HYDROCORTISONE

Glucocorticoid. Steroidal anti-inflammatory medicine

Dosage Forms

Injection

100 mg hydrocortisone sodium succinate

Cream/ointment

1% hydrocortisone

Eye drops

1%

Eye ointment

0.5%

Eye drops (combination)

hydrocortisone 1.5% + oxytetracycline 0.5% + polymixin B 10,000 IU/ml

Uses

  • Severe asthma
  • Anaphylactic shock
  • Allergic angioedema
  • Allergic skin reaction
  • Itching due to insect stings
  • Allergic conjunctivitis
  • Adrenocortical insufficiency (specialist use only)

Dose and Duration

Severe asthma (in combination with inhaled salbutamol); anaphylactic shock (in combination with epinephrine); allergic angioedema
  • Adult and child >12years: 200 mg IV stat
  • Child 6–12 years: 100 mg IM or slow IV stat
  • Child 1–5 years: 50 mg IM or slow IV stat
  • Child <1 year: 25 mg IM or slow IV stat
Repeat the dose every 4–6 hours as need arises depending on the patient's response
Allergic skin reaction and itching due to insect stings
Apply thin layer of cream to affected area every 12 hours until improvement is seen
Allergic conjunctivitis
Apply 1 drop every 2 hours then reduce frequency as infection is controlled and continue for 48 hours after healing. At night, use the ointment as it lasts longer at site of action
If using ointment alone, apply every 6‒8 hours
If infection present, use combination with antibiotics

Preparation

  • Dissolve powder for injection in 2 ml water for injection

Contraindications

  • Untreated systemic bacterial, fungal, and viral infections (can make infection worse)
  • Untreated skin infections (can make infection worse)
  • Acne
  • Patients who have just received live virus vaccines (polio, BCG, measles vaccines)

Side Effects

  • Fluid retention
  • Cream may make local skin infection worse
  • Dry and thin skin (prolonged use), skin irritation
  • Eye drops may cause local irritation
  • Stops body's natural production of corticosteroids (after prolonged use or with high doses) causing: increased risk of infections, Cushing’s syndrome, muscle wasting, moon face, acne, oedema and high blood pressure, bones easily fracture, easy bruising, mental disturbances, diabetes mellitus, menstrual disturbances, inhibition of growth in children, glaucoma

Interactions

  • Carbamazepine, phenobarbital, phenytoin, rifamycins (reduced effect of hydrocortisone)
  • Amphotericin B (increased risk of hypokalaemia)
  • Live vaccines (high doses of hydrocortisone impair immune response to vaccines)

Patient Instructions

  • Do not apply to eyes, broken skin, or mucous membranes
  • Avoid prolonged use
  • Wash hands thoroughly before and after use

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Do not withdraw treatment suddenly after prolonged use. Dose should be reduced gradually
  • Patient on long term therapy should carry a steroid treatment card