatment:
- The development of Cushing's Syndrome (CS), adrenal insufficiency, and osteoporosis in patients using topical corticosteroids depends on the weekly dosage, with a higher risk when exceeding 50 grams per week 5
- Side effects of hydrocortisone can be dose-dependent and may occur during the first few weeks of therapy 3, 4