Skip to content

Hydrocortisone

    Brands

    DEA Class; Rx

    Common Brand Names; Alkindi Sprinkle, Cortef, SoluCortef

    • Corticosteroids

    hydrocortisone topical (Rx, OTC)

    Brand and Other Names: Westcort, Locoid, Aquanil, Calmurid Cream, Cetacort, Claritin Skin Itch Relief, Coraz, CortaGel, Cortaid, Cortate, Cortisone-10 Poison Ivy Relief Pads, Cortisone-10 Quick Shot, Cortizone, Cortoderm, Dermacort, Dermazene Cream, DermiCort, Emo Cort, Hyderm, Hydrocort, HydroSKIN, HydroVal, Hytone, LactiCare, AlaCort, Locoid Lipocream, Massengill, Neosporin Eczema Essentials Anti-Itch Cream, Nutracort, Pediaderm HC, Penecort, Preparation H Anti-Itch Cream, Prevex HC, Proctocort, Proctocream, Sarna HC, Sarnol, Texacort, Timodine, Uniroid HC, AlaScalpt
    • Classes: Corticosteroids, Topical

    hydrocortisone probutate topical (Rx)

    Brand and Other Names: Pandel
    • Classes: Corticosteroids, Topical

    hydrocortisone rectal (Rx)

    Brand and Other Names: Anusol HC, Cortifoam, Anucort-HC, Peranex HC, Proctol, Proctomyxin, Proctosedyl, Proctosedyl Ointment, Xyralid RC, Cortenema
    • Classes: Corticosteroids, Gastrointestinal

    Naturally occurring adrenal steroid hormone with glucocorticoid and mineralocorticoid activity
    A preferred corticosteroid for adrenal insufficiency states; also used for a variety of inflammatory diseases systemically and rectally
    Topical dosage forms are considered low-potency; used for mild to moderate corticosteroid responsive dermatoses

    Indicated for use in nonspecific proctitis, postirradiation (factitial) proctitis, cryptitis, or for other non-specific inflammatory conditions of the anorectum.

    For the treatment of primary adrenocortical insufficiency (e.g., Addison’s Disease, congenital adrenal hyperplasia or CAH) or secondary adrenocortical insufficiency.
    For the relief of inflammation, pruritus ani, and swelling associated with hemorrhoids.
    For the treatment of Crohn’s disease.
    For the treatment of allergic disorders including anaphylaxis, anaphylactic shock, or anaphylactoid reactions, angioedema, acute noninfectious laryngeal edema, hypersensitivity reactions (drug or food allergy), transfusion-related reactions, urticaria, serum sickness.
    For the systemic treatment of severe inflammatory dermatoses, like severe exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, or psoriasis unresponsive to topical treatment.
    For the treatment of corticosteroid-responsive dermatologic disorders (e.g., alopecia areata, atopic dermatitis, bullous dermatitis herpetiformis, contact dermatitis including Rhus dermatitis due to poison ivy, poison oak, poison sumac, diaper dermatitis, discoid lupus erythematosus, eczema, exfoliative dermatitis, insect bites or stings, granuloma annulare, keloids, lichen striatus, lichen planus, lichen simplex, necrobiosis lipoidica diabeticorum, pemphigus, pityriasis rosea, polymorphous light eruption, pompholyx (dyshidrosis), pruritus, psoriasis, seborrheic dermatitis, xerosis).
    For the short-term treatment of hypercalcemia associated with neoplastic disease.
    For the management of nephrotic syndrome to induce diuresis or decrease proteinuria.
    For the treatment of thyroiditis.
    For asthma exacerbation.

    Untreated serious infections (except tuberculous meningitis or septic shock)

    Idiopathic thrombocytopenic purpura (IM administration only)

    Intrathecal administration (injection)

    Use in premature infants (formulations containing benzyl alcohol only)

    Documented hypersensitivity

    Systemic fungal infections

    Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids

    Underlying infection

    Hypersensitivity

    Ophthalmic use

    Treatment of diaper dermatitis

    Fluid and electrolyte disturbances

    • Sodium retention
    • Fluid retention
    • Potassium loss
    • Hypokalemic alkalosis

    Cardiovascular

    • Congestive heart failure in susceptible patients
    • Increased blood pressure

