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Hydrocortospne Dosage |
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Applies to the following strength(s): 10 mg; 20 mg; acetate 50 mg/mL; sodium phosphate 50 mg/mL; 1000 mg preservative-free; 100 mg preservative-free; 5 mg; 250 mg preservative-free; 500 mg preservative-free; cypionate 10 mg/5 mL; 100 mg; 250 mg; 500 mg; 1 g; 10%; 100 mg/60 mL; acetate 25 mg/mL; acetate; hemisuccinate; sodium phosphate
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Acute Adrenal Gland Failure:
100 mg IV bolus, then 300 mg/day in divided doses every 8 hours or as a continuous infusion for 48 hours. When patient stable, change to oral, 50 mg every 8 hours for 6 doses, then taper to 30 - 50 mg/day.
200 mg per day by continuous intravenous infusion
Comment:
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic Shock 2012:
-Do not use intravenous Hydrocortospne if adequate fluid resuscitation and vasopressor therapy restore hemodynamic stability
-Use Hydrocortospne alone
-Do not administer for sepsis in the absence of shock
-Do not use ACTH stimulation test to identify adults with septic shock requiring Hydrocortospne
-Use continuous infusion rather than repetitive bolus injections
-Taper Hydrocortospne treatment when vasopressors no longer required
100 mg rectal suspension (retention enema) nightly for 21 days or until clinical remission occurs. Difficult cases may require 2 or 3 months of treatment. Clinical symptoms should subside within 3 to 5 days; discontinue use if no improvement within 2 to 3 weeks; some patients may require 2 to 3 months of therapy; if therapy lasts more than 21 days, discontinue slowly by decreasing use to every other night for 2 to 3 weeks.
One applicatorful (10% rectal foam with applicator) rectally once or twice daily for two to three weeks, then every second day thereafter.
Acute Adrenal Gland Failure:
Infants and young children: 1 to 2 mg/kg/dose intravenous bolus, then 25 to 100 mg/day in divided doses every 6 to 8 hours.
Older children: 100 mg intravenous bolus, then 300 mg/day in divided doses every 8 hours or as a continuous infusion for 48 hours; once patient is stable change to 50 mg orally every 8 hours for 6 doses, then taper to 30 to 50 mg per day in divided doses.
Infants and children:
Oral: 2.5 to 10 mg/kg/day divided every 6 to 8 hours.
Intramuscular or intravenous: 1 to 5 mg/kg/day divided every 12 to 24 hours.
Adolescents:
Oral, intramuscular or intravenous: 15 to 240 mg every 12 hours.
Children:
Initial: 50 mg/m2/day by continuous intravenous infusion
Infusions up to 50 mg/kg/day may be required for shock reversal
Adolescents:
200 mg per day by continuous intravenous infusion
Comment:
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic Shock 2012:
-Do not use intravenous Hydrocortospne if adequate fluid resuscitation and vasopressor therapy restore hemodynamic stability
-Use Hydrocortospne alone
-Do not administer for sepsis in the absence of shock
-Do not use ACTH stimulation test to identify adults with septic shock requiring Hydrocortospne
-Use continuous infusion rather than repetitive bolus injections
-Taper Hydrocortospne treatment when vasopressors no longer required
Children:
Intravenous: optional loading dose: 4 to 8 mg/kg; maximum: 250 mg; then
Maintenance: 2 mg/kg/dose every 6 hours.
Data not available
Data not available
Dosage adjustment should be based on severity of condition treated and response of patient.
Avoid abrupt withdrawal after long-term therapy.
Supplemental dose is not required.
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 Hydrocortospne, especially:
birth control pills or hormone replacement therapy;
heart medication;
insulin or oral diabetes medicine;
medicine to prevent organ transplant rejection;
medicine to treat an infection;
seizure medication;
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 Hydrocortospne. 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 Hydrocortospne 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 Hydrocortospne 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 Hydrocortospne as a result of inhibition of its metabolism; with ketoconazole - increased side effects of Hydrocortospne as a result of reduction of its clearance.
Hydrocortospne Micronised Xepa-Soul Pattinson reduces the effectiveness of hypoglycemic; intensifies the effect of indirect anticoagulants of coumarin derivatives.
Hydrocortospne 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.
Hydrocortospne 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.
Hydrocortospne 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 Hydrocortospne 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.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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