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Hydrocortisone is a steroid medicine that is used in the treatment of many different conditions, including allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, multiple sclerosis, or lung disorders.
Hydrocortisone is also used to replace steroids in people with adrenal insufficiency (decreased production of natural steroids by the adrenal glands).
Hydrocortisone affects your immune system and is often used to treat certain blood cell disorders such as anemia (low red blood cells) or thrombocytopenia (low platelets).
Hydrocortisone is also used in the treatment of certain cancers such as leukemia, lymphoma, and multiple myeloma.
Hydrocortisone may also be used for purposes not listed in this medication guide.
You should not use hydrocortisone if you have a fungal infection anywhere in your body.
Tell your doctor about any illness or infection you have had within the past several weeks.
You should not use hydrocortisone if you are allergic to it, or if you have a fungal infection anywhere in your body.
Steroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.
Tell your doctor if you have ever had:
heart disease, high blood pressure;
tuberculosis;
kidney disease;
cirrhosis or other liver disease;
a thyroid disorder;
low bone mineral density (osteoporosis);
stomach ulcers, ulcerative colitis, diverticulitis;
diabetes;
a colostomy or ileostomy;
depression or mental illness;
glaucoma or cataracts;
herpes infection of the eyes; or
a muscle disorder such as myasthenia gravis.
Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis.
It is not known whether hydrocortisone will harm an unborn baby. However, using this medicine during pregnancy may cause a hormone deficiency in the newborn. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breast-feed while using hydrocortisone.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Take with food if hydrocortisone upsets your stomach.
If you have trouble sleeping, you may need to take this medicine early in the day. Follow your doctor's dosing instructions very carefully.
Your dose needs may change if you have a serious illness, fever or infection, surgery or a medical emergency. Tell your doctor about any such situation that affects you.
Your doctor will need to check your progress on a regular basis.
You should not stop taking hydrocortisone suddenly. Follow your doctor's instructions about tapering your dose.
Store at room temperature away from moisture, heat, and light.
In case of emergency, wear or carry medical identification to let others know you use steroid medication.
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
An overdose of hydrocortisone is not expected to produce life threatening symptoms. Long term use of high doses can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
Do not receive a "live" vaccine while using hydrocortisone. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using steroid medication.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
blurred vision, tunnel vision, eye pain, or seeing halos around lights;
muscle weakness, loss of muscle mass;
new or unusual pain in your joints, bones, or muscles;
severe headaches, ringing in your ears, pain behind your eyes;
unusual changes in mood or behavior;
a seizure;
fluid retention--shortness of breath (even while lying down), swelling, rapid weight gain (especially in your face and midsection);
new signs of infection--such as fever, chills, cough, trouble breathing, sores in your mouth or on your skin, diarrhea, or burning when you urinate;
increased adrenal gland hormones--slow wound healing, skin discoloration, thinning skin, increased body hair, tiredness, menstrual changes, sexual changes; or
decreased adrenal gland hormones--weakness, tiredness, diarrhea, nausea, menstrual changes, skin discoloration, craving salty foods, and feeling light-headed.
Hydrocortisone can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using hydrocortisone.
Common side effects may include:
thinning skin, bruising or discoloration;
increased sweating;
stomach bloating;
changes in your menstrual periods;
increased appetite, weight gain;
headache, dizziness; or
trouble sleeping.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your current medicines. Many drugs can affect hydrocortisone, especially:
birth control pills or hormone replacement therapy;
heart medication;
insulin or oral diabetes medicine;
medicine to treat an infection;
seizure medication;
a blood thinner such as warfarin (Coumadin, Jantoven); or
aspirin or an NSAID (nonsteroidal anti-inflammatory drug) such as ibuprofen, naproxen, celecoxib, indomethacin, Advil, Aleve, Motrin, and others.
This list is not complete and many other drugs may affect hydrocortisone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Hydrocortisone Valerate (www.drugs.com/mtm/hydrocortisone.html).
Applies to hydrocortisone: oral tablet
Other dosage forms:
Along with its needed effects, hydrocortisone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking hydrocortisone:
More common
Incidence not known
Some side effects of hydrocortisone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Incidence not known
Applies to hydrocortisone: compounding powder, injectable powder for injection, injectable solution, injectable suspension, oral suspension, oral tablet, rectal foam with applicator, rectal suspension
Corticosteroid side effects/complications are primarily dose and duration dependent; adverse effects are infrequent with physiologic or lower pharmacologic dosages. Short-term effects have included sodium retention-related weight gain and fluid accumulation, hyperglycemia/glucose intolerance, hypokalemia, and psychic disturbances. Long-term effects have included hypothalamus-pituitary-adrenal activity suppression, Cushingoid appearance, hirsutism, impotence, menstrual irregularities, peptic ulcer disease, cataracts and increased intraocular pressure/glaucoma, myopathy, osteoporosis, and vertebral compression fractures.
Frequency not reported: Bradycardia, cardiac arrest, cardia arrhythmias, cardiac enlargement, circulatory collapse, fat embolism, hypertension, congestive heart failure, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, thrombophlebitis, vasculitis, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis, necrotising angiitis
Frequency not reported: Hypothalamus-pituitary-adrenal activity has been suppressed up to 12 months following long-term corticosteroid administration, Cushingoid appearance with chronic therapy, hirsutism, virilism, impotence, menstrual irregularities, hypertrichosis, moon face, latent hyperparathyroidism, hypoparathyroidism
An antagonism occurs between the parathyroids and hypercorticism. Latent hyperparathyroidism may be unmasked by administration of corticosteroids; hypoparathyroidism may be manifest by phosphate retention occurring in renal failure caused by adrenal insufficiency.
