Hydrocortisone

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Molecule Description

Hydrocortisone belongs to the class of medicines called corticosteroids. It is a synthetic version of cortisol, a hormone naturally produced by your adrenal glands. It acts as an anti-inflammatory agent and immune system suppressant, helping to alleviate symptoms like swelling, redness, itching, and severe allergic reactions. It is widely used to treat conditions where the body's immune system is overreacting, such as severe allergies (hay fever, asthma), various skin conditions (eczema, psoriasis), inflammatory bowel diseases (Crohn's, colitis), and for replacement therapy when the body doesn't produce enough of its own cortisol (adrenal insufficiency). It works by calming the chemical signals that trigger and sustain inflammation, helping to bring relief and allow damaged tissues to heal. Take Hydrocortisone exactly as prescribed; never stop it suddenly, especially if you've been on it for a long time, as your doctor needs to create a tapering schedule to allow your body to adjust. Take with food to reduce stomach upset. Common side effects can include stomach irritation, difficulty sleeping, or increased appetite. Limit or avoid alcohol as it can increase the risk of stomach issues. Seek urgent medical help if you experience signs of a severe allergic reaction (trouble breathing, swelling), severe stomach pain, or significant mood changes. While generally safe regarding fertility and driving, inform your doctor about all existing conditions (like high blood pressure or diabetes) as this medicine can affect them.

Uses

It can be used as replacement therapy for children with congenital adrenal hyperplasia (which affects the body's natural production of steroids)
It is also used to treat severe asthma and allergic reactions (in adults and children)

Contraindications

When should one not use Hydrocortisone

If you are allergic to Hydrocortisone or any of the other ingredients
If you are suffering from an infection
If you are going to have any vaccinations

Side effects

Common side effects of this drug are:

Fits (convulsions)
Difficulty sleeping (insomnia)
Irritability
Vertigo
Mood swings
Depression
Increased appetite
Delayed wound healing
Bleeding ulcers (indicated by stomach pain, bleeding from the anus, black stools or being sick with blood present)
Muscle weakness
Thinning of bones which makes fractures more likely (osteoporosis)
Cataracts (clouding of the lens in the eye)
Increase in blood sugar
Diabetes mellitus
Thromboembolism

Precautions and Warnings

Pregnancy

It is advised not to take this medicine if you are pregnant or planning for pregnancy. Consult a doctor before taking this medicine during pregnancy.

Breast Feeding

It can be pass into breast milk. So breastfeeding women should tell their doctor before taking this medicine.

Driving

It may make affect your vision or make you feel dizzy. If you have any of these symptoms, you should not drive.

Alcohol

You must make sure that you don’t consume alcohol when you are taking the medicine.

Other General Warnings

Talk to your doctor if

You feel itching or skin rashes, swelling of the face, lips or throat, difficulty breathing or wheeziness
You have liver, kidney, thyroid or heart problems
You have any infections
You have any thyroid problems or suffering from tuberculosis (TB)
You have a history of liver, kidney or any heart problems
You have diabetes or high blood pressure
You have a condition of osteoporosis (thinning of the bones)
You are suffering from glaucoma (increased pressure in the eye)
You have HIV infection or epilepsy
You are suffering from stomach ulcers or other digestive problems
You have a history of chickenpox, shingles or measles

Mode of Action

How Does It Work?

Hydrocortisone is a Corticosteroid or a steroid that reduces the skin inflammation by inhibiting the synthesis of prostaglandins and leukotrienes, which is responsible for inflammation. It can also suppress the immune system.

Interactions

Interactions with other medicines

Medicine used to assist medical termination of pregnancy (Mifepristone)
Diuretics (water tablets)
Medicine used to treat ulcers (Carbenoxolone)
Medicine used to treat rheumatoid arthritis
Medicines used to treat asthma and other breathing problems (Theophylline, Bambuterol, Fenoterol, Formoterol, Ritodrine, Salbutamol, Salmeterol and Terbutaline)
Medicines used to treat high blood pressure
Medicines used to thin the blood like Warfarin
Aspirin
Medicines used to treat mild to moderate pain such as Ibuprofen, Diclofenac or Naproxen
Medicines for diabetes (Insulin)
Medicines used to treat bacterial infections (Erythromycin or Clarithromycin)
Oral contraceptive pill
Medicines used to treat HIV infections (Efavirenz or Nevirapine)
Medicine used to treat glaucoma (Acetazolamide)
Medicines used to treat fungal infections (Amphotericin, Ketoconazole, Itraconazole, Posaconazole or Voriconazole)
Medicine used for treating depression
Medicines used to treat epilepsy (Phenytoin, Phenobarbital, Carbamazepine and Primidone)
Medicines used to treat TB (Rifabutin and Rifampicin)
Medicine used in the treatment of cancer
Medicines used to treat heart failure and irregular heartbeat (Digoxin)

Interactions with food items

Limit the portion of carbohydrates and salt intake
Start taking potassium supplements
Consume meals that are high in protein

Dosage

Overdose

You must ensure that you seek immediate medical attention if you believe that you have overdosed on the medicine. Symptoms of overdosage may include nausea, vomiting, sodium and water retention, and occasional gastrointestinal bleeding.

Missed a Dose

If you missed a dose, try to follow the regular dosage schedule. Do not double the dose.

Frequently Asked Questions (FAQs)

You should never use over-the-counter preparations of Hydrocortisone on your face unless a doctor prescribes them. Most of the Hydrocortisone products are not sold to be used on the face. The skin on the face is very delicate. Long-term use of such steroids that are strong can cause noticeable damage to the face.

If you have diabetes, then yes, Hydrocortisone has a high chance of increasing the blood sugar levels in your body.

It should take around 72 hours for the effects to show clearly. It is recommended that you use Hydrocortisone cream for seven days. If you don’t see any results, you may need a stronger formulation of Hydrocortisone or a different steroid. If used for an extended period, Hydrocortisone begins to reduce its effect.

You must never stop taking Hydrocortisone suddenly, especially if you have been on it for more than a few weeks. This can lead to withdrawal symptoms and a potentially dangerous condition called adrenal crisis. Your doctor must create a gradual "tapering" schedule to safely reduce the dose.

Long-term use or high doses can increase the risk of side effects, including thinning of the bones (osteoporosis), easy bruising, high blood pressure, diabetes, eye problems (cataracts/glaucoma), and an increased risk of infections. Your doctor will monitor you closely.