Hydrocortisone
- Atc Codes:A01AC03#A07EA02#C05AA01#D07AA02#D07XA01#H02AB09#S01BA02#S01CB03#S02BA01
- CAS Codes:50-23-7
- PHARMGKB ID:50-23-7
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Hydoftal, Hydrocortone, Hydroderm; Belgium: Azacortine, Cremicort-H, Hydrocortisone, Locoid, Onctose à l’hydrocortisone, Pannocort, Solu-Cortef; Bulgaria: Laticort, Locoid; Cyprus: Alphaderm, Cortopin, Derm Aid, Filocot, Hydrocortistab, Proctosedyl, Uni-Roid HC; Czech Republic: Hydrocortison, Locoid; Denmark: Colifoam, Hydem, Hydrokortison, Locoid, Mildison Lipid, Proctasedyl; Estonia: Hydrocortisone, Locoid, Solu-Cortef; Finland: Ampikyy, Bucort, Colifoam, Cortovance, Hydrocortison, Kyypakkaus, Locoid, Solu-cortef; France: Aphilan Demangeaisons, Calmicort, Cortapaisyl, Ccortisedermyl, Dermaspraid, Dermofenac Efficort, Hydracort, Hydrocortisone, Locoid, Mitocortyl; Germany: Adhoc Robugen, Alfason, Aquilan, Colifoam, Cortavance, Ebenol, Fenistil Hydrocort, Ficortril, Hydrocortison, Hydro Heumann, Hydrocutan, Hydrogalen, Hydroson, Hytison, Laticort, Linola Akut, Linolacort Hydro, Muni, Neuroderm, Pandel, Posterisan, Retef, Sanatison Mono, Soventol, Systral Hydrocort; Greece: Hydrocortisone, Locoid, Lyo-Cortin, Rolak, Solu-Cortef; Hungary: Cortef, Hydrocortison, Hydrokortizon, Solu-Cortef; Ireland: Colifoam, Corlan, Cortopin, Dioderm, Emucream, Hydrocortisone, Locoid, Solu-Cortef; Italy: Colifoam, Cortidro, Cortop, Dermirit, Flebocortid, Foille Insetti, Idroco, Idracemi, Lanacort, Lenirit, Locoidin, Scalpicin, Sintotrat, Solu-Cortef; Latvia: Hidrokortizons, Hydrocortisonum, Laticort, Locoid, Solu-Cortef; Lithuania: Hydrocortison, Hydrocortisonum; Luxembourg: Cortril, Hydrocortison, Hyproderm HC, Solu-Cortef; Malta: Colifoam, Cortopin, Hydrocortone, Hydrocotisyl, Locoid, Solu-Cortef; Netherlands: Buccalsone, Cremicort, Cremor, Hydrocortison, Hydrocortisonacetaat, Hydrocortisoni, Locoid, Mildison, Solu-Cortef; Poland: Corhydron, HC45, Hydrocort, Hydrocortison, Hydrocortisonum, Iwostin HC, Laticort, Locoid, Ophticor H, Procortin, Solu-Cortef; Portugal: Colifoam, Hidalone, Hidrocortisona, Hydrocortone, Lactisona, Locoid, Pandel, Pandermil, Rapicort, Solu-Cortef; Romania: Hydrocortisone, Hydrocortizon, Locoid; Slovakia: Hydrocortison, Locoid; Slovenia: Locoidon, Solu-Cortef; Spain: Actocortina, Aftasone, Anginovag, Ceneo, Hidroaltesona, Hidrocisdin, Hidrocortisona, Lactisona, Oftalmolosa Cusi Hidrocortisona, Oralsone, Schericur, Suniderma; Sweden: Colifoam, Ficortril, Hydrokortison, Hyderm, Locoid, Mildison, Solu-Cortef, Uniderm; UK: Colifoam, Corlan, Dioderm, Efcortelan, Hidrocortisone, Hydrocortistab, Locoid, Mildison, Solu-Cortef.