    Musculoskeletal

    • Muscle weakness
    • Steroid myopathy
    • Loss of muscle mass
    • Osteoporosis
    • Tendon rupture, particularly of the Achilles tendon
    • Vertebral compression fractures
    • Aseptic necrosis of femoral and humeral heads
    • Pathologic fracture of long bones

    Gastrointestinal

    • Peptic ulcer with possible perforation and hemorrhage
    • Pancreatitis
    • Abdominal distention
    • Ulcerative esophagitis
    • Increased ALT, AST, and alkaline phosphatase

    Dermatologic

    • Impaired wound healing
    • Thin fragile skin
    • Petechiae and ecchymoses
    • Facial erythema
    • Increased sweating
    • May suppress reactions to skin tests

    Neurological

    • Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment
    • Convulsions
    • Vertigo
    • Headache
    • Epidural lipomatosis
    • Behavioral and mood changes

    Endocrine

    • Increased appetite and weight gain
    • Development of Cushingoid state
    • Suppression of growth in children
    • Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
    • Menstrual irregularities
    • Decreased carbohydrate tolerance
    • Manifestations of latent diabetes mellitus
    • Increased requirements for insulin or oral hypoglycemic agents in diabetics

    Ophthalmic

    • Central serous chorioretinopathy
    • Posterior subcapsular cataracts
    • Increased intraocular pressure
    • Glaucoma
    • Exophthalmos

    Metabolic

    • Negative nitrogen balance due to protein catabolism
    • Blood and lymphatic system disorders H4
    • Leukocytosis

    Skin atrophy

    Striae

    Acneform lesions

    Perioral dermatitis

    Folliculitis

    Itching

    Pigmentation changes

    HPA suppression (with higher potency used >2 wk)

    Burning (2%)

    Stinging (1%)

    Paresthesia

    Itching

    Irritation

    Dryness

    Folliculitis

    Hypertrichosis

    Acneiform eruptions

    Hypopigmentation

    Perioral dermatitis

    Allergic contact dermatitis

    Secondary infections

    Skin atrophy

    Striae

    Miliaria

    Use with caution in cirrhosis, ocular herpes simplex, hypertension, diverticulitis, myasthenia gravis, peptic ulcer disease, ulcerative colitis, psychotic tendencies, renal insufficiency, pregnancy, diabetes mellitus, congestive heart failure, thromboembolic disorders, GI disorders

    Use caution in head injury; increased mortality reported in patients receiving high-dose corticosteroids; not for use as part of head injury management

    Thromboembolic disorders and myopathy may occur

    High dose corticosteroids associated with increased bone loss and osteoporotic fractures; use caution

    Anaphylactoid reactions reported in patients receiving corticosteroids

    Delayed wound healing is possible

    Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

    Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

    Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

    Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts

    Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted

    Pheochromocytoma crisis, which can be fatal, reported after administration of systemic corticosteroids; in patients with suspected pheochromocytoma, consider risk of pheochromocytoma crisis prior to administering corticosteroids

    Chronic topical corticosteroid therapy may interfere with growth and development in children

    Use lower potency in children; may absorb proportionally larger amounts after topical application and may cause systemic effects

    Occlusive dressings, prolonged use, application to large surface areas, or application to denuded skin, may increase percutaneous absorption, which may result in Cushing syndrome, glycosuria, and hyperglycemia

    Prolonged use may increase risk of Kaposi’s sarcoma

    Pregnancy category: C

    Lactation: Drug enters breast milk; use with caution

    Corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route of administration, and patient response.

    Hydrocortisone

    tablet (Cortef, generic)

    • 5mg
    • 10mg
    • 20mg

    powder for injection (SoluCortef)

    • 100mg/vial
    • 250mg/vial
    • 500mg/vial
    • 1g/vial

    topical cream

    • 0.1%
    • 0.2%
    • 0.5%
    • 1%
    • 2.5%

    topical lotion

    • 0.1%
    • 1%
    • 2%
    • 2.5%

    topical gel

    • 1%
    • 10%

    topical solution

    • 1%
    • 2.5%

    topical ointment

    • 0.2%
    • 0.5%
    • 1%
    • 2.5%

    topical cream

    • 0.1%

    cream

    • 1%
    • 0.5%
    • 1%
    • 2%
    • 2.5%

    enema

    • 100mg/60mL

    foam

    • 10% (15g)

    suppository

    • 25mg
    • 30mg