hydrocortisone, oral (cont.)
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.
PREGNANCY: Hydrocortisone can be used in pregnancy, but
is
generally avoided.
NURSING MOTHERS: Hydrocortisone can appear in breast
milk, and
can have adverse effects on the baby. Therefore, mothers taking
hydrocortisone should discontinue nursing.
SIDE EFFECTS: Hydrocortisone side effects depend on the
dose,
the duration and the frequency of administration. Short courses
of
hydrocortisone are usually well tolerated with few and mild
side effects.
Long term, high doses of hydrocortisone will usually 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. Alternate day dosing
can also
help reduce side effects.
Side effects of hydrocortisone and other corticosteroids range
from mild
annoyances to serious irreversible bodily damages. Side effects
include
fluid retention, weight gain, high blood pressure, potassium
loss,
headache, muscle weakness, puffiness of and hair growth on the
face,
thinning and easy bruising of the skin, glaucoma, cataracts,
peptic
ulceration, worsening of diabetes, irregular menses, growth
retardation in
children, convulsions, and psychic disturbances. Psychic
disturbances can
include depression, euphoria, insomnia, mood swings,
personality changes,
and even psychotic behavior. The bone and joint complications of
corticosteroids are discussed above in DRUG INTERACTIONS.
Reference: FDA Prescribing Information
Last Editorial Review: 12/31/1997
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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