North America
Canada: A-Hydrocort, Barriere HC, Claritin Skin, Cortamed, Cortate, Cortef, Cortenema, Cortifoam, Cortoderm, Dermaflex HC, Emo Cort, Hycort, Hyderm, Hydrocortisone, Hydroval, Hydrocort, Prevex HC, Neo HC, Sarna HC, Solu-Cortef, Uni-Cort; USA: A-Hydrocort, Ala-Cort, Ala-Scalp, Anusol, HC, Colocort, Cortef, Cortenema, Cortifoam, HC, Hi-Cor, Hydro-RX, Hydrocortisone, Hytone, Locoid, Micort HC, Nutracort, Orabase HCA, Solu-Cortef, Stie-Cort, Synacort, Texacort, Westcort.
Latin America
Argentina: Alfacort, Azuthidrona, Demacort, Fridalit, Hidrocortisona, Hidrotisona, Lactid HC, Locoid, Medrocil, Microsona, Oralsone, Sirotamicin HC, Transderma H; Brazil: Acetato de Hidrocortisona, Berlison, Cortisonal, Cortiston, Cortizol, Cortizon, Hicortin, Hidrocortex, Hidrocortisona, Hidyn H, Locoid, Nutracort, Stiefcortil, Succinato Sod. Hidrocortisona, Therasona, Westcort; Mexico: Aquanil HC, Collicort, Efficort Lipo, Fadol, Flebocortid, Flemex, Hidrocortisona, Icorsan, Lacticare HC, Locoid, Microsona, Nositrol, Nutracort, Solhidrol, Westcort.
Asia
Japan: Cleiton, Cortes, Cortril, Dojifurin, HC-Solone, Hydrocortone, Saxizon, Solu-Cortef.
Drug combinations
Hydrocortisone and Acetic Acid Glacial
Hydrocortisone and Acyclovir
Hydrocortisone and Benzoyl Peroxide
Hydrocortisone and Ciprofloxacin
Hydrocortisone and Cloramphenicol
Hydrocortisone and Clotrimazole
Hydrocortisone and Fusidic Acid
Hydrocortisone and Lidocaine
Hydrocortisone and Miconazole
Hydrocortisone and Naphazoline
Hydrocortisone and Neomycin
Hydrocortisone and Nystatin
Hydrocortisone and Oxytetracycline
Hydrocortisone and Pramoxine
Hydrocortisone and Retinol (Vitamin A)
Hydrocortisone and Tioconazole
Hydrocortisone and Urea
Hydrocortisone, Boric Acid, and Retinol (Vitamin A)
Hydrocortisone, Chloramphenicol, and Neomycin
Hydrocortisone, Ciprofloxacin, and Lidocaine
Hydrocortisone, Diphenhydramine, and Neomycin
Hydrocortisone, Ethyl Aminobenzoate, and Hinokitiol
Hydrocortisone, Gentamicin, and Ketoconazole
Hydrocortisone, Gentamicin, and Miconazole
Hydrocortisone, Hydroquinone, and Tretinoin
Hydrocortisone, Naphazoline, and Neomycin
Hydrocortisone, Neomycin, and Polymyxin B
Hydrocortisone, Oxytetracycline, and Polymyxin B
Hydrocortisone, Bacitracin, Neomycin, and Polymyxin B
Hydrocortisone, Boric Acid, Lidocaine, and Zinc Oxide
Hydrocortisone, Boric Acid, Metronidazole, and Nystatin
Hydrocortisone, Colistin Sulfate, Neomycin, and Thonzonium Bromide
Hydrocortisone, Dexamethasone, Gentamicin, and Ketoconazole
Hydrocortisone, Dibucaine, Esculoside, and Neomycin
Hydrocortisone, Lidocaine, Neomycin, and Retinol (Vitamin A)
Hydrocortisone, Lidocaine, Phenylephrine and Tetracaine
Hydrocortisone, Benzalkonium Chloride, Chlorhexidine, Diphenhydramine, and Salicylate
Hydrocortisone, Boric Acid, Econazole, Griseofulvin, Neomycin, and Salicylic Acid
Hydrocortisone, Gotu Kola, Metronidazole, Miconazole, Neomycin, and Polymyxin B
Hydrocortisone, Boric Acid, Diflorasone, Econazole, Griseofulvin, Neomycin, and Salicylic Acid
Chemistry
Hydrocortisone: C~21~H~30~O~5~. Mw: 362.46. (1) Pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11β)-; (2) Cortisol. CAS-50-23-7.
