Detailed Drug Information:

DRUG CLASS AND MECHANISM: Hydrocortisone is a naturalcorticosteroid produced by the adrenal glands located adjacent to thekidneys. Corticosteroids have potent anti-inflammatory properties, and areused in a wide variety of inflammatory conditions such as arthritis,colitis, asthma, bronchitis, certain skin rashes, and allergic orinflammatory conditions of the nose and eyes. There are numerouspreparations of corticosteroids including oral tablets, capsules, liquids,topical creams and gels, inhalers and eye drops, and injectable andintravenous solutions. Hydrocortisone that is prescribed in oral tabletand liquid forms is addressed in this article.

Dosage requirements of corticosteroids vary among individuals and thediseases being treated. In general, the lowest possible effective dose isused. Corticosteroids given in multiple doses throughout the day are moreeffective, but also more toxic, than if the same total dose is given oncedaily, or every other day.

PREPARATIONS: tablets: 10mg, 20mg

STORAGE: Store at room temperature, sealed container.

PRESCRIBED FOR: Hydrocortisone is used to achieve promptsuppression of inflammation in many inflammatory and allergic conditions.Examples of inflammatory conditions include rheumatoid arthritis, systemiclupus, acute gouty arthritis, psoriatic arthritis, ulcerative colitis, andCrohn's disease. Severe allergic conditions that fail conventionaltreatment may also respond to hydrocortisone. Examples include bronchialasthma, allergic rhinitis, drug-induced dermatitis, and contact and atopicdermatitis. Chronic skin conditions treated with hydrocortisone includedermatitis herpetiformis, pemphigus, severe psoriasis and severeseborrheic dermatitis. Chronic allergic and inflammatory conditions of theuvea, iris, conjunctiva and optic nerves of the eyes are also treated withhydrocortisone.

Hydrocortisone is also used in the treatment of blood cell cancers(leukemias), and lymph gland cancers (lymphomas). Blood diseases involvingdestruction of platelets by the body's own immune cells (idiopathicthrombocytopenia purpura), and destruction of red blood cells by immunecells (autoimmune hemolytic anemia) can also be treated withhydrocortisone. Other miscellaneous conditions treated with thismedication include thyroiditis and sarcoidosis. Finally, hydrocortisone isused as a hormone replacement in patients whose adrenal glands are unableto produce sufficient amounts of corticosteroids.

DOSING: Should be taken with food.

DRUG INTERACTIONS: Prolonged use of hydrocortisone can depressthe ability of body's adrenal glands to produce corticosteroids. Abruptlystopping hydrocortisone in these individuals can cause symptoms ofcorticosteroid insufficiency, with accompanying nausea, vomiting, and evenshock. Therefore, withdrawal of hydrocortisone is usually accomplished bygradual tapering. Gradually tapering hydrocortisone not only minimizes thesymptoms of corticosteroid insufficiency, it also reduces the risk of anabrupt flare of the disease under treatment. The insufficient adrenalgland function may not recover fully for months after stoppinghydrocortisone. These patients need additional hydrocortisone treatmentduring periods of stress, such as surgery, to avoid symptoms ofcorticosteroid insufficiency and shock, while the adrenal gland is notresponding by producing its own corticosteroid.

Hydrocortisone and other corticosteroids can mask signs of infection andimpair the body's natural immune response to infection. Patients oncorticosteroids are more susceptible to infections, and can develop moreserious infections than healthy individuals. For instance, chicken pox andmeasles viruses can produce serious and even fatal illnesses in patientson high doses of hydrocortisone. Live virus vaccines, such as the smallpox vaccine, should be avoided in patients taking high doses ofhydrocortisone, since even vaccine viruses may cause disease in thesepatients. Some infectious organisms, such as tuberculosis (TB) andmalaria, can remain dormant in a patient for years. Hydrocortisone andother corticosteroids can reactivate dormant infections in these patientsand cause serious illnesses. Patients with dormant TB may require anti-TBmedications while undergoing prolonged corticosteroid treatment.

By interfering with the patient's immune response, hydrocortisone canimpede the effectiveness of vaccinations. Hydrocortisone can alsointerfere with the tuberculin skin test and cause false negative resultsin patients with tuberculosis infection.