Hydrocortisone

Brand Name(s): Alkindi Sprinkle®, Cortef®, Cortril®, Hydrocortone®; also available generically

Cortisol

WHY is this medicine prescribed?

Hydrocortisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Hydrocortisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys, blood, thyroid, stomach, and intestines. It is also sometimes used to treat the symptoms of certain types of cancer. Hydrocortisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.

HOW should this medicine be used?

Hydrocortisone comes as a tablet and granules to take by mouth. If you are taking the tablets, your doctor will prescribe a dosing schedule that is best for you. Hydrocortisone granules come in capsules and are usually taken 2 or 3 times a day. Hydrocortisone may be taken with food or milk to prevent stomach upset. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydrocortisone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

To take the granules, open the capsule(s) and either pour all of the granules directly from the capsule(s) into your child's mouth or pour the granules onto a clean spoon and place the spoonful of medication in your child's mouth. You can also pour all of the granules from the capsule(s) onto a spoonful of cold or room temperature soft food such as yogurt or a fruit-based soft food, such as applesauce. Swallow the granules or the mixture of soft food and granules right away (within 5 minutes) without chewing or crushing the granules. Take several sips of liquid such as water, formula, or breast milk right away to be sure that any leftover granules have been swallowed. Do not swallow the capsules that contain the granules.

If your child vomits or spits up after taking a dose of hydrocortisone granules, call your doctor right away. Your doctor will tell you if you need to give your child another dose. Do not give another dose unless your doctor tells you to do so.

Your doctor may change your dose of hydrocortisone often during your treatment to be sure that you are always taking the lowest dose that works for you. Your doctor may also need to change your dose if you experience unusual stress on your body such as surgery, illness, or infection. Tell your doctor if your symptoms improve or get worse or if you get sick or have any changes in your health during your treatment.

Hydrocortisone may help control your condition but may not cure it. Continue to take hydrocortisone even if you feel well. Do not stop taking hydrocortisone without talking to your doctor. If you suddenly stop taking hydrocortisone, your body may not have enough natural steroids to function normally. This may cause extreme tiredness, weakness, loss of appetite, weight loss, an upset stomach, vomiting, drowsiness, joint and muscle pain, changes in skin color, and craving for salt. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. If these problems occur, call your doctor immediately. You may need to increase your dose of hydrocortisone temporarily or start taking it again.

Are there OTHER USES for this medicine?

Hydrocortisone is also sometimes used with other medications for the treatment of serious complications from coronavirus disease 2019 (COVID-19). Talk to your doctor about the risks of using this drug for your condition.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking hydrocortisone,

The following nonprescription or herbal products may interact with hydrocortisone: aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking hydrocortisone. Do not start these medications while taking hydrocortisone without discussing it with your healthcare provider.

tell your doctor and pharmacist if you are allergic to hydrocortisone, any other medications, or any of the ingredients in hydrocortisone tablets or granules. Ask your pharmacist for a list of the ingredients.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
if you have a fungal infection (other than on your skin), do not take hydrocortisone without talking to your doctor.
tell your doctor if you have or have ever had high blood pressure; depression or other mental illness; myasthenia gravis (a condition in which the muscles become weak); osteoporosis (a condition in which the bones become thin and weak and break easily); threadworms (a type of worm that can live inside the body); seizures; tuberculosis (TB; a serious lung infection); stomach ulcers; cataracts (clouding of the lens of the eye), glaucoma (an eye disease), or other eye problems; or liver, kidney, intestinal, heart, or thyroid disease. Also tell your doctor if you have any type of untreated infection anywhere in your body or a herpes eye infection (a type of infection that causes a sore on the eyelid or eye surface).
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking hydrocortisone, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking hydrocortisone.
tell your doctor if you have never had chicken pox or measles and you have not been vaccinated against these infections. Stay away from people who are sick, especially people who have chicken pox or measles. If you are exposed to one of these infections or if you develop symptoms of one of these infections, call your doctor right away. You may need treatment to protect you from these infections.

What SPECIAL DIETARY instructions should I follow?

Your doctor may instruct you to follow a low-salt, high-potassium, or high-calcium diet. Follow these directions.

Talk to your doctor about eating grapefruit and drinking grapefruit juice while you are taking this medication.

What should I do IF I FORGET to take a dose?

When you start to take hydrocortisone, ask your doctor what to do if you forget a dose. Write down these instructions so that you can refer to them later. Call your doctor or pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make up for a missed dose.

What SIDE EFFECTS can this medicine cause?

Hydrocortisone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

nausea
headache
dizziness
insomnia
acne
irregular or absent menstrual periods

If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

rash; hives; itching; swelling of the eyes, face, lips, mouth, throat, or tongue; or difficulty breathing or swallowing
vomiting
diarrhea
sudden weight gain
muscle weakness
unusual bruising
swollen face, lower legs, or ankles
depression
hallucinations (seeing things or hearing voices that do not exist)
mania (frenzied or abnormally excited mood)
eye pain, redness, or tearing; blurred vision; or other vision problems
sore throat, fever, chills, cough, or other signs of infection
stomach pain
difficult or painful urination
seizures

Hydrocortisone may slow growth and development in children. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor about the risks of giving hydrocortisone to your child.

Hydrocortisone may increase the risk that you will develop osteoporosis. Talk to your doctor about the risks of taking hydrocortisone and about things that you can do to decrease the chance that you will develop osteoporosis.

Some patients who took hydrocortisone or similar medications developed a type of cancer called Kaposi's sarcoma. Talk to your doctor about the risks of taking hydrocortisone.

Hydrocortisone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to hydrocortisone.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: March 15, 2023.