Alkindi Sprinkle
Alkindi Sprinkle (hydrocortisone) is a medication used in children to treat adrenocortical insufficiency, a condition where the body doesn't make enough of a hormone called cortisol. It replaces the body's cortisol and balances out hormone levels. The capsules must be opened and sprinkled on the tongue or soft food, which can be helpful for children who have trouble swallowing pills.
What is Alkindi Sprinkle (hydrocortisone)?
What is Alkindi Sprinkle (hydrocortisone) used for?
Replacement therapy for children with adrenocortical insufficiency
How Alkindi Sprinkle (hydrocortisone) works
Alkindi Sprinkle (hydrocortisone) is a glucocorticoid, which is part of a group of medications called corticosteroids. It's a man-made hormone that's similar to the ones made by your body called cortisol. Alkindi Sprinkle (hydrocortisone) works by replacing the low cortisol levels in the body. These hormones affect the body in many ways, including metabolism, the immune system, and helping to maintain the body's salt and water balance.
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What are the side effects of Alkindi Sprinkle (hydrocortisone)?
Common Side Effects
- Fever (56%)
- Stomach flu (gastroenteritis) (50%)
- Upper respiratory tract infection (i.e., common cold, 44%)
- Vomiting (39%)
- Viral infection (33%)
- Pink eye (conjunctivitis) (28%)
- Viral ear infection (17%)
- Infection of the tonsils (17%)
- Rise in body temperature (11%)
- Infection of lining of the lungs (bronchitis) (11%)
- Dental cavities (11%)
- Diarrhea (11%)
- Urinary tract surgery (11%)
- Throat infection (11%)
- Respiratory tract infection (11%)
- Runny nose (11%)
Other Side Effects
- Swelling
- High blood sugar
- High blood pressure
- Changes in mood and behavior
- High appetite
- Weight gain
- Slowed growth
Serious Side Effects
- Adrenal crisis (low cortisol levels): unusual tiredness, weakness, stomach pain, headache, high or low temperature, vomiting
- Serious allergic reaction: rash, difficulty breathing, trouble swallowing, swelling of the face, lips, or throat
- Infections: fever, chills, vision changes, muscle pain, feeling tired or weak
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Cushing syndrome—increased fat around the midsection, upper back, neck, or face, pink or purple stretch marks on the skin, thinning, fragile skin that easily bruises, unexpected hair growth
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Increase in blood pressure
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Swelling of the ankles, hands, or feet
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Acne
- General discomfort and fatigue
- Headache
- Increase in appetite
- Nausea
- Trouble sleeping
- Weight gain
Pros and cons of Alkindi Sprinkle (hydrocortisone)
Pros
Can be taken with or without food
Dose can be adjusted based on symptoms
Available in four different strengths that are color-coded for easy identification
Bitter taste is masked with a special coating of the granules
Cons
Needs to be taken 2 or 3 times daily
Only available as a brand medication, so it can be expensive
Can't swallow the capsules whole (they must be opened)
Can cause problems if the dose is too low or too high
Pharmacist tips for Alkindi Sprinkle (hydrocortisone)
Don't swallow Alkindi Sprinkle (hydrocortisone) capsules whole. You must open the capsule and give the granules inside of the capsule.
Alkindi Sprinkle (hydrocortisone) can be given by pouring the granules directly on your child's tongue, pouring the granules on a spoon first and then and placing it in your child's mouth, or pouring the granules onto a spoonful of soft food like yogurt or fruit puree that's cold or room temperature. The granules are to be swallowed, not chewed or crushed since this can damage the medication.
Don't dissolve Alkindi Sprinkle (hydrocortisone) in liquid because the special coating on them will dissolve and make it taste bitter.
To open Alkindi Sprinkle (hydrocortisone), hold the capsule upright with the strength printed on the top and tap to make sure all the granules are in the lower half of the capsule. Gently squeeze the bottom of the capsule and twist off the top.
Tap the capsule to make sure all of the granules have come out. Try to keep the capsule dry because getting it wet on the tongue or soft food can cause the granules to stick to the capsule.
Alkindi Sprinkle (hydrocortisone) should be given and swallowed within 5 minutes because waiting too long can lead to a bitter taste.
After swallowing the granules, drink liquid (such as water, milk, or breast milk) right away to make sure that all the granules are swallowed properly.
Let your provider know if your child is taking other medications before taking Alkindi Sprinkle (hydrocortisone) to make sure there's no interactions.
Don't stop taking Alkindi Sprinkle (hydrocortisone) suddenly without speaking to the provider because this can lead to serious hormone problems.
Use Alkindi Sprinkle (hydrocortisone) within 60 days of opening the bottle.
Frequently asked questions about Alkindi Sprinkle (hydrocortisone)
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What are the risks and warnings for Alkindi Sprinkle (hydrocortisone)?
