What Are the Most Common Uses for Hydrocortisone Tablets?

Hydrocortisone tablets, the indications are mainly used for replacement therapy of adrenal insufficiency and congenital adrenal hyperplasia, and can also be used for rheumatoid arthritis, rheumatic fever, gout, bronchial asthma, allergies Sexually transmitted diseases, and can be used for severe infections and anti-shock treatment.

Drug Name: Hydrocortisone tablets
Drug type: Prescription medicines, essential medicines, medicines for medical workers' injuries

Special medicine: Doping
Use classification: Glucocorticoid

Hydrocortisone tablet ingredients

Hydrocortisone.

Chemical name: 11, 17, 21-trihydroxypregn-4-ene-3,20-dione

Molecular formula: C ₂₁ H ₃₀ O ₅

Molecular weight: 362.47

Hydrocortisone Tablet Properties

This product is a white tablet.

Hydrocortisone tablets indications

It is mainly used for the replacement of adrenal insufficiency and congenital adrenal hyperplasia. It can also be used for rheumatoid arthritis, rheumatic fever, gout, bronchial asthma, allergic diseases, and can be used for severe infections and Anti-shock treatment.

Hydrocortisone Tablet Specifications

(1) 10mg
(2) 20mg

Hydrocortisone tablets dosage

Oral: for the treatment of adult adrenal insufficiency, daily dose of 20-30mg, 2/3 in the morning, 1/3 after lunch. When there is stress, you should increase the amount appropriately, which can be increased to 80mg per day, and taken in divided doses. The therapeutic dose for children is 20 to 25 / m ² per day based on body surface area, divided into 3 times and taken once an hour.

Adverse effects of hydrocortisone tablets

Glucocorticoids have no obvious adverse effects when applying physiological dose replacement therapy, and most of the adverse reactions occur when applying pharmacological doses, and are closely related to the course of treatment, dose, usage and route of administration. The common adverse reactions are as follows:
1. Long-term use can cause the following side effects: iatrogenic Cushing's syndrome, face and body shape, weight gain, lower limb edema, purple streaks, tendency to bleed easily, poor wound healing, acne, menstrual disorders, humeral or femoral head ischemic necrosis Osteoporosis and fractures (including vertebral compression fractures, long bone pathological fractures), muscle weakness, muscle atrophy, hypokalemia syndrome, gastrointestinal irritation (nausea, vomiting), pancreatitis, peptic ulcer or perforation, Growth inhibition, glaucoma, cataracts, benign intracranial pressure syndrome, impaired glucose tolerance and exacerbation of diabetes in children.
2. Patients may have mental symptoms: euphoria, agitation, delirium, restlessness, disorientation, or inhibition. Mental symptoms include those who are prone to suffer from chronic wasting diseases and those who have had mental disorders in the past.
3. Concurrent infection is the main adverse reaction of adrenocortical hormone. Mainly fungi, tuberculosis, staphylococcus, proteus, Pseudomonas aeruginosa and various herpes viruses.
4. glucocorticoid withdrawal syndrome. Sometimes patients have dizziness, fainting tendency, abdominal pain or back pain, low fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue, weakness after discontinuation of medication. Careful inspection can rule out adrenal insufficiency and the original disease. The re-ignition can be considered as glucocorticoid dependence syndrome.

Hydrocortisone taboo

Those who are allergic to this product and other steroid hormones are contraindicated. Patients with the following diseases are generally unsuitable for use. Special circumstances should be weighed against pros and cons, but attention should be paid to the possible deterioration of the condition: severe mental illness (past or present) and epilepsy, active peptic ulcer disease, recent gastrointestinal anastomosis, fractures, and trauma repair. Corneal ulcers, adrenal hyperfunction, hypertension, diabetes, pregnant women, infections that cannot be controlled by antibacterials, such as chicken pox, measles, fungal infections, heavier osteoporosis, etc. Adrenal insufficiency and congenital adrenal hyperplasia are still used in pregnancy and diabetes.

