Short-acting steroidal anti-inflammatory drug (corticosteroid)
Indications
Symptomatic treatment of severe allergic and inflammatory reactions, when oral administration is not possible
Forms and strengths, route of administration
Powder for injection, 100 mg hydrocortisone (hemisuccinate, succinate or phosphate) in vial, to be dissolved in 2 ml water for injection, for IM or slow IV injection or infusion
Dosage and duration
Child one month to 11 years: 4 mg/kg (max. 100 mg)
Child 12 years and over and adult:100 to 200 mg
Doses may be repeated at 6 or 8 hour-intervals up to 3 or 4 times according to reaction severity and clinical response. Change to oral route with prednisolone as soon as possible.
Contra-indications, adverse effects, precautions
In case of systemic infection, only administer if patient is under antimicrobial treatment.
Avoid prolonged administration in patients with peptic ulcer, diabetes mellitus or cirrhosis.
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth retardation, increased susceptibility to infections, sodium and water retention (oedema and hypertension), osteoporosis, hypokalaemia, digitalis toxicity due to potassium loss in patients taking digitalis glycosides.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
Remarks
20 mg of hydrocortisone has the same anti-inflammatory activity as 5 mg of prednisolone or prednisone and 0.75 mg of dexamethasone.
Hydrocortisone acetate is a suspension insoluble in water, used as a local treatment only: intra- or periarticular injection, epidural(sciatic neuralgia).