Alkindi Sprinkle (hydrocortisone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low or high hormone levels
Risk factors: Taking more or less Alkindi Sprinkle (hydrocortisone) than needed | Stopping Alkindi Sprinkle (hydrocortisone) suddenly | Stress | Infection | Illness | Surgery | Switching from other steroids
If the dose of Alkindi Sprinkle (hydrocortisone) is too low for your child's condition, or if your child suddenly stops taking Alkindi Sprinkle (hydrocortisone), they can have a higher risk of experiencing serious problems with their adrenal glands not making enough hormones, including death. Don't stop giving your child Alkindi Sprinkle (hydrocortisone) without talking to their provider. Let the provider know right away if your child experiences symptoms of low hormone levels, such as loss of appetite, tiredness, muscle weakness, joint pain, nausea, vomiting, or low blood sugar. If your child's body is going through stress, such as having an infection or getting surgery, their provider might need to raise the dose of Alkindi Sprinkle (hydrocortisone). If your child has taken a different steroid medication before switching to Alkindi Sprinkle (hydrocortisone), the dose might also need to be adjusted by the provider.
On the other hand, taking too much Alkindi Sprinkle (hydrocortisone) for a long time can cause a condition called Cushing's syndrome. This can cause problems like weight gain, slowed growth rate, high blood sugar, high blood pressure, swelling, easy bruising, muscle weakness, red round face, depression, or mood swings. Let your provider know if your child experiences any of those symptoms and they can adjust the dose.
Risk of infections
Risk factors: High doses
Taking too much steroid medications, including Alkindi Sprinkle (hydrocortisone), might raise the risk of new infections or worsen existing infections. Proper treatment to replace corticosteroid levels in people with adrenocortical insufficiency shouldn't suppress (weaken) the immune system, so your child shouldn't have a higher risk of getting an infection if taking the correct dose. It might be okay for your child to get a live vaccine while taking Alkindi Sprinkle (hydrocortisone) for adrenocortical insufficiency, but speak to your child's provider first. Make sure you follow up with your provider to ensure the appropriate dose is given to prevent your child from getting too much of Alkindi Sprinkle (hydrocortisone) in their system. Let your provider know right away if your child experiences any signs of infections, such as fever, cough, flu-like symptoms, stomach pain, or diarrhea.
Slowed growth in children and bone problems
Risk factors: Long-term use of high doses
Children who take too much Alkindi Sprinkle (hydrocortisone) for a long time can have a slowed growth rate. The risk of Alkindi Sprinkle (hydrocortisone) affecting your child's growth is less likely if this medication is used for replacement therapy for their hormone levels. It should be taken at the lowest dose possible to treat their symptoms.
Steroids like Alkindi Sprinkle (hydrocortisone) reduce bone formation which raises the risk of osteoporosis (bone loss). Your provider will monitor your child's growth and bones, and will adjust the dose of this medication depending on your child's size.
Behaviorial changes
Risk factors: History of mental health conditions | High dose
Alkindi Sprinkle (hydrocortisone) might cause changes to your child's mood or behavior, which can happen within a few days or weeks of starting this medication. Let your provider know right away if you notice any mood swings (feeling extreme excitement, happiness, or depression), hallucinations (hearing or seeing things that aren't there), or a loss of contact with reality while taking this medication.
Vision problems
Risk factors: Long-term use of high doses
Taking Alkindi Sprinkle (hydrocortisone) at a higher dose for a long time might raise the risk of eye problems, such as cataracts, glaucoma, and having fluid build up under the eye (central serous chorioretinopathy). Let your provider know if your child develops blurry vision or other vision problems while taking Alkindi Sprinkle (hydrocortisone).
Stomach problems
Risk factors: History of stomach problems | Taking non-steroidal anti-inflammatory drugs (NSAIDs)
Alkindi Sprinkle (hydrocortisone) can raise the risk of stomach problems, such as getting a tear in the stomach lining. The risk for stomach side effects is higher when taking steroid medications like Alkindi Sprinkle (hydrocortisone) together with NSAIDs (e.g., ibuprofen (Motrin)) or if your child has a history of stomach problems. Tell your provider if your child has any stomach problems, such as stomach ulcers, infections, or recent stomach surgery.
Alkindi Sprinkle (hydrocortisone) dosage forms
Typical dosing for Alkindi Sprinkle (hydrocortisone)
Dosing for Alkindi Sprinkle (hydrocortisone) is based on body surface area and can vary depending on your child's age and symptoms. In general:
The typical starting dose is 8 mg/m2 to 10 mg/m2 daily, split into 2 or 3 doses taken by mouth throughout the day. Your healthcare provider will adjust your child's dose based on their age and individual condition.
How much does Alkindi Sprinkle (hydrocortisone) cost?
What are alternatives to Alkindi Sprinkle (hydrocortisone)?
Replacement therapy for children with adrenocortical insufficiency
Allergies or allergic reactions
Joint conditions (e.g., rheumatoid arthritis)
Skin conditions (e.g. psoriasis)
Conditions affecting certain hormones (e.g., low adrenal hormones)
Gut conditions (e.g., ulcerative colitis)
Conditions related to red blood cells, white blood cells, and platelets
Certain cancers (e.g., leukemia)
Nervous system conditions (e.g., multiple sclerosis)
Eye conditions
Lung conditions
Kidney conditions
Allergies or allergic reactions
Joint conditions (e.g., rheumatoid arthritis)
Skin conditions (e.g. psoriasis)
Conditions affecting certain hormones (e.g., low adrenal hormones)
Gut conditions (e.g., ulcerative colitis)
Conditions related to red blood cells, white blood cells, and platelets
Certain cancers (e.g., leukemia)
Nervous system conditions (e.g., multiple sclerosis)
Eye conditions
Lung conditions
Kidney conditions
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