Precautions for hydrocortisone tablets

1. Induced infections: Patients with adrenal insufficiency are prone to infection. Under the action of hormones, infections that have been controlled can become active. The most common is recurrence of tuberculosis infection. Application of hormones in certain infections can reduce tissue damage, reduce exudation, and reduce symptoms of infection poisoning, but must be treated with effective antibiotics at the same time, closely observe changes in the condition, after short-term medication, it should be quickly reduced and discontinued.
2. Interference to diagnosis:
(1) Glucocorticoids can increase blood glucose, blood cholesterol and blood fatty acids, blood sodium levels, and decrease blood calcium and potassium.
(2) The effect on peripheral blood image is decreased lymphocytes, eukaryotic cells, eosinophils, and basophils, multinucleated leukocytes and platelets, and the latter can also decrease.
(3) Long-term high-dose glucocorticoids can cause false negative skin test results, such as tuberculin test, histoplasmin test, and allergic skin test.
(4) It can also reduce the thyroid ¹³¹ I uptake rate, weaken the response of thyroid stimulating hormone (TSH) to TSH-releasing hormone (TRH) stimulation, and make the TRH excitation test result false positive. Interfering with the results of the luteinizing hormone-releasing hormone (LHRH) excitement test.
(5) Weaken or thin the isotope brain and bone imaging.
3 The following conditions should be used with caution: heart disease or acute heart failure, diabetes, diverticulitis, emotional instability and psychosis, systemic fungal infections, glaucoma, liver damage, herpes simplex, hyperlipoproteinemia, hypertension , Hypothyroidism (increased glucocorticoid effect at this time), myasthenia gravis, osteoporosis, gastric ulcer, gastritis or esophagitis, impaired renal function or stones, tuberculosis, etc.
4 Follow-up inspection: Those who have been using glucocorticoid for a long time should regularly check the following items:
(1) Blood glucose, urine glucose or glucose tolerance test, especially those with diabetes or diabetes tendency.
(2) Pediatrics should be regularly tested for growth and development.
(3) Eye examination, pay attention to the occurrence of cataract, glaucoma or eye infection.
(4) Serum electrolyte and fecal occult blood.
(5) Examination of hypertension and osteoporosis, especially in the elderly.

Hydrocortisone tablets for pregnant and lactating women

1. Medication during pregnancy: Glucocorticoids can pass through the placenta. Animal experimental studies have confirmed that administration during pregnancy can increase the incidence of embryonic cleft palate, placental insufficiency, spontaneous abortion and intrauterine growth retardation. Human use of pharmacological doses of glucocorticoids can increase the incidence of placental insufficiency, neonatal weight loss, or stillbirth.
2. Drugs for lactation: Because glucocorticoids can be excreted from milk, it has adverse effects on infants, such as growth inhibition and adrenal cortex function inhibition. Pregnant women and lactating women should avoid using it as much as possible while weighing the pros and cons.

Hydrocortisone tablets for children

Pediatric use of adrenal corticosteroids must be very careful.

Hydrocortisone tablets for elderly

Elderly patients are prone to hypertension and diabetes with glucocorticoids. The use of glucocorticoids in elderly patients, especially postmenopausal women, is likely to worsen osteoporosis.

Hydrocortisone tablets drug interactions

1. Non-steroidal anti-inflammatory analgesics can enhance their ulcer-causing effects.
2. Can enhance the liver toxicity of acetaminophen.
3 Combined with amphotericin B or carbonic anhydrase inhibitors, it can aggravate hypokalemia, and long-term combined with carbonic anhydrase inhibitors, prone to hypocalcemia and osteoporosis.
4 Combined with protein anabolic hormones, it can increase the incidence of edema and make acne worse.
5. Long-term combination with anticholinergic drugs (such as atropine) can cause increased intraocular pressure.
6. Tricyclic antidepressants can aggravate the mental symptoms they cause.
7. When combined with hypoglycemic agents such as insulin, the dose of hypoglycemic agents should be adjusted appropriately because it can increase blood sugar in patients with diabetes.
8. Thyroid hormone can increase its metabolic clearance. Therefore, the dose of the latter should be adjusted appropriately in combination with thyroid hormone or antithyroid drugs.
9. Combined with contraceptives or estrogen preparations, it can enhance its therapeutic effect and adverse reactions.
10 Combined with cardiac glycoside, it can increase the toxicity of digitalis and heart rhythm disturbance.
11. Combined with potassium-releasing diuretics, it can cause severe hypokalemia, and weaken the sodium-releasing and diuretic effects of diuretics due to water and sodium retention.
12. Combined with ephedrine, it can enhance its metabolic clearance.
13. Combined with immunosuppressants, it can increase the risk of infection and may induce lymphoma or other lymphoplastic diseases.
14. May increase isoniazid metabolism and excretion in the liver, reduce isoniazid blood concentration and efficacy.
15. Can promote the metabolism of mexiletine in the body and reduce blood concentration.
16. Used in combination with salicylate to reduce plasma salicylate concentration.
17. Combined with growth hormone, can inhibit the growth-promoting effect of the latter.

Hydrocortisone tablets overdose

Can cause adrenal-like hyperfunction syndrome.

Hydrocortisone tablets pharmacology and toxicology

Adrenal corticosteroids. Super physiological amount of glucocorticoids has a variety of pharmacological effects such as anti-inflammatory, anti-allergic and immune suppression.
1. Anti-inflammatory effect: Glucocorticoids reduce and prevent tissues from responding to inflammation, thereby reducing the manifestation of inflammation.
2. Immunosuppressive effects: prevent or suppress cell-mediated immune responses, delayed allergic reactions, and reduce the spread of primary immune responses.
3 Anti-toxic and anti-shock effects: Glucocorticoids can counteract the stimulating response of bacterial endotoxins to the body, reduce cell damage and protect the body.

Pharmacokinetics of hydrocortisone tablets

This product can be quickly absorbed from the digestive tract, the blood concentration reaches a peak in about 1 hour, its biological t _1/2 is about 100 minutes, and more than 90% of hydrocortisone in the blood is combined with plasma proteins. Most of the metabolites are combined into glucuronide and very small amounts are excreted in the urine as a prototype.