info on cortef

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GENERIC NAME: hydrocortisone, oral

BRAND NAMES: Hydrocortone, Cortef

DRUG CLASS AND MECHANISM: Hydrocortisone is a natural corticosteroid

produced by the adrenal glands located adjacent to the kidneys.

Corticosteroids have potent anti-inflammatory properties, and are

used in a wide variety of inflammatory conditions such as arthritis,

colitis, asthma, bronchitis, certain skin rashes, and allergic or

inflammatory conditions of the nose and eyes. There are numerous

preparations of corticosteroids including oral tablets, capsules,

liquids, topical creams and gels, inhalers and eye drops, and

injectable and intravenous solutions. Hydrocortisone that is

prescribed in oral tablet and liquid forms is addressed in this

article.

Dosage requirements of corticosteroids vary among individuals and the

diseases being treated. In general, the lowest possible effective

dose is used. Corticosteroids given in multiple doses throughout the

day are more effective, but also more toxic, than if the same total

dose is given once daily, or every other day.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: tablets: 10mg, 20mg

STORAGE: Store at room temperature, sealed container.

PRESCRIBED FOR: Hydrocortisone is used to achieve prompt suppression

of inflammation in many inflammatory and allergic conditions.

Examples of inflammatory conditions include rheumatoid arthritis,

systemic lupus, acute gouty arthritis, psoriatic arthritis,

ulcerative colitis, and Crohn's disease. Severe allergic conditions

that fail conventional treatment may also respond to hydrocortisone.

Examples include bronchial asthma, allergic rhinitis, drug-induced

dermatitis, and contact and atopic dermatitis. Chronic skin

conditions treated with hydrocortisone include dermatitis

herpetiformis, pemphigus, severe psoriasis and severe seborrheic

dermatitis. Chronic allergic and inflammatory conditions of the uvea,

iris, conjunctiva and optic nerves of the eyes are also treated with

hydrocortisone.

Hydrocortisone is also used in the treatment of blood cell cancers

(leukemias), and lymph gland cancers (lymphomas). Blood diseases

involving destruction of platelets by the body's own immune cells

(idiopathic thrombocytopenia purpura), and destruction of red blood

cells by immune cells (autoimmune hemolytic anemia) can also be

treated with hydrocortisone. Other miscellaneous conditions treated

with this medication include thyroiditis and sarcoidosis. Finally,

hydrocortisone is used as a hormone replacement in patients whose

adrenal glands are unable to produce sufficient amounts of

corticosteroids.

DOSING: Should be taken with food.

DRUG INTERACTIONS: Prolonged use of hydrocortisone can depress the

ability of body's adrenal glands to produce corticosteroids. Abruptly

stopping hydrocortisone in these individuals can cause symptoms of

corticosteroid insufficiency, with accompanying nausea, vomiting, and

even shock. Therefore, withdrawal of hydrocortisone is usually

accomplished by gradual tapering. Gradually tapering hydrocortisone

not only minimizes the symptoms of corticosteroid insufficiency, it

also reduces the risk of an abrupt flare of the disease under

treatment. The insufficient adrenal gland function may not recover

fully for months after stopping hydrocortisone. These patients need

additional hydrocortisone treatment during periods of stress, such as

surgery, to avoid symptoms of corticosteroid insufficiency and shock,

while the adrenal gland is not responding by producing its own

corticosteroid.

Hydrocortisone and other corticosteroids can mask signs of infection

and impair the body's natural immune response to infection. Patients

on corticosteroids are more susceptible to infections, and can

develop more serious infections than healthy individuals. For

instance, chicken pox and measles viruses can produce serious and

even fatal illnesses in patients on high doses of hydrocortisone.

Live virus vaccines, such as the small pox vaccine, should be avoided

in patients taking high doses of hydrocortisone, since even vaccine

viruses may cause disease in these patients. Some infectious

organisms, such as tuberculosis (TB) and malaria, can remain dormant

in a patient for years. Hydrocortisone and other corticosteroids can

reactivate dormant infections in these patients and cause serious

illnesses. Patients with dormant TB may require anti-TB medications

while undergoing prolonged corticosteroid treatment.

By interfering with the patient's immune response, hydrocortisone can

impede the effectiveness of vaccinations. Hydrocortisone can also

interfere with the tuberculin skin test and cause false negative

results in patients with tuberculosis infection.