What happens if I overdose Hydrocortisone Acetate?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Hydrocortisone Acetate may be harmful if swallowed.
Proper storage of Hydrocortisone Acetate:
Store Hydrocortisone Acetate at room temperature, below 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not freeze. Do not store in the bathroom. Keep Hydrocortisone Acetate out of the reach of children and away from pets.
Overdose of Hydrocortisone Acetate in details
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
What should I avoid while taking Hydrocortisone Acetate?
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.
Do not receive a "live" vaccine while you are being treated with Hydrocortisone Acetate. Vaccines may not work as well while you are taking a steroid.
Avoid drinking alcohol while you are taking Hydrocortisone Acetate.
Hydrocortisone Acetate warnings
(Systemic use): Sodium bisulfite may cause allergic – type reactions including an anaphylactic symptoms. Systemic corticosteroids should be used with great caution in the presence of heart failure, recent MI, hypertension, diabetes mellitus, epilepsy, glaucoma, hypothyroidism, hepatic failure, osteoporosis, peptic ulceration, psychoses or severe affective disorders, and renal impairment, growth retardation in children, live vaccines should not be give to patients receiving high-dose systemic corticosteroid therapy nor for atleast 3 months afterwards. killed vaccines or toxoids may be given although the response may be attenuated.
During prolonged courses, sodium intake may need to reduced and calcium and potassium supplements may be necessary. Rapid intravenous injection of massive doses of corticosteroids may sometimes cause cardiovascular colapse and injections should therefore be given slowly or by infusion.(Topical use): Before using Hydrocortisone Acetate,the patient has to tell the doctor or pharmacist if he is allergic to it; or to other corticosteroids (e.g., prednisone, triamcinolone); or if the patient have any other allergies. If the patient have itching of the outer female genitals with vaginal discharge, she have to consult the doctor before using this product. During pregnancy, this medication should be used only when clearly needed.
What should I discuss with my healthcare provider before taking Hydrocortisone Acetate?
Some medical conditions may interact with Hydrocortisone Acetate. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a parasitic, bacterial, fungal, or viral infection; diabetes; diarrhea; swelling of the esophagus; stomach problems; blockage or the intestine or other intestinal problems; measles; tuberculosis (TB); a positive TB skin test; chicken pox; shingles; herpes infection of the eye; ulcers; kidney problems; high blood pressure; thyroid problems; or you have received a recent vaccination
- if you have a history of heart failure or heart attack
Some MEDICINES MAY INTERACT with Hydrocortisone Acetate. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Barbiturates (eg, phenobarbital), carbamazepine, cholestyramine, colestipol, fluconazole, hydantoins (eg, phenytoin), lithium, rifampin, or thioamines (eg, propylthiouracil) because they may decrease Hydrocortisone Acetate acetate foam's effectiveness
- Aprepitant, clarithromycin, estrogens (eg, estradiol), macrolide immunosuppressants (eg, tacrolimus), nefazodone, or steroidal contraceptives (eg, birth control pills) because side effects such as adrenal gland or central nervous system problems may occur
- Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), live vaccines, macrolide immunosuppressants (eg, tacrolimus), nondepolarizing muscle relaxants (eg, vecuronium), ritodrine, or theophylline because their actions and the risk of their side effects may be increased by Hydrocortisone Acetate
- Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), interleukin-2, mifepristone, or nondepolarizing muscle relaxants (eg, vecuronium) because their effectiveness may be decreased by Hydrocortisone Acetate
This may not be a complete list of all interactions that may occur. Ask your health care provider if Hydrocortisone Acetate may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Hydrocortisone Acetate precautions
Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients.
Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings.
Therefore, patients receiving a large dose of potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests. If HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent steroid.
Recovery of HPA axis function is generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.
Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity.
If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted.
In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.
Information for the Patient
Patients using topical corticosteroids should receive the following information and instructions:
- This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes.
- Patients should be advised not to use this medication for any disorder other than for which it was prescribed.
- The treated skin area should not be bandaged or otherwise covered or wrapped as to be occlusive unless directed by the physician.
- Patients should report any signs of local adverse reactions especially under occlusive dressings.
- Parents of pediatric patients should be advised not to use tight-fitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings.
The following tests may be helpful in evaluating the HPA axis suppression:
Urinary free cortisol test.
ACTH stimulation test.
Carcinogenesis, Mutagenesis, and Impairment of Fertility
Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids.
Studies to determine mutagenicity with prednisolone and Hydrocortisone Acetate have revealed negative results.
Pregnancy: Teratogenic effects: Pregnancy Category C
Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time.
It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and Cushing's syndrome, than maturepatients, because of a larger skin surface area to body weight ratio.
Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in pediatric patients receiving topical corticosteroids. Manifestations of adrenal suppression in pediatric patients include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.
Administration of topical corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of pediatric patients.
What happens if I miss a dose of Hydrocortisone Acetate?
Since this medication is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
- DailyMed. "CIPROFLOXACIN HYDROCHLORIDE; HYDROCORTISONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "hydrocortisone". http://www.drugbank.ca/drugs/DB00741 (accessed September 17, 2018).
- MeSH. "Anti-Inflammatory Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology