Skin Treatment Uses, Warnings, Side Effects, Dosage

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Generic Title: hydrocortisone

Model and Different Names: Alkindi Sprinkle, Cortef, SoluCortef

Drug Class: Corticosteroids

What’s hydrocortisone, and what’s it used for?

Hydrocortisone is an artificial formulation of cortisol, the pure steroid hormone produced within the cortex area of the adrenal glands, therefore often known as a corticosteroid. Hydrocortisone is used to manage or cut back irritation attributable to all kinds of circumstances, to deal with persistent adrenal insufficiency and to exchange insufficient pure cortisol manufacturing.

Hydrocortisone has assorted metabolic results and likewise modifies the physique’s immune response. Hydrocortisone works in a number of methods to cut back irritation:

Controls the speed of protein synthesis
Inhibits launch of proinflammatory substances
Prevents migration and aggregation of polymorphonuclear leukocytes (PMN), forms of white cells resembling neutrophils, eosinophils and basophils that launch inflammatory substances
Reduces capillary permeability to stop the leakage of inflammatory cells and proteins (cytokines) into the irritation web site
Inhibits the exercise of histamine, an inflammatory chemical launched by immune cells
Stabilizes the membranes of cells, and lysosomes, the organelles inside cells that include digestive enzymes
Prevents migration of fibroblasts, cells that kind extracellular matrix, the supportive construction of tissue, and prevents scar tissue formation

Hydrocortisone could also be used systemically as oral drugs or injections and are additionally out there in varied types of topical purposes, used to deal with allergic skin conditions. Hydrocortisone is principally a prescription drug, although some formulations of topical purposes can be found over-the-counter (OTC). Topical hydrocortisone purposes could also be utilized in each adults and pediatric sufferers to deal with:

Atopic dermatitis
Corticosteroid dermatoses (pores and skin lesions)
Systemic hydrocortisone makes use of embody the next:


Standing asthmaticus (acute extreme asthma)
Power adrenal insufficiency
Acute adrenal disaster (off-label)
COVID-19 in adults (off-label)
A number of metabolic and inflammatory circumstances together with:

Endocrine problems
Rheumatic problems
Collagen ailments
Dermatologic ailments
Allergic states
Ophthalmic ailments
Respiratory ailments
Hematologic ailments
Neoplastic ailments (cancers)
Edematous ailments (circumstances that trigger edema/swelling)
Gastrointestinal ailments
Tuberculous meningitis
Trichinosis with neurological or myocardial involvement


Adrenocortical insufficiency
Acute adrenal disaster
Different circumstances embody:

What are the uncomfortable side effects of hydrocortisone?

Widespread uncomfortable side effects of systemic hydrocortisone embody:

This isn’t an entire checklist of all uncomfortable side effects or opposed reactions which will happen from using this drug. Name your physician for medical recommendation about severe uncomfortable side effects or opposed reactions. You may additionally report uncomfortable side effects or well being issues to the FDA at 1-800-FDA-1088.

What are the dosages of hydrocortisone?

Pill (Cortef, generic)

Powder for injection (SoluCortef)


Capsule, immediate-release oral granules (Alkindi Sprinkle) — pediatric use

Topical purposes (starting from 0.1% to 2.5%)




15-240 mg oral/intramuscular/intravenous (PO/IM/IV) each 12 hours
100-500 mg/dose IV/IM each 2 hours, 4 hours, or 6 hours

Standing Asthmaticus

1-2 mg/kg intravenously (IV) each 6 hours initially for twenty-four hours; upkeep: 0.5-1 mg/kg each 6 hours

Power Adrenal Insufficiency

15-25 mg/day orally divided each 8-12 hours

Acute Adrenal Disaster Therapy (off-label)

100 mg intravenous (IV) bolus, then 300 mg/day IV divided each 8 hours or administered by steady infusion for 48 hours
When a affected person is stabilized: 50 mg orally each 8 hours for six doses, then tapered to 30-50 mg/day orally in divided doses

COVID-19 (off-label)

If dexamethasone is just not out there
Hydrocortisone 160 mg PO/IV daily for as much as 10 days or discharge, whichever comes first; use along with normal of care

Different metabolic and inflammatory circumstances:

Regular oral dosing vary: 10-320 mg/day divided each 6-8 hours
Regular IV/IM dosing vary (sodium succinate): 100-500 mg as wanted initially; could also be repeated each 2 hours, 4 hours, or 6 hours as wanted



Youngsters under 12 years of age: 2.5-10 mg/kg/day orally divided each 6-8 hours, or 1-5 mg/kg/day IM/IV divided each 12-24 hours
Youngsters 12 years of age and above: 15-240 mg oral/intramuscular/intravenous/subcutaneous (PO/IM/IV/SC) each 12 hours

