HYDROCORTISONE

Background and Date of Approval

Hydrocortisone has been used topically for many years and received its initial FDA approval in the 1950s. Since that time, multiple hydrocortisone creams and ointments have been approved for both over-the-counter and prescription use. The FDA approval date for hydrocortisone cream and ointment formulations intended for topical application may differ based on the specific product and its manufacturer.

Uses

Hydrocortisone is a medication used to treat a variety of medical conditions, including skin conditions such as eczema, psoriasis, and dermatitis. It can also be used to manage symptoms of allergic reactions, such as itching, swelling, and redness. It can help reduce inflammation and swelling in the airways for individuals with asthma, making breathing easier. This medication is also used to reduce inflammation and pain in joints affected by arthritis and to suppress the immune system in certain autoimmune disorders such as lupus and rheumatoid arthritis. In individuals with adrenal insufficiency, it can be used to replace low levels of cortisol.

How is it administered?

For topical hydrocortisone cream or ointment, apply a thin layer to the affected area, typically 2-3 times daily. For oral tablets, the dosage and frequency of administration will be determined by the healthcare professional. Oral hydrocortisone tablets are taken with food to minimize gastrointestinal side effects. For injectables, hydrocortisone is given as an intravenous or intramuscular injection by a healthcare professional. If you miss a dose, taking or applying it as soon as you remember is important. However, if it is close to the time for your next dose, it is best to skip the missed dose and resume your regular schedule. Do not double the dose to make up for the missed one.

Side Effects

Like any medication, it can cause side effects. Some of the common side effects of hydrocortisone include increased appetite and weight gain, fluid retention and swelling in the face and limbs, elevated blood pressure, mood changes such as irritability or anxiety, difficulty sleeping or insomnia, acne or other skin reactions, increased susceptibility to infections, and muscle weakness or wasting. These side effects are typically mild and may subside with continued medication use. However, some more serious side effects of hydrocortisone may occur, such as allergic reactions, severe mood changes such as depression or psychosis, high blood sugar levels, peptic ulcers or gastrointestinal bleeding, osteoporosis or increased risk of fractures, glaucoma or cataracts, and adrenal suppression or failure.

Warnings

Hydrocortisone can suppress the immune system, making it more difficult for the body to fight off infections. Long-term use can suppress the function of the adrenal glands, which produce important hormones that regulate various bodily functions, and increase the risk of osteoporosis, which causes bones to become weak and brittle. Some people may experience allergic reactions to hydrocortisone. If you experience symptoms such as rash, itching, swelling, or difficulty breathing, seek medical attention immediately.

Precautions

Hydrocortisone is a prescription medication that should only be used by the person for whom it was prescribed. Do not share your medication with others, even if they have similar symptoms. If you develop a fever or other signs of infection while taking hydrocortisone, contact your healthcare professional immediately. Avoid vaccination during the treatment with this medicine. Tell your doctor if you have any fungal infections before taking medicine. It is important to inform your allergic conditions and diseases to your doctor before taking this medication. Avoid exposure to people who have chickenpox, measles, or shingles during the treatment. Consult your doctor if you experience mental health problems while taking medicine. This medicine contains lactose. Ask for a doctor’s advice if you are intolerant to sugars.

Word of Advice

Hydrocortisone is a prescription medication that must be used only under the guidance and supervision of a qualified healthcare professional. Do not share your medication with others, and do not use it for any condition other than the one for which it was prescribed. Take only the dose prescribed; do not take more or less, and continue to consult with your healthcare professional regularly. Inform your healthcare professional immediately if you experience any side effects or have any safety concerns, particularly if you have a history of liver disease, kidney disease, diabetes, or other medical conditions. Your healthcare professional may need to adjust your dose or recommend an alternative treatment to ensure your safety and optimise treatment outcomes. If you have questions or concerns about using this medication, speak with your healthcare professional.

References

KD Tripathi, Essentials of Medical Pharmacology, Corticosteroids, 7th edition, 2013,282 - 293. Goodman & Gilman’s, The Pharmacological Basis of Therapeutics, ACTH, Adrenal Steroids and Pharmacology of the Adrenal Cortex,12th edition, 2011, 1228-1229. Pfizer, US Food and Drug Administration, [ Revised on Nov 2019] [ Accessed on 13th April 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/008697s036lbl.pdf

Frequently Asked Questions

Is it safe to use hydrocortisone for an extended period?

Hydrocortisone should not be used for an extended period without the guidance of a healthcare professional. Prolonged use can increase the risk of side effects, including adrenal gland suppression and Cushing's syndrome.

Is hydrocortisone addictive?

No, hydrocortisone is not addictive. However, prolonged use can lead to physical dependence and withdrawal symptoms if the medication is stopped abruptly.

Can hydrocortisone be used to treat eye infections?

Hydrocortisone should not be used to treat eye infections. It can make some eye infections worse. Speak with a healthcare professional if you are experiencing eye issues.

Can hydrocortisone be used on children?

Hydrocortisone can be used on children, but it should be used with caution and under the guidance of a healthcare professional. Children are more susceptible to the side effects of this medication, especially if it is used for an extended period.

Can hydrocortisone be used with other topical medications?

Yes, hydrocortisone can be used with other topical medications, but it is important to follow the guidance of a healthcare professional. Combining certain medications can increase the risk of side effects or reduce the effectiveness of the treatment.

Available Brands 10

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS