April 29, 2017
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Hydrocortisone

Medical and Pharmacy Editor:

Brand Name: Hydrocort, Alphosyl, Aquacort, Cortef, Cortenema, SoluCortef

Generic Name: hydrocortisone

Drug Class: Corticosteroids

What Is Hydrocortisone and How Does It Work?

Hydrocortisone is approved by the U.S. Food and Drug Administration as a prescription steroid medication that is indicated to treat inflammation, status asthmaticus, acute and chronic adrenal insufficiency, and as physiologic replacement in pediatric use.

In topical (applied to the skin) form, such as creams, lotions, and ointments, hydrocortisone is used as a treatment for redness, swelling, itching, and discomfort of various skin problems and conditions, as well as inflammatory conditions and rashes. Topical hydrocortisone cream is most often used as the treatment for these purposes. Some forms of hydrocortisone are available with or without a prescription.

Hydrocortisone is often compared to similar steroid drug treatments such as prednisone. Prednisone is a prescription oral corticosteroid drug that often used for managing, reducing or eliminating symptoms associated with your body's immune system responses (such as allergies and eczema).

Hydrocortisone is available under the following different brand names: Hydrocort, Alphosyl, Aquacort, Cortef, Cortenema, and SoluCortef.

Dosages of Hydrocortisone:

Adult and Pediatric Dosage Forms and Strengths

Tablet

  • 5 mg
  • 10 mg
  • 20 mg

Powder for injection

  • 100 mg
  • 250 mg
  • 500 mg
  • 1 g

Dosage Considerations – Should be Given as Follows:

Inflammation

  • Adult: 15-240 mg oral/intramuscular/intravenous (PO/IM/IV) every 12 hours
  • Children under 12 years: 2.5-10 mg/kg/day orally divided every 6-8 hours or 1-5 mg/kg/day IM/IV divided every 12-24 hours
  • Children 12 years and older: 15-240 mg oral/intramuscular/intravenous/subcutaneous (PO/IM/IV/SC) every 12 hours

Status Asthmaticus

  • Adult: 1-2 mg/kg intravenously (IV) every 6 hours initially for 24 hours; maintenance: 0.5-1 mg/kg every 6 hours
  • Pediatric
  • 1-2 mg/kg IV every 6 hours for 24 hours; not to exceed 250 mg
  • IV Maintenance: 2 mg/kg/day IV divided every 6 hours
  • Oral Maintenance: 0.5-1 mg/kg every 6 hours

Acute Adrenal Insufficiency

  • 100 mg intravenous (IV) bolus, then 300 mg/day IV divided every 8 hours or administered by continuous infusion for 48 hours
  • When patient is stabilized: 50 mg orally every 8 hours for 6 doses, then tapered to 30-50 mg/day orally in divided doses

Chronic Adrenal Insufficiency

  • 15-25 mg/day orally divided every 8-12 hours

Physiologic Replacement, Pediatric

  • 8-10 mg/mē/day oral/intramuscular/intravenous (PO/IM/IV) divided every 8 hours

Acute Adrenal Crisis Treatment (Off-label)

  • Children age 1 month-1 year
    • 25 mg intravenous (IV) bolus, then 50 mg/mē/day by continuous IV drip or divided every 6-8 hours
    • Alternative: 1-2 mg/kg IV bolus, then 25-150 mg/kg/day IV divided every 6-8 hours
  • Children 1-12 years
    • 50-100 mg rapid intravenous (IV) bolus, then 50 mg/mē/day by continuous IV drip or divided every 6-8 hours
    • Alternative: 1-2 mg/kg IV bolus, then 150-250 mg/day divided every 6-8 hours
  • Dosage Considerations
    • Usual oral dosing range: 10-320 mg/day divided every 6-8 hours
    • Usual intravenous/intramuscular (IV/IM) dosing range (sodium succinate): 100-500 mg as needed initially; may be repeated every 2 hours, every 4 hours, or every 6 hours as needed
    Medically Reviewed by a Doctor on 4/26/2017



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