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.
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.
PREPARATIONS: Powder for injection: 100, 250, 500, and 1000 mg
STORAGE: Unopened products should be stored at room temperature between 20 C
to 25 C (68 F to 77 F).
DOSING: 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.
Combining corticosteroids with amphotericin B injection or
potassium-depleting agents (for example, diuretics) can lead to low blood
Macrolide antibiotics (for example,
erythromycin) may increase blood levels
of corticosteroids by decreasing their elimination from the body.
Combining corticosteroids and
(Coumadin) usually results in inhibition of
response to warfarin.
Dosage adjustments of antidiabetic agents may be required because
corticosteroids may increase blood glucose concentrations.
phenytoin (Dilantin, Dilantin Infatabs, Phenytek, Phenytoin Infatabs),
carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol, Epitol, Teril), rifampin and other
increase the activity of cytochrome P450 3A4, an enzyme in the
enhance the breakdown of corticosteroids.
ketoconazole (Nizoral, Extina, Xolegel, Kuric),
erythromycin, troleandomycin, and other drugs that inhibit cytochrome P450 3A4
liver enzymes may increase blood levels of corticosteroids. Ketoconazole may
significantly decrease the breakdown of certain corticosteroids by up to 60%,
leading to an increased risk of corticosteroid side effects.
Corticosteroids reduce the response to live or inactivated vaccines because
they suppress the immune system. Corticosteroids may also help some organisms
contained in live attenuated vaccines grow.
Vaccination should be delayed until
after corticosteroid therapy is completed.
Corticosteroids may also suppress reactions to skin tests.
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.