Hydrocortisone should be used with caution in: children, the elderly, patients with ulcers of the stomach or duodenum, patients with a history of or family history of mental illness including depression, renal disease, liver disease, heart failure, heart attack, diabetes, glaucoma (an eye condition), osteoporosis (a bone condition), inflammation of the bowel (ulcerative colitis), high blood pressure, fitting (epilepsy), the muscle condition steroid myopathy, underactive thyroid gland, history of tuberculosis (TB), clotting problems, patients with ongoing ulcers of the mouth or mouth ulcers that become severe, patients with an intolerance to certain sugars (applies to certain preparations only).
It should not be used in: patients with an allergy to hydrocortisone or to any other ingredients contained in the medicine or an allergy to other corticosteroids, intestinal obstruction, abscess or perforation (tearing), peritonitis (inflammation of the lining of the abdomen), other conditions of the intestine (anastomosis or fistulae), inflammation of the brain (cerebral oedema) associated with head injury or stroke, infection, broken or infected skin including the skin conditions impetigo, cold sores, acne, athlete's foot and scabies, bites and stings not caused by insects (e.g. animal bites, nettle stings), patients vaccinated with a live virus, pregnant or breast-feeding women.
Also see list of precautions and interactions
Store below 25ºC.
Hydrocortisone is used to increase the amount of corticosteroid in your body. Corticosteroids occur naturally in your body and help you to remain healthy and well. Increasing the amount of corticosteroid in your body is a way of treating a number of different conditions which cause inflammation in the body.
It is a corticosteroid, sometimes known as a steroid.
It is used to reduce pain, swelling and inflammation and to reduce the body's immune response.
In general this drug is used to treat hormonal conditions when the body does not produce enough of its own steroids, and to treat a range of immune and allergic conditions.
Benefits of being on this drug can include relief from pain, inflammation and swelling and associated symptoms.
Listed below are the typical uses of hydrocortisone.
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
How often do I take it?
- Take this medication orally usually in divided doses twice daily as directed by your doctor. Take with or without food. You may have been prescribed hydrocortisone pellets for mouth ulcers. Do not suck the pellets but instead place one pellet as close to the mouth ulcer as possible and allow it to dissolve. If you are taking hydrocortisone long term you will receive a steroid card. Always carry this with you and show it to any doctor or nurse treating you.Other hydrocortisone formulations (eye drops, ear drops, injection, skin cream or ointment and rectal preparations) may need to be taken or used more or less frequently, as indicated by your doctor or pharmacist. Make sure that you carefully read the patient information leaflet provided with your medicine so that you know exactly how and how often to take or use your hydrocortisone medicine. If you are unsure consult your doctor or pharmacist.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- It may take some days before the full benefit of this drug takes effect. Information on the time to maximum effect is not available.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Keep away from people who have chickenpox, shingles or measles. If you do come into contact with somebody with chickenpox or shingles, contact your doctor straightaway (this applies to certain hydrocortisone formulations only). Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop. If you are on long term hydrocortisone treatment, the importance of not suddenly stopping treatment is explained in more detail in your steroid treatment card.
HYDROCORTISONE SIDE EFFECTS
- Mental (psychiatric) problems
- Feeling depressed
- Feeling suicidal
- Feeling very high (mania)
- Seeing things that aren't really there (hallucinations)
- Strange or frightening thoughts
- Feeling anxious
- Sleep problems
- Feeling confused
- Loss of memory (amnesia)
- Worsening of diabetes, the bone disease osteoporosis, high blood pressure (hypertension), epilepsy (fitting) and the eye condition glaucoma
- Worsening of an infection of the mouth
- Stomach ulcers
- Weakness of the arms and legs
- Developing a rounder face
- Periods stop unexpectedly
- Slowing of growth in children and adolescents
- Increase in weight
- Increased appetite
- Hair growth on your face (women only)
- Dusky complexion (appearance) with purple markings
- Local irritation
- Tingling, prickling or numbness of skin (paraesthesia)
- Water retention
- Yeast infection (Candidiasis)
- Inflammation of the pancreas (pancreatitis)
- Thinning of the skin
If any of these persist or you consider them severe then inform your doctor or pharmacist. Further information on other side effects can be found in the patient information leaflet.
Tell your doctor immediately if you develop any of the following symptoms:
- Mental health problems including feeling depressed, suicidal or very high (manic).
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking hydrocortisone, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: an allergy to hydrocortisone or to any other ingredients contained in the medicine or an allergy to other corticosteroids, intestinal obstruction, abscess or perforation (tearing), peritonitis (inflammation of the lining of the abdomen), other conditions of the intestine (anastomosis or fistulae), inflammation of the brain (cerebral oedema) associated with head injury or stroke, infection, broken or infected skin including the skin conditions impetigo, cold sores, acne, athlete's foot and scabies, bites and stings not caused by insects (e.g. animal bites, nettle stings), have been vaccinated with a live virus, you are pregnant or breastfeeding.
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following ulcers of the stomach or duodenum, a history of or family history of mental illness including depression, renal disease, liver disease, heart failure, heart attack, diabetes, glaucoma (an eye condition), osteoporosis (a bone condition), inflammation of the bowel (ulcerative colitis), high blood pressure, fitting (epilepsy), the muscle condition steroid myopathy, underactive thyroid gland, history of tuberculosis (TB), clotting problems, ongoing ulcers of the mouth or mouth ulcers that become severe, an intolerance to certain sugars (applies to certain preparations only).
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol intake is not known to affect hydrocortisone.
The elderly: hydrocortisone should be used with caution in the elderly as it may be associated with more serious side effects than in younger people.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Hydrocortisone is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Hydrocortisone is not safe to take if you are breastfeeding
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: Live vaccines
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Medicines that thin the blood such as warfarin
- Medicines for diabetes including insulin
- Medicines for high blood pressure
- Medicines for epilepsy (fitting)
- Medicines for fungal infections such as amphotericin
- Medicines for viral infections
- Cardiac glycosides such as digoxin
- Calcium salts
- Water tablets (diuretics)
- Medicines containing oestrogens (including the oral contraceptive pill)
- Beta2-agonists (such as formoterol and salbutamol)
- Non-steroidal anti-inflammatory drugs (NSAIDs)
This information does not contain all possible interactions. Therefore, before using hydrocortisone, tell your doctor or pharmacist of all the products you use. For further information on other potential drug interactions please see the patient information leaflet.
If you accidentally use to much hydrocortisone, contact the nearest hospital casualty department or your doctor immediately.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of hydrocortisone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.