Frequency not reported: Gastrointestinal upset, nausea, vomiting, peptic ulcer disease, pancreatitis, ulcerative esophagitis, abdominal distention, gastrointestinal perforation and hemorrhage, esophageal candidiasis
Rare (0.01% to 0.1%): Hypernatremia
Frequency not reported: Decreased glucose tolerance, hyperglycemia, hypokalemia, fluid retention, negative nitrogen balance due to protein catabolism, increased blood urea nitrogen concentration, sodium retention, hypokalemic alkalosis, increased appetite, weight gain, hypertriglyceridemia
Aseptic necrosis has been reported most often to affect the femoral head. Corticosteroid myopathy has presented as weakness and wasting of the proximal limb and girdle muscles and generally has been reversible following cessation of therapy.
Corticosteroids inhibit intestinal absorption and increase urinary excretion of calcium leading to bone resorption and bone loss. Postmenopausal females are at risk of loss of bone density. Sixteen percent of elderly patients treated with corticosteroids for 5 years may experience vertebral compression fractures.
Frequency not reported: Steroid myopathy, muscle weakness, loss of muscle mass, osteoporosis, vertebral compression fractures, tendon rupture (particularly the Achilles tendon), aseptic necrosis of bone, growth suppression in pediatric patients, Charcot-like arthropathy, post-injection flare (intra-articular use), osteonecrosis
Frequency not reported: Impairment in cell-mediated immunity, increased susceptibility to bacterial, viral, fungal and parasitic infections, immunosuppression, opportunistic infections from mild to fatal, reactivation of tuberculosis
Increases in serum transaminases and alkaline phosphatase have been observed with corticosteroid therapy; these laboratory changes are generally small, not associated with clinical symptoms, and are reversible upon discontinuation.
Frequency not reported: Reversible increases in serum transaminase and alkaline phosphatase concentrations, hepatomegaly
Corticosteroid therapy has been associated with a total increase in WBC; with an increase in neutrophils and a decrease in monocytes, lymphocytes, and eosinophils.
Frequency not reported: Leukocytosis
Frequency not reported: Increased ease in bruising, ecchymosis, petechiae, delayed wound healing, acne, thin fragile skin, facial erythema, increased sweating, suppress reaction to skin testing, allergic dermatitis, burning or tingling in the perineal area after IV injection, cutaneous and subcutaneous atrophy, edema, hyperpigmentation, hypopigmentation, erythema, sterile abscess, striae, thinning scalp hair, urticaria
Frequency not reported: Increased intraocular pressure, glaucoma, posterior subcapsular cataracts, exophthalmos, central serous chorioretinopathy, corneal or scleral thinning, exacerbation of ophthalmic viral disease
In adults, the incidence of severe psychic reactions has been estimated to be around 5% to 6%. Psychological effects have been reported on withdrawal of corticosteroids, although the incidence is unknown.
Frequency not reported: Psychoses, personality or behavioral changes, depression, emotional instability, euphoria, insomnia, mood swings, personality changes, psychic disorders, exacerbation of preexisting affect lability or psychotic behavior
Case reports of hypersensitivity reactions to corticosteroids have been relatively uncommon. Side effects have included bronchospasm, shock, urticaria, and angioedema. Cross-reactivity between aspirin and hydrocortisone in patients with aspirin-sensitive respiratory disease has been suggested as the mechanism in patients with asthma, however data are controversial. Anaphylaxis has been most frequently associated with rapid injection or infusion of a high dose of corticosteroid. Reactions may be mediated by an immune or nonimmune mechanism.
Bronchospasm after intravenous hydrocortisone has been reported in some patients with aspirin-sensitive respiratory disease. A challenge study with oral aspirin followed with 100 mg hydrocortisone (IV) resulted in respiratory reactions to aspirin in 45 of 53 patients. These 45 patients then received a hydrocortisone challenge. No naso-ocular, dermal, or respiratory reactions were noted in 44 of 45 patients administered hydrocortisone. One aspirin-sensitive patient experienced bronchospasm and naso-ocular reactions to hydrocortisone and naso-ocular with minimal bronchospasm with methylprednisolone. Following aspirin desensitization and while on maintenance aspirin therapy, this patient again reacted with similar symptoms to hydrocortisone.
Rare (0.01% to 0.1%): Hypersensitivity reaction (enema)
Frequency not reported: Anaphylaxis, anaphylactoid reaction, angioedema
Frequency not reported: Vertigo, abnormal fat deposits, malaise
Frequency not reported: Glycosuria, increased or decreased motility and number of spermatozoa
Frequency not reported: Convulsions, increased intracranial pressure with papilledema/pseudo-tumor cerebri (usually occurs after treatment), headache, neuritis, neuropathy, paresthesia, arachnoiditis, meningitis, paraparesis/paraplegia, sensory disturbances, epidural lipomatosis
Paresthesia, arachnoiditis, meningitis, paraparesis/paraplegia, and sensory disturbances have occurred after intrathecal administration. Intrathecal use is contraindicated and epidural administration is not recommended due to the occurrence of serious adverse events having been associated with these routes of administration.
Frequency not reported: Kaposi's sarcoma
Frequency not reported: Pulmonary edema, hiccups
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Hydrocortisone Valerate (www.drugs.com/mtm/hydrocortisone.html).
September 17, 2020
September 17, 2020
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