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Dosage of Hydrocortisone in details
Hydrocortisone may be administered by IV injection, IV infusion or IM injection. The preferred method for initial emergency use is IV injection.
Following the initial emergency period, consideration should be given to employing a longer-acting injectable preparation or an oral preparation.
Therapy is initiated by administering Hydrocortisone IV over a period of 30 sec (eg, Hydrocortisone sodium succinate equivalent to Hydrocortisone 100 mg) to 10 min (≥500 mg). In general, high-dose corticosteroid therapy should be continued only until the patient's condition has stabilized, usually not beyond 48-72 hrs. Although adverse effects associated with high-dose, short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be indicated.
When high-dose Hydrocortisone therapy must be continued beyond 48-72 hrs, hypernatremia may occur. Under such circumstances, it may be desirable to replace Hydrocortisone sodium succinate with a corticoid product eg, one containing methylprednisolone sodium succinate which causes little or no sodium retention.
Initial Dose: 100-500 mg or more (Hydrocortisone equivalent of Hydrocortisone sodium succinate), depending on the severity of the condition.
This dose may be repeated at intervals of 2, 4 or 6 hrs as indicated by the patient's responses and clinical condition. While the dose may be reduced for infants and children, it is governed more by the severity of the condition and response of the patient than by age or body weight but should not be less than 25 mg daily. Patients subjected to severe stress following corticosteroid therapy should be observed closely for signs and symptoms of adrenocortical insufficiency.
Corticosteroid therapy is an adjunct to, and not a replacement for, conventional therapy.
In Patients with Liver Disease, there may be an increased effect and reduced dosing may be considered.
Administration: Preparation of Solutions:
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
100 mg Plain or with Bacteriostatic Water for Injection: For IV or IM injection, prepare solution by aseptically adding not >2 mL of bacteriostatic water for injection or bacteriostatic sodium chloride injection to the contents of 1 vial. For IV infusion, first prepare solution by adding not >2 mL of bacteriostatic water for injection to the vial; this solution may then be added to 100-1000 mL of the following: dextrose in water 5% (or isotonic saline solution or dextrose in isotonic saline solution 5% if patient is not on sodium restriction).
Directions for Using the Act-O-Vial Two-Compartment Vial: Remove protective cap, give the plunger-stopper a quarter-turn and press to force diluent into the lower compartment.
Gently agitate to effect solution.
Sterilize top of plunger-stopper with a suitable germicide.
Insert needle squarely through center of plunger-stopper until tip is just visible. Invert vial and withdraw dose.
Further dilution is not necessary for IV or IM injection. For IV infusion, first prepare solution as just described. The 100-mg solution may then be added to 100-1,000 mL of dextrose in water 5% (or isotonic saline solution or dextrose in isotonic saline solution 5% if patient is not on sodium restriction). The 250-mg solution may be added to 250-1,000 mL, the 500-mg solution may be added to 500-1,000 mL and the 1,000 mg solution to 1000 mL of the same diluents. In cases where administration of a small volume of fluid is desirable, Hydrocortisone 100-3,000 mg (Hydrocortisone equivalent of Hydrocortisone sodium succinate) may be added to 50 mL of the above diluents. The resulting solutions are stable for at least 4 hrs and may be administered either directly or by IV piggyback.
What other drugs will affect Hydrocortisone?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your current medicines. Many drugs can affect Hydrocortisone, especially:
birth control pills or hormone replacement therapy;
insulin or oral diabetes medicine;
medicine to prevent organ transplant rejection;
medicine to treat an infection;
a blood thinner such as warfarin (Coumadin, Jantoven); or
aspirin or an NSAID (nonsteroidal anti-inflammatory drug) such as ibuprofen, naproxen, celecoxib, indomethacin, Advil, Aleve, Motrin, and others.
