Hydrocortisone: Side Effects, Dosage, Uses, and More (original) (raw)

Highlights for hydrocortisone

Hydrocortisone oral tablet is available as a brand-name drug and in a generic form. Brand name: Cortef.
Hydrocortisone comes in many forms. These include a tablet you take by mouth, and an injectable form.
Hydrocortisone oral tablet is used to treat adrenocortical deficiency, and swelling and inflammation. It’s also used to slow down your immune system.

Infection risk warning: Hydrocortisone can weaken your body’s response to infection because the drug weakens your immune system. Using this medication may also make it harder for you to know that you have an infection.
Vaccine warning: Due to hydrocortisone weakening your immune system, you shouldn’t be given a live vaccine, such as the chickenpox vaccine, when taking high doses of hydrocortisone or if you’ve taken hydrocortisone for a long time. Instead, you may be given killed or inactivated vaccines. However, the vaccine may not work as well.
Warning for stopping this drug: If you’ve been taking hydrocortisone for a long time, don’t stop taking it suddenly. This can cause withdrawal that can last a long time. Symptoms of withdrawal may include fever, muscle and joint pain, and overall discomfort. To prevent withdrawal, your doctor will slowly lower your dosage of hydrocortisone over time or have you take it less often.

Hydrocortisone is a prescription medication. It comes in many forms, including an oral tablet.

Hydrocortisone oral tablet is available as the brand-name drug Cortef and in a generic form. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Why it’s used

Hydrocortisone is used to treat adrenocortical deficiency, swelling and inflammation, and to slow down your immune system.

It’s approved for:

rheumatic disorders, such as rheumatoid arthritis and ankylosing spondylitis
eye conditions, such as severe allergic and inflammatory conditions
stomach or intestinal disorders, such as ulcerative colitis and intestinal swelling
collagen disorders, such as systemic lupus erythematosus
endocrine disorders, such as thyroid inflammation
respiratory disorders, such as Loeffler’s syndrome or inflammation of the lung due to beryllium or aspiration
infections, such as tuberculosis, meningitis in tuberculosis, and roundworm infections
adrenocortical deficiency
swelling and inflammation caused by:
to slow down your immune system (immunosuppression):
- skin disorders, such as pemphigus, Stevens-Johnson syndrome, exfoliative dermatitis, mycosis fungoides, severe psoriasis, or seborrheic dermatitis
- allergies. It’s used as treatment of severe conditions if other therapy doesn’t work. These include allergic rhinitis, bronchial asthma, skin reactions, serum sickness, and allergic reactions to medications.
- blood disorders, such as idiopathic thrombocytopenic purpura and secondary thrombocytopenia in adults, red blood cell anemia, autoimmune hemolytic anemia, and congenital hypoplastic anemia
fluid retention (edema)
cancer-related conditions, such as leukemia symptoms, lymphoma symptoms, and hypercalcemia associated with cancer

How it works

Hydrocortisone belongs to a class of drugs called glucocorticoids or adrenocorticoids. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Hydrocortisone is a steroid hormone that blocks certain proteins in your body. It works to decrease swelling and stop your immune system from reacting to different triggers.

Hydrocortisone also affects how your body uses and stores carbohydrates, proteins, and fats and how your body balances water and electrolytes.

Hydrocortisone oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of hydrocortisone include:

headaches
muscle weakness
skin problems such as acne or thin, shiny skin

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reactions. Symptoms can include:
- skin rash
- itching
- hives
- swelling of your face, lips, or tongue
- breathing problems
Infection. Symptoms can include:
- fever
- sore throat
- sneezing
- cough
- wounds that won’t heal
- pain when urinating
Mental changes, such as:
- depression
- mood swings
Stomach problems, including:
- vomiting
- severe stomach pain
Central serous chorioretinopathy. Symptoms can include:
- distorted vision
- blind spot in your line of vision
- objects looking smaller or farther away than they really are
Epidural lipomatosis. Symptoms can include:
- fatty deposits on your back
- back pain
- weakness or numbness in your legs or feet
Pheochromocytoma crisis. Symptoms can include:
- high blood pressure
- rapid heartbeat
- excessive sweating
- severe headache
- tremors
- paleness in your face
Pain in your hips, back, ribs, arms, shoulders, or legs
High blood sugar. Symptoms can include:
- passing urine more often than usual
- increased thirst
- feeling hungrier than normal
Feeling unusually weak or tired
Swelling of your feet or lower legs
Seizures

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Hydrocortisone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with hydrocortisone are listed below.

