hydrocortisone
Oral hydrocortisone (Cortef) is a corticosteroid. It's taken by adults and children to treat health conditions related to inflammation or an overactive immune system, including rheumatoid arthritis and certain skin conditions. Hydrocortisone (Cortef) comes as a tablet that you take by mouth daily, though dosing can also differ depending on your condition. There's a separate intravenous or IV form called Solu-Cortef. Some side effects of hydrocortisone (Cortef) include adrenal insufficiency and weight gain. Hydrocortisone (Cortef) is available as both a brand-name and generic medication.
What is Hydrocortisone (Cortef)?
What is Hydrocortisone (Cortef) used for?
Hydrocortisone (Cortef) is used for many different conditions. Generally, it's used for autoimmune or inflammatory conditions. Some examples include:
- 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
- Lupus erythematosus
How Hydrocortisone (Cortef) works
Hydrocortisone (Cortef) is a corticosteroid. It's a man-made version of cortisol, a natural hormone your body makes. It works by lowering certain chemicals in your body that normally cause itching, redness, swelling, or pain.
Drug facts
Side effects of Hydrocortisone (Cortef)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Swelling (e.g., puffiness in the face, hands, or feet)
- High blood pressure
- High blood sugar
- Muscle weakness
- Stomach pain
- Insomnia (trouble sleeping)
- Changes in your mood
- Headache
- Acne
- Weight gain and greater appetite
Hydrocortisone (Cortef) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reaction: trouble breathing or swallowing, swelling (on your face, lips, mouth, or throat), peeling skin, rash, or hives
- Serious infection: fever, chills, flu-like signs, cough, pain with passing urine, or a wound that won't heal
More on Hydrocortisone (Cortef) side effects
The following Hydrocortisone (Cortef) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Blistering, burning, crusting, dryness, or flaking of the skin
irritation
itching, scaling, severe redness, soreness, or swelling of the skin
redness and scaling around the mouth
thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (e.g. between the fingers)
thinning, weakness, or wasting away of the skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
burning and itching of the skin with pinhead-sized red blisters
burning, itching, and pain in hairy areas, or pus at the root of the hair
increased hair growth on the forehead, back, arms, and legs
lightening of normal skin color
lightening of treated areas of dark skin
reddish purple lines on the arms, face, legs, trunk, or groin
softening of the skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Hydrocortisone (Cortef)
Pros
- Taken by mouth
- Not as strong as other corticosteroids, making it less likely to cause side effects
- Available as a lower-cost generic
Cons
- Stopping suddenly can lead to withdrawal symptoms, like tiredness and dizziness
- Can cause weight gain
- Long-term use in children can cause stunted growth
Pharmacist tips for Hydrocortisone (Cortef)
- Take hydrocortisone (Cortef) with food. This helps to avoid an upset stomach.
- Corticosteroids like hydrocortisone (Cortef) can make it hard to fall asleep, so it's best to take the medication in the morning. If your prescriber wants you to take a dose in the morning and evening, take it 2 to 3 hours before bedtime to help you sleep better at night.
- Taking hydrocortisone (Cortef) can raise your blood sugar and blood pressure. If you have high blood pressure or diabetes, it's important that you check your blood pressure and blood sugar while taking this medication.
- Ask your prescriber before getting a vaccine. Some vaccines are live vaccines and you might not be recommended get them during treatment since hydrocortisone (Cortef) can weaken your immune system. Live vaccines include varicella (chicken pox), the yellow fever vaccine, or the measles, mumps and rubella (MMR) vaccine.
- Call your prescriber right away if you have a fever, chills, flu-like signs, cough, pain with passing urine, or a wound that won't heal. These could be signs of an infection. Taking hydrocortisone (Cortef) can make it more likely for you to catch an infection.
- If you need to take hydrocortisone (Cortef) for longer than one week, you'll need to lower your dose slowly before completely stopping. If this is the case, take it exactly as your healthcare professional prescribed and don't suddenly stop taking hydrocortisone (Cortef).
Common questions about Hydrocortisone (Cortef)
Yes, hydrocortisone (Cortef) is a short-acting, low-potency corticosteroid. It's less "strong" and shorter acting than a similar oral steroid, prednisone.
Hydrocortisone (Cortef) is considered a "short-acting" steroid. It leaves your body about 8 hours after a dose. But this can depend on your health conditions and other medications you're taking.
No, hydrocortisone (Cortef) isn't an antibiotic. In fact, steroids like hydrocortisone (Cortef) can actually raise the risk for an infection. If you have an infection that needs treatment with an antibiotic, go see your healthcare professional (HCP).
If you suddenly stop taking hydrocortisone (Cortef) after taking it regularly for a while, there's a chance that you'll experience steroid withdrawal symptoms, including body aches and dizziness. This happens because when you take a corticosteroid for a longer period of time, your body will stop making its own cortisol hormone. And when you stop hydrocortisone (Cortef) too quickly, your body isn't able to start making cortisol quickly enough to meet your needs. If you need to stop treatment, your healthcare team will help lower your dose of hydrocortisone (Cortef) slowly over time (taper) to help you avoid symptoms of steroid withdrawal.
There's limited information on how taking hydrocortisone (Cortef) during pregnancy might affect mothers and unborn babies. For this reason, you'll need to weigh the benefits and risks to you and your unborn baby with your obstetrician gynecologist (OB-GYN) and healthcare team.
One of the way corticosteroids, like hydrocortisone (Cortef), work is to calm the immune system and lessen swelling. But keep in mind that taking hydrocortisone (Cortef) can cause swelling because it can cause your body to hold on to more fluids. If you're concerned about swelling after starting hydrocortisone (Cortef), talk with your healthcare team.