This list is not complete and many other drugs may affect Hydrocortisone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Drug Interactions (in more detail)
With simultaneous use of Hydrocortisone increases the toxicity of cardiac glycosides (because of the emerging hypokalemia increases the risk of arrhythmias); with acetylsalicylic acid - accelerates its excretion and reduces its concentration in blood plasma (with the abolition of Hydrocortisone concentration of salicylates in the blood increases, and increases the risk of side effects); with paracetamol - increased risk of hepatotoxic action of paracetamol (induction of hepatic enzymes and formation of a toxic metabolite of paracetamol); with cyclosporine - increased side effects of Hydrocortisone as a result of inhibition of its metabolism; with ketoconazole - increased side effects of Hydrocortisone as a result of reduction of its clearance.
Hydrocortisone Micronised Xepa-Soul Pattinson reduces the effectiveness of hypoglycemic; intensifies the effect of indirect anticoagulants of coumarin derivatives.
Hydrocortisone reduces the effect of vitamin D on the absorption of calcium ions into the lumen of the intestine. Ergocalciferol and parathyroid hormone hinder the development of osteopathy caused by GCS.
Hydrocortisone Micronised Xepa-Soul Pattinson increases the metabolism of isoniazid, meksiletina (especially in "fast acetylators"), which leads to a decrease in their plasma concentrations; increases (with prolonged therapy) the content of folic acid reduces the concentration of praziquantel in blood.
Hydrocortisone in high doses reduces the effect somatropina.
Hypokalemia caused by GCS, may increase the severity and duration of muscle blockade on the background of muscle relaxants.
Antacids reduce the absorption of the GCS.
At simultaneous application with SCS thiazides, carbonic anhydrase inhibitors, other GCS, amphotericin B increase the risk of hypokalemia, drugs containing sodium ions - swelling and increase blood pressure.
NSAIDs and ethanol increases the risk of gastrointestinal ulcerations and bleeding, in combination with NSAIDs to treat arthritis may reduce the dose of GCS due to summation of therapeutic effect. Indomethacin displacing the SCS from its association with albumin, increases the risk of its side effects.
Amphotericin B and carbonic anhydrase inhibitors increase the risk of osteoporosis.
The therapeutic effect of GCS is reduced under the influence of inducers of microsomal liver enzymes (including phenytoin, barbiturates, ephedrine, theophylline, rifampin) due to increased rate of metabolism of these substances.
Inhibitors of the function of the adrenal cortex (including mitotan) may necessitate higher doses of GCS.
Clearance GCS increased against the background of preparations of thyroid hormones.
Immunosuppressants increase the risk of infection and lymphoma or other lymphoproliferative disorders associated with Epstein-Barr virus.
Estrogens (including oral contraceptives containing estrogen) reduce the clearance of GKS, lengthens T1/2 and their therapeutic and toxic effects. The appearance of hirsutism and acne promotes the simultaneous use of other steroid hormone funds - androgens, estrogens, anabolic steroids, oral contraceptives.
Tricyclic antidepressants may increase the severity of depression caused by GCS (not shown for the treatment of these side effects).
The risk of developing cataracts increases with the application against other GCS antipsychotic funds (neuroleptics), carbutamide and azathioprine. Simultaneous of Hydrocortisone Micronised Xepa-Soul Pattinson with the appointment of m-cholinoblockers, as well as with means having m-anticholinergic action (including antihistamines, tricyclic antidepressants), with nitrates improves the intraocular pressure.
With simultaneous application of SCS with live vaccines and antiviral compared to other types of immunization increases the risk of activation of viruses and development of infections.
- 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).
- FDA/SPL Indexing Data. "WI4X0X7BPJ: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
- MeSH. "Anti-Inflammatory Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
ReviewsThe results of a survey conducted on ndrugs.com for Hydrocortisone are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Hydrocortisone. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
1 consumer reported frequency of useHow frequently do I need to take Hydrocortisone?
It was reported by ndrugs.com website users that Hydrocortisone should ideally be taken Once in a day as the most common frequency of the Hydrocortisone. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Hydrocortisone should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
|Once in a day||1||100.0%|
2 consumers reported dosesWhat doses of Hydrocortisone drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Hydrocortisone drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
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Information checked by Dr. Sachin Kumar, MD Pharmacology