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| Drug class description : | Glucocorticoid-mineralocorticoids (corticosteroids, steroids). |
| Generic Name : | Hydrocortisone |
| Drug description : | 1 mL and 5 mL ampoules. |
| Presentation : | Injection, hydrocortisone (as sodium phosphate) 100 mg /mL. |
| Indications : | Status asthmaticus, acute allergic reactions, adrenal crisis, severe shock, soft tissue lesions. |
| Adult Dosage : | 100 - 500 mg by slow intravenous injection over at least 30 seconds repeated as required. Maximum 4 doses in 24 hours. |
| Child Dosage : | Up to 1 year, 25 mg; 1 - 5 years, 50 mg; 6 - 12 years, 100 mg. All by slow intravenous injection. Maximum 4 doses in 24 hours. |
| Contra Indications : | Systemic infections unless specific anti-infective therapy is used. Intrathecal injection. |
| Special Precautions : | Tuberculosis, viral, fungal or active infections, latent or active amoebiasis. Warn patients to avoid contact with chickenpox or herpes zoster while they are or herpes zoster while they are receiving steroids and for 3 months post-treatment. In the event of exposure to chickenpox, non-immunised patients should receive varicella-zoster immunoglobulin ideally within 3 days and not later than 10 days from the time of contact. Patients diagnosed with chickenpox should be referred for specialist care. Recent intestinal anastomoses, ulcerative colitis, diverticulitis, active or latent peptic ulcer, thrombophlebitis, psychoses, exanthematous disease, chronic nephritis, acute glomerulonephritis, renal insufficiency, liver failure, cirrhosis, metastatic carcinoma, osteoporosis, hypertension, congestive heart failure, recent MI, glaucoma, epilepsy, diabetes, hypothyroidism, ocular herpes simplex, myasthenia gravis, previous steroid myopathy, cerebral malaria. Limit use in children. Elderly. Pregnancy, lactation. Stress, intercurrent illness, trauma or surgical procedures; monitor patients to avoid life-threatening reactions, (including babies of women who have received large doses of steroids). Use for the shortest length of time at the lowest effective dose, review regularly. Administration in the morning or, if possible, on alternate days helps to reduce risk of adrenal suppression. Advise patient to carry "steroid treatment card". Withrawal: Withdrawal should be gradual in patients who have received systemic steroids for more than 3 weeks, or who have taken high doses or repeat courses, or who have repeatedly taken doses in the evening. In some patients treated for less than 3 weeks, withdrawal may be abrupt if the disease is unlikely to relapse or if high or repeated doses have not been given; reinstate if stressed. |
| Interactions : | Phenytoin, phenobarbital (phenobarbitone), primidone, carbamazepine, aminoglutethimide, ephedrine, diuretics, antihypertensives, oestrogens, anticholinesterases, cardiac glycosides, hypoglycaemics, oral anticoagulants, NSAIDs, salicylates, live vaccines, amphoterecin, acetazolamide, carbenoxolone, methotrexate, cyclosporin, erythromycin, azole antifungals. |
| Adverse Reactions : | Depending on steroid, dose and length of treatment, both glucocorticoid and mineralocoticoid adverse effects may be seen. These include suppression of growth in children, hypertension, water retention, potassium loss, muscle weakness, aseptic necrosis of femoral and humeral heads, cushingoid changes, hyperglycaemia, osteoporosis, depression, euphoria, peptic ulceration, posterior subcapsular cataracts, impaired wound healing, skin thinning. |
| Manufacturer : | Sovereign |
| Drug Availability : | (POM) |
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