hydrocortisone injection (Solu-Cortef, A-Hydrocort)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is hydrocortisone acetate-injection, and how does it work (mechanism of action)?

Hydrocortisone is a corticosteroid (steroid medicine) that is used to treat inflammation due to a number of diseases and conditions. The medicine in hydrocortisone is similar to cortisol, a natural hormone produced by our adrenal glands. Corticosteroids have potent anti-inflammatory actions and also suppress the immune response. The FDA approved hydrocortisone injection in April, 1955.

What brand names are available for hydrocortisone acetate-injection?

Solu-Cortef, A-Hydrocort

Is hydrocortisone acetate-injection available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for hydrocortisone acetate-injection?

Yes

What are the side effects of hydrocortisone acetate-injection?

Side effects of corticosteroids include:

Hydrocortisone side effects depend on the dose, the duration and the frequency of administration. Short courses of hydrocortisone usually are well tolerated with few and mild side effects. Long term, high doses of hydrocortisone usually will produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of hydrocortisone should be used for the shortest possible length of time to minimize side effects.

Hydrocortisone and other corticosteroids can mask signs of infection and impair the body's natural immune response to infection. Patients on corticosteroids are more susceptible to infections, and can develop more serious infections than healthy individuals. For instance, chickenpox and measles viruses can produce serious and even fatal illnesses in patients on high doses of hydrocortisone. Live virus vaccines, such as the smallpox vaccine, should be avoided in patients taking high doses of hydrocortisone, since even vaccine viruses may cause disease in these patients.

Some infectious organisms, such as tuberculosis (TB) and malaria, can remain dormant in a patient for years. Hydrocortisone and other corticosteroids can reactivate dormant infections in these patients and cause serious illness. Patients with dormant TB may require anti-TB medications while undergoing prolonged corticosteroid treatment. Prolonged use of hydrocortisone can depress the ability of body's adrenal glands to produce corticosteroids. Abruptly stopping hydrocortisone in these individuals can cause symptoms of corticosteroid insufficiency, with accompanying nausea, vomiting, and even shock. Therefore, withdrawal of hydrocortisone is usually is gradually tapered. Gradually tapering hydrocortisone not only minimizes the symptoms of corticosteroid insufficiency, it also reduces the risk of an abrupt flare of the disease under treatment. The insufficient adrenal gland function may not recover fully for many months after stopping hydrocortisone. These patients need additional hydrocortisone treatment during periods of stress, such as surgery, to avoid symptoms of corticosteroid insufficiency and shock, while the adrenal gland is not responding by producing its own corticosteroid.

Hydrocortisone impairs calcium absorption and new bone formation. Patients on prolonged treatment with hydrocortisone and other corticosteroids can develop osteoporosis and an increased risk of bone fractures. Supplemental calcium and vitamin D are encouraged to slow this process of bone thinning. More aggressive treatment may be necessary if osteoporosis occurs.

In rare individuals, destruction of large joints (aseptic necrosis) can occur while undergoing treatment with hydrocortisone or other corticosteroids. These patients experience severe pain in the joints involved, and can require joint replacements. The reason behind such destruction is not clear.

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What is the dosage for hydrocortisone acetate-injection?

Hydrocortisone injection may be administered into a large muscle such as the buttock or hip, into a vein, or added to the intravenous (IV) fluid bag. Dosing varies and is based on the condition being treated. The intravenous or intramuscular injection dose range for adults is 100-500 mg given every 2, 4, or 6 hours as needed.

Is hydrocortisone acetate-injection safe to take if I'm pregnant or breastfeeding?

Birth defects including cleft palate, still birth, and premature abortion have been reported in some patients taking corticosteroids. Therefore, hydrocortisone injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

NURSING MOTHERS: Hydrocortisone is excreted into human milk and should be used with caution in nursing mothers.

What else should I know about hydrocortisone acetate-injection?

What preparations of hydrocortisone acetate-injection are available?

Powder for injection: 100, 250, 500, and 1000 mg

How should I keep hydrocortisone acetate-injection stored?

Unopened products should be stored at room temperature between 20 C to 25 C (68 F to 77 F).

REFERENCE: FDA Prescribing Information

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Reviewed on 3/2/2005
References
REFERENCE: FDA Prescribing Information

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