Pharmacologic Category
Hormones and Synthetic Substitutes; Adrenals. EENT Preparations; Anti-inflammatory Agents; Corticosteroids. Skin and Mucous Membrane Agents; Anti-inflammatory Agents. Rectal Corticosteroid. Systemic Corticosteroid. Topical Corticosteroid. (ATC-Code: A01AC03; A07EA02; C05AA01; D07AA02; D07XA01; H02AB09; S01BA02; S01CB03; S02BA01).
Mechanism of action
Corticosteroid secreted by adrenal cortex. Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. Also inhibits edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation.
Therapeutic use
Management of adrenocortical insufficiency. Relief of inflammation of corticosteroid-responsive dermatoses. Adjunctive treatment of ulcerative colitis. Treatment of a variety of oral diseases of allergic, inflammatory, or autoimmune origin.
Pregnancy and lactiation implications
Hydrocortisone crosses placenta. Corticosteroid use associated with cleft palate, neonatal adrenal suppression, low birth weight, and cataracts in infant; including cases associated with topical administration. Topical products not recommended for extensive use, in large quantities, or for long periods of time in pregnant women. Use caution during lactation.
Unlabeled use
Management of septic shock when blood pressure is poorly responsive to fluid resuscitation and vasopressor therapy.
Contraindications
Hypersensitivity to hydrocortisone or any component of the formulation. Serious infections, except septic shock or tuberculous meningitis. Viral, fungal, or tubercular skin lesions.
Warnings and precautions
May cause hypercorticism or suppression of HPA axis, particularly in younger children or in patients receiving high doses for prolonged periods. Prolonged use of corticosteroids may increase incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox should be avoided. Corticosteroids should not be used to treat ocular herpes simplex, or for treatment of cerebral malaria or viral hepatitis. Prolonged treatment with corticosteroids associated with development of Kaposi’s sarcoma. Acute myopathy reported with high dose corticosteroids, usually in neuromuscular transmission disorders. Corticosteroid use may cause psychiatric disturbances, including depression, euphoria, insomnia, mood swings, and personality changes. Pre-existing psychiatric conditions may be exacerbated by corticosteroid use. Use with caution in heart failure or hypertension (long-term use may cause fluid retention and hypertension). Use with caution in diabetes mellitus (may alter glucose production/regulation leading to hyperglycemia). Use with caution in GI diseases (diverticulitis, peptic ulcer, ulcerative colitis) due to perforation risk. High-dose corticosteroids should not be used for management of head injury. Use with caution in hepatic impairment, including cirrhosis (long-term use may cause fluid retention). Use with caution in each of the following situations: myasthenia gravis (exacerbation of symptoms might occur), following acute MI (risk of myocardial rupture), cataracts and/or glaucoma (risk of increased intraocular pressure, open-angle glaucoma, and cataracts occurred with prolonged use), osteoporosis (high doses and/or long-term use may cause increased bone loss and osteoporotic fractures), renal impairment (fluid retention might occur), or in history of seizure disorder (seizures reported with adrenal crisis). Metabolic clearance of corticosteroids increases in hyperthyroidism and decreases in hypothyroidism. Use may affect growth velocity in pediatric patients. Avoid use of topical preparations with occlusive dressings or on weeping or exudative lesions. Avoid abrupt withdrawal of therapy.