Hydrocortisone Oral (patient information)

Why this medication is prescribed

Hydrocortisone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It is often used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Hydrocortisone is also used to treat certain types of cancer.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How this medication should be used

Hydrocortisone comes as a tablet and suspension to be taken by mouth. Your doctor will prescribe a dosing schedule that is best for you. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydrocortisone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not stop taking hydrocortisone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, an upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. Watch for these side effects if you are gradually decreasing your dose and after you stop taking the tablets or oral liquid, even if you switch to an inhalation. If these problems occur, call your doctor immediately. You may need to increase your dose of oral hydrocortisone temporarily or start taking it again.

Special precautions

Before taking hydrocortisone:

• tell your doctor and pharmacist if you are allergic to hydrocortisone, aspirin, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), arthritis medication, aspirin, cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), diuretics ('water pills'), estrogen (Premarin), ketoconazole (Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.
• if you have a fungal infection (other than on your skin), do not take hydrocortisone without talking to your doctor.
• tell your doctor if you have or have ever had liver, kidney, intestinal, or heart disease; diabetes; an underactive thyroid gland; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; tuberculosis (TB); or ulcers.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking hydrocortisone, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking hydrocortisone.
• if you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit your consumption of alcoholic beverages while taking this drug. Hydrocortisone makes your stomach and intestines more susceptible to the irritating effects of alcohol, aspirin, and certain arthritis medications. This effect increases your risk of ulcers.

Special dietary instructions

Your doctor may instruct you to follow a low-sodium, low-salt, potassium-rich, or high-protein diet. Follow these directions.

Hydrocortisone may cause an upset stomach. Take hydrocortisone with food or milk.

What to do if you forget a dose

When you start to take hydrocortisone, ask your doctor what to do if you forget a dose. Write down these instructions so that you can refer to them later.

If you take hydrocortisone once a day, take the missed dose as soon as you remember it. If you do not remember a missed dose until it is time for the next dose, skip the missed dose completely and take only the regularly scheduled dose.

If you take more than one dose a day, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Side effects

Minor side effects

Hydrocortisone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• stomach irritation
• vomiting
• headache
• dizziness
• insomnia
• restlessness
• depression
• anxiety
• acne
• increased hair growth
• easy bruising
• irregular or absent menstrual periods

Severe side effects

If you experience any of the following symptoms, call your doctor immediately:

• skin rash
• swollen face, lower legs, or ankles
• vision problems
• cold or infection that lasts a long time
• muscle weakness
• black or tarry stool

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Other information

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to hydrocortisone. Checkups are especially important for children because hydrocortisone can slow bone growth.

If your condition worsens, call your doctor. Your dose may need to be adjusted.

Carry an identification card that indicates that you may need to take supplementary doses (write down the full dose you took before gradually decreasing it) of hydrocortisone during periods of stress (injuries, infections, and severe asthma attacks). Ask your pharmacist or doctor how to obtain this card. List your name, medical problems, drugs and dosages, and doctor's name and telephone number on the card.

This drug makes you more susceptible to illnesses. If you are exposed to chicken pox, measles, or tuberculosis (TB) while using hydrocortisone, call your doctor. Do not have a vaccination, other immunization, or any skin test while you are taking hydrocortisone unless your doctor tells you that you may.

Report any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment.

Your doctor may instruct you to weigh yourself every day. Report any unusual weight gain.

If your sputum (the matter you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, call your doctor; these changes may be signs of an infection.

If you have diabetes, hydrocortisone may increase your blood sugar level. If you monitor your blood sugar (glucose) at home, test your blood or urine more frequently than usual. Call your doctor if your blood sugar is high or if sugar is present in your urine; your dose of diabetes medication and your diet may need to be changed.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Cortef®
• Hydrocortone®

Other names

• Cortisol