Medications and Drugs

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.

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