$Unique_ID{BRK03180} $Pretitle{} $Title{hydrocortisone (systemic)} $Subject{systemic Cortef Upjohn Hydrocortone Merck Sharp Dohme Adrenocorticosteroid hormone hydrocortisone cortisol fluid balance temperature reaction inflammation cortisone-like endocrine hormonal rheumatic asthma blood cancers eye disorders gastrointestinal disturbances ulcerative colitis respiratory diseases inflammations arthritis dermatitis poison ivy allergic} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. hydrocortisone (systemic) ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Cortef (Upjohn) hydrocortisone (various manufacturers) Hydrocortone (Merck Sharp & Dohme) TYPE OF DRUG Adrenocorticosteroid hormone INGREDIENT hydrocortisone (cortisol) DOSAGE FORMS Tablets (5 mg, 10 mg, and 20 mg) Oral suspension (10 mg per 5-ml spoonful) STORAGE Store at room temperature in a tightly closed container. Never freeze this medication. USES Your adrenal glands naturally produce certain cortisone-like chemicals. These chemicals are involved in various regulatory processes in the body (such as those involving fluid balance, temperature, and reaction to inflammation). Hydrocortisone belongs to a group of drugs known as adrenocorticosteroids (or cortisone-like medications). It is used to treat a variety of disorders, including endocrine (hormonal) and rheumatic disorders; asthma; blood diseases; certain cancers; eye disorders; gastrointestinal disturbances, such as ulcerative colitis; respiratory diseases; and inflammations such as arthritis, dermatitis, poison ivy, and other allergic conditions. How this medication acts to relieve these disorders is not completely understood. TREATMENT In order to prevent stomach irritation, you can take hydrocortisone with food or milk. If you are taking only one dose of this medication each day, try to take it before 9:00 a.m. This mimics the normal hormonal production in your body. The oral suspension form of this medication should be shaken well just before measuring each dose. The contents tend to settle on the bottom of the bottle, so it is necessary to shake the container to distribute the ingredients evenly and equalize the doses. Each dose should then be measured carefully with a specially designed 5-ml measuring spoon. An ordinary kitchen teaspoon is not accurate enough. It is important to try not to miss any doses of hydrocortisone. However, if you do miss a dose of this medication, follow these guidelines: 1. If you are taking ihydrocorizone more than once a day, take the missed dose as soon as possible, then return to your regular schedule. If it is already time for the next dose, double the dose. 2. If you are taking this medication once a day, take the dose you missed as soon as possible, unless you don't remember until the next day. In that case, do not take the missed dose at all; just follow your regular schedule. Do not double the next dose. 3. If you are taking this drug every other day, take the missed dose as soon as you remember. If you missed the scheduled dose by a whole day, take it when you remember and then skip a day before you take the next dose. Do not double the dose. If you miss more than one dose of hydrocortisone, CONTACT YOUR DOCTOR. SIDE EFFECTS Minor. Dizziness, false sense of well-being, increased appetite, increased sweating, indigestion, menstrual irregularities, nausea, reddening and swelling of the skin on the face, restlessness, sleep disorders, or weight gain. These side effects should disappear as your body adjusts to the medication. To help avoid potassium loss while using this drug, take your dose with a glass of fresh or frozen orange juice, or eat a banana each day. The use of a salt substitute also helps to prevent potassium loss. Check with your doctor before changing your diet or using a salt substitute. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about abdominal (area around and above the waist) enlargement; acne or other skin problems; back or rib pain; bloody or black, tarry stools; blurred vision; convulsions; eye pain; fever and sore throat; growth impairment (in children); headaches; slow healing of wounds; increased thirst and urination; mental depression; mood changes; muscle wasting; muscle weakness; nightmares; rapid weight gain (three to five pounds within a week); rash; red lines across the abdomen; severe abdominal pain; shortness of breath; thinning of the skin; unusual bleeding or bruising; or unusual weakness. INTERACTIONS The systemic form of hydrocortisone adrenocorticosteroid hormone interacts with several other types of medications: 1. Alcohol, aspirin, and anti-inflammatory medications (such as diclofenac, diflunisal, flurbiprofen, ibuprofen, indomethacin, ketoprofen, mefenamic acid, meclofenamate, naproxen, piroxicam, sulindac, and tolmetin) aggravate the stomach problems that are common with use of this medication. 2. The dosage of oral anticoagulants (blood thinners, such as warfarin), oral antidiabetic drugs, or insulin may need to be adjusted when this medication is started or stopped. 3. The loss of potassium caused by hydrocortisone can lead to serious side effects in individuals taking digoxin. Also, thiazide diuretics (water pills) can increase the potassium loss caused by hydrocortisone. 4. Phenobarbital, phenytoin, rifampin, and ephedrine can increase the elimination of hydrocortisone from the body, thereby decreasing its effectiveness. 5. Oral contraceptives (birth control pills) and estrogen-containing drugs may decrease the elimination of this drug from the body, which can lead to an increase in side effects. 6. Hydrocortisone can increase the elimination of aspirin and isoniazid from the body, thereby decreasing the effectiveness of these two medications. 7. Cholestyramine and colestipol can chemically bind this medication in the stomach and gastrointestinal tract, preventing its absorption and decreasing its effectiveness. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to hydrocortisone or other adrenocorticosteroids (such as betamethasone, cortisone, dexamethasone, fluocinolone, methylprednisolone, prednisolone, prednisone, and triamcinolone). * Tell your doctor if you now have or if you have ever had bone disease, diabetes mellitus, emotional instability, glaucoma, fungal infections, heart disease, high blood pressure, high cholesterol levels, myasthenia gravis, peptic ulcers, osteoporosis, thyroid disease, tuberculosis, ulcerative colitis, kidney disease, or liver disease. * If you are using this medication for longer than a week, you may need to receive higher dosages if you are subjected to stress, such as serious infections, injury, or surgery. Discuss this with your doctor. * If you have been taking this drug for more than a week, do not stop taking it suddenly. If it is stopped suddenly, you may experience abdominal or back pain, dizziness, fainting, fever, muscle or joint pain, nausea, vomiting, shortness of breath, or extreme weakness. Your doctor may, therefore, want to reduce the dosage gradually. Never increase the dosage or take the drug for longer than the prescribed time, unless you first consult your doctor. * While you are taking this drug, you should not be vaccinated or immunized. This medication decreases the effectiveness of vaccines and can lead to overwhelming infection if a live-virus vaccine is administered. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Because this drug can cause glaucoma and cataracts with long-term use, your doctor may want you to have your eyes examined by an ophthalmologist periodically during treatment. * If you are taking this medication for prolonged periods, you should wear or carry an identification card or notice that clearly states that you are taking an adrenocorticosteroid medication. * This medication can raise blood sugar levels in diabetic patients. Blood sugar levels should, therefore, be monitored carefully with blood or urine tests when this medication is being taken. * Be sure to tell your doctor if you are pregnant. This drug crosses the placenta. Although studies in humans have not been conducted, birth defects have been observed in the offspring of animals that were given large doses of this drug during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this drug pass into breast milk and may cause growth suppression or a decrease in natural adrenocorticosteroid hormone production in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.