Secondary adrenal insufficiency medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Medical Therapy

• Adrenal crisis

  • Intravenous fluids
  • Intravenous steroid (Solu-Cortef/injectable hydrocortisone) later hydrocortisone, prednisone or methylpredisolone tablets
  • Rest

• Cortisol deficiency (primary and secondary)

  • Hydrocortisone (Cortef)
  • Prednisone (Deltasone)
  • Prednisolone (Delta-Cortef)
  • Methylprednisolone (Medrol)
  • Dexamethasone (Decadron)

• Mineralocorticoid deficiency (low aldosterone)

  • Fludrocortisone acetate

(To balance sodium, potassium and increase water retention)

Contraindicated medications

Uncorrected adrenal insufficiency is considered an absolute contraindication to the use of the following medications:

• Levothyroxine

Adrenal insufficiency is considered an absolute contraindication to the use of the following medications:

• Drospirenone and Ethinyl estradiol

Adrenal insufficiency with hyperkalemia is considered an absolute contraindication to the use of the following medications:

• Potassium chloride

References

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