Standing asthmaticus

1-2 mg/kg IV each 6 hours for twenty-four hours; to not exceed 250 mg
IV Upkeep: 2 mg/kg/day IV divided each 6 hours
Oral Upkeep: 0.5-1 mg/kg each 6 hours

Adrenocortical insufficiency

8-10 mg/m²/day oral/intramuscular/intravenous (PO/IM/IV) divided each 8 hours

Acute adrenal disaster

Youngsters of age 1 month-1 12 months
25 mg intravenous (IV) bolus, then 50 mg/m²/day by steady IV drip or divided each 6-8 hours
Various: 1-2 mg/kg IV bolus, then 25-150 mg/kg/day IV divided each 6-8 hours
Youngsters 1-12 years of age
50-100 mg fast intravenous (IV) bolus, then 50 mg/m²/day by steady IV drip or divided each 6-8 hours
Various: 1-2 mg/kg IV bolus, then 150-250 mg/day divided each 6-8 hours


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What medication work together with hydrocortisone?

Inform your physician of all drugs you might be at the moment taking, who can advise you on any attainable drug interactions. By no means start taking, immediately discontinue, or change the dosage of any remedy with out your physician’s advice.

Extreme Interactions of hydrocortisone embody:

Hydrocortisone has severe interactions with at the very least 75 totally different drugs.
Hydrocortisone has reasonable interactions with at the very least 240 totally different medication.
Hydrocortisone has delicate interactions with at the very least 128 totally different medication.

The drug interactions listed above should not the entire attainable interactions or opposed results. For extra data on drug interactions, go to the RxList Drug Interplay Checker.

It is very important at all times inform your physician, pharmacist, or well being care supplier of all prescription and over-the-counter drugs you employ, in addition to the dosage for every, and hold an inventory of the data. Verify together with your physician or well being care supplier you probably have any questions in regards to the remedy.

Being pregnant and breastfeeding

There aren’t any sufficient and well-controlled research to be used of hydrocortisone in girls of child-bearing potential, pregnant or breastfeeding girls.
Hydrocortisone could also be utilized in pregnant girls if potential advantages outweigh potential dangers to the mom and fetus.
Systemic hydrocortisone seems in breast milk and should be used with warning in nursing moms.
Some recommendations (not totally substantiated) of barely elevated cleft palate danger if corticosteroids are utilized in pregnancy

What else ought to I find out about hydrocortisone?

Blood clot blockages in blood vessels (thromboembolisms) and muscle harm or weakness (myopathy) might happen
Excessive dose corticosteroids are related to elevated bone loss and osteoporotic fractures
Anaphylactoid (severe allergic) reactions have been reported
Delayed wound therapeutic is feasible
Sufferers on corticosteroids ought to keep away from chickenpox or measles-infected individuals if unvaccinated
Latent tuberculosis could also be reactivated (sufferers with optimistic tuberculin check needs to be monitored)
Extended corticosteroid use might end in eye conditions resembling elevated intraocular pressure, glaucoma, or cataracts
Killed or inactivated vaccines could also be administered with warning; nevertheless, the response to such vaccines can’t be predicted
Immunization procedures could also be undertaken in sufferers who’re receiving hydrocortisone as alternative remedy in low doses due to pure deficiency (e.g., for Addison’s illness)
Pheochromocytoma (a sort of cancer that impacts adrenal glands) disaster, which will be deadly, reported after administration of systemic corticosteroids
Corticosteroid results are enhanced  in sufferers with hypothyroidism and in these with cirrhosis; may have dosage changes when adjustments in thyroid standing happen
Myopathy reported with excessive dose corticosteroids; principally in sufferers with neuromuscular transmission problems; prone to have an effect on ocular and/or respiratory muscular tissues
Incidence of Kaposi sarcoma, a sort of cancer, is  related to extended corticosteroid remedy; take into account discontinuing remedy if it happens
Thinning and fragility of pores and skin (atrophy)  might happen on the web site of injection
Corticosteroids needs to be used cautiously in sufferers with herpes simplex eye infections  due to attainable corneal perforation
Extended use of corticosteroids might improve the incidence of secondary infections
Sodium retention with edema and potassium loss might happen with corticosteroid use; should be used with warning in sufferers with hypertension, congestive coronary heart failure or renal insufficiency
Security and effectiveness of epidural administration of corticosteroids haven’t been established, and corticosteroids should not permitted for this use. Critical neurologic occasions, some leading to dying, have been reported with epidural injection of corticosteroids

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Medically Reviewed on 3/7/2022

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