Mifepristone

Don’t take mifepristone with hydrocortisone. It can block the effect of hydrocortisone and make it ineffective.

Seizure drugs

Taking these medications with hydrocortisone can lower the amount of hydrocortisone in your body and decrease its effect. If you start or stop taking a seizure drug while taking hydrocortisone, your doctor may need to change your dosage of hydrocortisone.

Examples of seizure drugs include:

phenobarbital
phenytoin

Antibiotic

Taking rifampin with hydrocortisone can lower the amount of hydrocortisone in your body and decrease its effect. If you start or stop taking rifampin while taking hydrocortisone, your doctor may need to change your dosage of hydrocortisone.

Antifungal drug

Taking ketoconazole with hydrocortisone can increase the amount of hydrocortisone in your body, which raises your risk of side effects. If you start or stop taking this drug while taking hydrocortisone, your doctor may need to change your dosage of hydrocortisone.

Ephedrine

Taking ephedrine with hydrocortisone can lower the amount of hydrocortisone in your body and decrease its effect. If you start or stop taking it while taking hydrocortisone, your doctor may need to change your dosage of hydrocortisone.

Live vaccines

Check with your doctor before getting any vaccines. You should not receive live vaccines if you take high doses of hydrocortisone or have been taking hydrocortisone for a long time. Examples of live vaccines include:

nasal spray flu vaccine
measles, mumps, and rubella vaccine
chickenpox and shingles vaccine

Inactivated vaccines

Inactivated vaccines may not work well to protect you if you’re taking hydrocortisone to weaken your immune system. Examples of these vaccines include:

tetanus, diphtheria, and pertussis vaccine (Tdap)
hepatitis B vaccine
pneumonia vaccine
intramuscular flu vaccine

Anticoagulant, blood thinner

Taking warfarin with hydrocortisone may increase or decrease the blood-thinning effects of warfarin. Your dosage may need to be adjusted by your doctor.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Taking NSAIDs with hydrocortisone can increase the stomach and intestinal side effects of NSAIDs. You may be at a higher risk of ulcers and bleeding.

There are many types of NSAIDs. Examples include:

aspirin
salicylates
ibuprofen
naproxen

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Hydrocortisone can cause a severe allergic reaction. Symptoms can include:

skin rash
itching
hives
swelling of your face, lips, or tongue
breathing problems

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take hydrocortisone if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Measles and chickenpox warning

Tell your doctor if you’ve been around someone who has measles or chickenpox. Hydrocortisone decreases your immune system’s ability to fight infections like these. If you get measles or chickenpox, you may have a severe case that can be fatal (cause death).

Infection and surgery warning

During your treatment with this drug and for up to 12 months after, call your doctor right away if you:

have symptoms of infection
have an injury
need to have surgery

Warnings for people with certain health conditions

For people with infections: This medication can cover up (mask) symptoms of infection. It can also make it harder for your body to fight an infection.

For people with high blood pressure: Hydrocortisone can raise your blood pressure. Use it with caution if you have high blood pressure or heart problems. Monitor your blood pressure more closely while you take hydrocortisone.

For people with diabetes: Hydrocortisone can increase your blood sugar levels. Monitor your blood sugar more closely while you’re taking this medication.

For people with glaucoma: Hydrocortisone can increase the pressure in your eyes. This may make your glaucoma worse. Your doctor may check your eyes regularly if you take this medication.

For people with stomach or intestinal problems: Hydrocortisone can irritate your stomach or intestines, which can worsen your stomach or intestinal problems. Don’t take hydrocortisone if you currently have a stomach ulcer.

For people with liver problems: Hydrocortisone is broken down in your liver. If you have severe liver disease, it may build up in your body and have dangerous effects. You may need a lower dosage of this medication.

For people with thyroid problems: If you have low thyroid function, you may be more sensitive to the effects of hydrocortisone.

