GENERIC NAME: hydrocortisone, oral
BRAND NAMES: Hydrocortone, Cortef
DRUG CLASS AND MECHANISM: Hydrocortisone is a natural
corticosteroid produced by the adrenal glands located adjacent
to the
kidneys. Corticosteroids have potent anti-inflammatory
properties, and are
used in a wide variety of inflammatory conditions such as
arthritis,
colitis, asthma, bronchitis, certain skin rashes, and allergic
or
inflammatory conditions of the nose and eyes. There are numerous
preparations of corticosteroids including oral tablets,
capsules, liquids,
topical creams and gels, inhalers and eye drops, and injectable
and
intravenous solutions. Hydrocortisone that is prescribed in
oral tablet
and liquid forms is addressed in this article.
Dosage requirements of corticosteroids vary among individuals
and the
diseases being treated. In general, the lowest possible
effective dose is
used. Corticosteroids given in multiple doses throughout the
day are more
effective, but also more toxic, than if the same total dose is
given once
daily, or every other day.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: tablets: 10mg, 20mg
STORAGE: Store at room temperature, sealed container.
PRESCRIBED FOR: Hydrocortisone is used to achieve prompt
suppression of inflammation in many inflammatory and allergic
conditions.
Examples of inflammatory conditions include rheumatoid
arthritis, systemic
lupus, acute gouty arthritis, psoriatic arthritis, ulcerative
colitis, and
Crohn's disease. Severe allergic conditions that fail
conventional
treatment may also respond to hydrocortisone. Examples include
bronchial
asthma, allergic rhinitis, drug-induced dermatitis, and contact
and atopic
dermatitis. Chronic skin conditions treated with hydrocortisone
include
dermatitis herpetiformis, pemphigus, severe psoriasis and severe
seborrheic dermatitis. Chronic allergic and inflammatory
conditions of the
uvea, iris, conjunctiva and optic nerves of the eyes are also
treated with
hydrocortisone.
Hydrocortisone is also used in the treatment of blood cell
cancers
(leukemias), and lymph gland cancers (lymphomas). Blood
diseases involving
destruction of platelets by the body's own immune cells
(idiopathic
thrombocytopenia purpura), and destruction of red blood cells
by immune
cells (autoimmune hemolytic anemia) can also be treated with
hydrocortisone. Other miscellaneous conditions treated with this
medication include thyroiditis and sarcoidosis. Finally,
hydrocortisone is
used as a hormone replacement in patients whose adrenal glands
are unable
to produce sufficient amounts of corticosteroids.
DOSING: Should be taken with food.
DRUG INTERACTIONS: 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
accomplished by
gradual tapering. 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 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 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,
chicken pox and
measles viruses can produce serious and even fatal illnesses in
patients
on high doses of hydrocortisone. Live virus vaccines, such as
the small
pox 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 illnesses. Patients with dormant TB may
require anti-TB
medications while undergoing prolonged corticosteroid
treatment.
By interfering with the patient's immune response,
hydrocortisone can
impede the effectiveness of vaccinations. Hydrocortisone can
also
interfere with the tuberculin skin test and cause false
negative results
in patients with tuberculosis infection.
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. In rare individuals, destruction of
large joints
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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From the Doctors at MedicineNet.com  |
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Back to Medications IndexLast Editorial Review: 12/31/1997
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