HYDROCORTISONE (Cortisol)

Brand & Generic Names

A-hydroCort
Cortef
Cortenema
Cortifoam
Hydrocortone
Hydrocortone Acetate
Hydrocortone Phosphate
Solu-Cortef

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Cortisone drug (adrenal corticosteroid)

Uses

• Reduces inflammation caused by many different medical problems.
• Treatment for some allergic diseases, blood disorders, kidney diseases, asthma and emphysema.
• Replaces corticosteroid deficiencies.

Dosage & Usage Information

How to take:
Tablet or liquid--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet.
Other forms--Follow label instructions.

When to take:
At the same times each day. Take once-a-day or once-every-other- day doses in mornings.

If you forget a dose:
Several-doses-per-day prescription--Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).
Once-a-day dose or less--Wait for next dose. Double this dose.

What drug does:
Decreases inflammatory responses.
Replaces cortisone in patients with adrenal insufficiency.

Time lapse before drug works:
2 to 4 days.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Headache, convulsions, fluid retention, heart failure.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Hives, rash, intense Seek emergency itching, faintness treatment immediately. soon after a dose (anaphylaxis).

Common:

Acne, poor wound healing, thirst, indigestion, nausea, vomiting.

Infrequent:

• Black, bloody or tarry stools.
• Blurred vision; halos around lights; sore throat; fever; muscle cramps; swollen legs, feet.
• Mood change, insomnia, fatigue, restlessness, frequent urination, weight gain, round face, weakness, irregular menstrual periods.

Rare:

• Irregular heartbeat.
• Rash, hallucinations, thrombophlebitis, pancreatitis, numbness or tingling in hands or feet, convulsions.

Warnings & Precautions

Don't take if:

• You are allergic to any cortisone drug.
• You have tuberculosis or fungus infection.
• You have herpes infection of eyes, lips or genitals.

Before you start, consult your doctor:

• If you have had tuberculosis.
• If you have congestive heart failure.
• If you have diabetes, peptic ulcer, glaucoma, underactive thyroid, high blood pressure, myasthenia gravis, blood clots in legs or lungs.

Over age 60:

• Adverse reactions and side effects may be more frequent and severe than in younger persons.
• Likely to aggravate edema, diabetes or ulcers.
• Likely to cause cataracts and osteoporosis (softening of the bones).

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Use only under medical supervision.

Prolonged use:

• Retards growth in children.
• Possible glaucoma, cataracts, diabetes, fragile bones and thin skin.
• Functional dependence.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood sugar, eyes, serum electrolytes, stools for blood.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
No problems expected.

Discontinuing:

• Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.
• Drug affects your response to surgery, illness, injury or stress for 2 years after discontinuing. Tell anyone who takes medical care of you about the drug for up to 2 years after discontinuing.

Others:

• Avoid immunizations if possible.
• Your resistance to infection is less while taking this medicine.
• Those who have inactive or "cured" tuberculosis may be subjected to possible recurrence of active tuberculosis.
• Children who must take cortisone drugs may grow less well.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Amphotericin B	Potassium depletion.
Anticholinergics*	Possible glaucoma.
Anticoagulants,	Decreased anti-
oral*	coagulant effect.
Anticonvulsants,	Decreased hydro-
hydantoin*	cortisone effect.
Antidiabetics,	Decreased anti-
oral*	diabetic effect.
Antihistamines*	Decreased hydro-cortisone effect.
Aspirin	Increased hydro-cortisone effect.
Attentuated virus	Possible viral
vaccines*	infection.
Barbiturates*	Decreased hydrocortisone effect.
	Oversedation.
Chloral hydrate	Decreased hydrocortisone effect.
Chlorthalidone	Potassium depletion.
Cholestyramine	Decreased hydrocortisone absorption
	effect.
Cholinergics*	Decreased cholinergic effect.
Colestipol	Decreased hydrocortisone absorption
	effect.
Contraceptives,	Increased hydro-
oral*	cortisone effect.
Cyclosporine	Increased risk of infection.
Digitalis	Dangerous potassium
preparations*	depletion. Possible digitalis
	toxicity.
Diuretics, thiazide*	Potassium depletion.
Ephedrine	Decreased hydrocortisone effect.
Estrogens*	Increased hydrocortisone effect.
Ethacrynic acid	Potassium depletion.
Furosemide	Potassium depletion.
Glutethimide	Decreased hydrocortisone effect.
Indapamide	Possible excessive potassium loss,
	causing dangerous heartbeat
	irregularity.
Indomethacin	Increased hydrocortisone effect.
Insulin	Decreased insulin effect.
Isoniazid	Decreased isoniazid effect.
Mitotane	Decreased hydrocortisone effect.
Non-steroidal	Increased risk of
anti-inflammatory	ulcers and increased
drugs (NSAIDs)*	hydrocortisone effect.
Oxyphenbutazone	Possible ulcers.
Phenobarbital	Decreased hydrocortisone effect.
Phenylbutazone	Possible ulcers.
Potassium	Decreased potassium
supplements*	effect.
Rifampin	Decreased hydrocortisone effect.
Salicylates*	Decreased salicylate effect.
Sympathomimetics*	Possible glaucoma.
Theophylline	Possible increased theophylline
	effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Risk of stomach ulcers.
Beverages:	No proven problems.
Cocaine:	Overstimulation. Avoid.
Foods:	No proven problems.
Marijuana:	Decreased immunity.
Tobacco:	Increased hydrocortisone effect.
	Possible toxicity.