For people with mental health problems: Hydrocortisone can worsen mood changes, personality changes, depression, and hallucinations. You may need dosage adjustments of your mental health medications.

For people with congestive heart failure: Hydrocortisone makes your body retain water and salt, which can make heart failure worse. You may need to eat a low-salt diet. Your heart medication dosage may need to be changed.

For people with Cushing syndrome: People with this condition already have too much steroid hormone in their body. Taking hydrocortisone, a steroid hormone, can worsen symptoms of Cushing syndrome.

For people with low potassium: Hydrocortisone may increase the amount of potassium that leaves your body in your urine. Your risk is higher if you take high doses of the drug. Your doctor will check your potassium levels while you take hydrocortisone. You may need to take potassium supplements.

For people with ocular herpes simplex: If you have ocular herpes simplex, use this drug with caution. It may increase your risk for perforation or small holes in the outer layer of your eye (called the cornea).

Warnings for other groups

For pregnant women: Taking hydrocortisone while you are pregnant may harm your pregnancy. Tell your doctor if you’re pregnant or plan to become pregnant. Hydrocortisone should be used during pregnancy only if the potential benefit justifies the potential risk.

For women who are breastfeeding: Taking hydrocortisone while you are breastfeeding may harm your breastfed child. Tell your doctor if you’re breastfeeding. You may need to decide whether to stop breastfeeding or stop taking hydrocortisone.

For seniors: If you’re a senior, this medication may increase your risk of breaking a bone. It may also increase your risk of developing osteoporosis.

For children: Hydrocortisone can delay growth and development in children and infants. Your doctor will monitor your child’s height and weight if they take this medication.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

your age
the condition being treated
how severe your condition is
other medical conditions you have
how you react to the first dose

Dosage for all approved conditions

Generic: Hydrocortisone

Form: oral tablet
Strengths: 5 mg, 10 mg, and 20 mg

Brand: Cortef

Form: oral tablet
Strengths: 5 mg, 10 mg, and 20 mg

Adult dosage (ages 18 years and older)

Typical starting dosage: 20–240 mg per day, depending on your condition and how severe it is.
Dosage adjustments: The starting dosage should be maintained or increased until your body has a good response. If your body responds well, your doctor may slowly start to decrease your dosage.

Child dosage (ages 0–17 years)

Your doctor will decide your child’s dosage. It will depend on factors such as the condition being treated and how severe it is.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Hydrocortisone oral tablet is used for short-term or long-term treatment. How long you take it will depend on the condition you’re treating.

This drug comes with risks if you don’t take it as prescribed by your doctor.

If you stop suddenly: Stopping the drug suddenly may lead to a withdrawal reaction. Symptoms of withdrawal may include fever, muscle and joint pain, and overall discomfort. Your risk is greater if you’ve taken hydrocortisone for more than a few days.

When it’s time to stop, your doctor may decrease your dosage slowly to avoid withdrawal.

If you take too much: Taking too much of this medication can be dangerous. If you think you’ve taken too much of this drug, call your doctor or local poison control center.

If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you can. If it’s close to the time for your next dose, contact your doctor or pharmacist. You might need to miss a dose or take an extra dose, depending on your condition.

Don’t take any extra doses without checking with your doctor or pharmacist first.

How to tell if the drug is working: You should notice a decrease in your swelling and other symptoms of your illness.

Keep these considerations in mind if your doctor prescribes hydrocortisone oral tablet for you.

General

Take with food to avoid an upset stomach.
Take this drug at the time(s) recommended by your doctor.
You can cut or crush the tablet.

Storage

Store at room temperature between 68°F and 77°F (20°C and 25°C).
Keep this drug away from light.
Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
Don’t worry about airport x-ray machines. They can’t harm your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor may check your thyroid and liver function to make sure this drug is suitable for you.

If you’re taking hydrocortisone for a long time, your doctor may:

check your eye pressure
do eye exams for cataracts
check calcium levels in your blood
do a complete blood count

Your diet

Hydrocortisone can cause you to retain salt and water. It can also change how your body handles carbohydrates and proteins. You might need to limit the amount of salt and carbohydrates you eat, take potassium supplements, and eat a high-protein diet. Talk to your doctor or pharmacist before making any major changes in your diet.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained here in is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.