Hair loss (alopecia) isn't a commonly reported side effect of hydrocortisone (Cortef). If you're experiencing hair loss, speak with your healthcare professional (HCP) about potential causes.
You're recommended to avoid drinking alcohol while taking hydrocortisone (Cortef). Doing so can raise the risk of side effects like headache, heartburn, and trouble sleeping, or even more serious side effects like bleeding from stomach ulcers. Both alcohol and hydrocortisone (Cortef) can also raise your risk of getting sick from infections.
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Risks and warnings for Hydrocortisone (Cortef)
Hydrocortisone (Cortef) 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.
Reduced adrenal gland function
- Risk factors: Taking high doses of corticosteroids | Using hydrocortisone (Cortef) for a long period of time | Young children | Stress such as trauma, injury, or infection
Your adrenal gland makes certain hormones for your body. Taking hydrocortisone (Cortef) for a long time can cause adrenal suppression. This is when your adrenal glands stop making your own natural hormones as your body gets used to hydrocortisone (Cortef). This is more likely to happen if you're using the medication over a long period of time. Lowering the dose or stopping it suddenly can lead to steroid withdrawal because your adrenal glands need some time to start working again. These withdrawal symptoms include tiredness, joint or muscle pain, and low energy. Talk to your HCP or pharmacist before making any sudden changes to how you take hydrocortisone (Cortef).
Greater risk of infections
- Risk factors: Taking other medications that weaken the immune system | Using hydrocortisone (Cortef) for a long time | High doses of hydrocortisone (Cortef) | Not vaccinated against viral illnesses | Coming into contact with people who have viral illnesses | History of long-term infections | Receiving live vaccines
Taking hydrocortisone (Cortef) for a long time or at high doses can raise your risk of getting an infection. This medication can also hide some signs of infection so it might be hard to recognize if you're sick. Avoid contact with anyone who has chickenpox or measles. If you had tuberculosis (TB) in the past, your healthcare professional (HCP) will need to follow up with you while you're taking hydrocortisone (Cortef) to check if the infection has come back. You might need to take antibiotics to prevent or treat TB. Also, talk to your HCP first before getting vaccines while you're taking hydrocortisone (Cortef). Depending on the vaccine and your treatment plan, they might not work as well or be safe for you during treatment. Let your HCP know if you feel sick while you're taking hydrocortisone (Cortef).
Eye problems
- Risk factors: Cataracts | Glaucoma | History of herpes simplex in the eye
Long-term use of hydrocortisone (Cortef) leads to a higher risk of cataracts, glaucoma, and certain eye infections. Don't take hydrocortisone (Cortef) if you have herpes simplex of the eye. Let your healthcare professional know if you have blurry vision, eye pain, or any vision changes. If you're on this medication for a long time, you might need to get regular eye exams.
Behavior changes
- Risk factors: History of psychiatric conditions
Like most corticosteroid medications, hydrocortisone (Cortef) can cause changes in your mood or behavior. Tell your HCP right away if you feel depressed, have mood swings, trouble sleeping, develop anxiety, or hallucinations (hearing or seeing things that aren't there) while taking this medication. If you need to make any changes or slowly lower your dose, talk to your prescriber or pharmacist first.
Bone problems with long-term use
- Risk factors: Taking hydrocortisone (Cortef) at high doses or for a long period of time | Risks for osteoporosis (e.g., female sex, history of falls, smoking) | Infants and young children
Long-term use of hydrocortisone (Cortef) can raise your risk of having weakened bones (osteoporosis) and bone fractures. This medication can also slow the growth in infants and children. This is more likely to happen if the medication is used for a long period of time. If your child needs to take hydrocortisone (Cortef) for a long time, their pediatrician will closely keep track of their growth during treatment. Discuss with a healthcare professional about any concerns you have about hydrocortisone (Cortef) and possible bone problems.
Stomach problems
- Risk factors: History of stomach bleeding | History of stomach ulcers | History of ulcerative colitis | Taking hydrocortisone (Cortef) with other medications that can also cause stomach problems | Alcohol use | Taking NSAIDs (non-steroidal anti-inflammatory drugs)
Taking hydrocortisone (Cortef) raises the risk of damage to your stomach. You should avoid drinking alcohol while taking this medication because it can worsen stomach irritation. Tell your HCP right away if you experience stomach pain that doesn't go away or you get bloody/dark stools. You might need to take an additional medication to protect your stomach if your prescriber told you to take hydrocortisone (Cortef) for a long period of time.
Changes in heart and kidney function
- Risk factors: High blood pressure | History of heart failure | Kidney problems
Hydrocortisone (Cortef) can cause high blood pressure, water buildup in the body, and other changes in the way your kidneys work. These changes can worsen certain medical conditions, like high blood pressure, heart failure, and kidney problems. If you currently have or have had any of these medical conditions, talk to your HCP first before using hydrocortisone (Cortef) to make sure it's safe for you to take.
Hydrocortisone (Cortef) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 30 tablets | $19.12 | $0.64 |
| 5mg | 90 tablets | $15.96 | $0.18 |
| 10mg | 90 tablets | $25.43 | $0.28 |
Typical dosage for Hydrocortisone (Cortef)
The typical dose of hydrocortisone (Cortef) can range from 20 mg to 240 mg by mouth per day. This depends on your condition and how severe it is. Your healthcare professional (HCP) will raise or lower your dose based on how you respond and if you have any side effects.
Interactions between Hydrocortisone (Cortef) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Hydrocortisone (Cortef) cost?
Hydrocortisone (Cortef) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Hydrocortisone (Cortef) will not be safe for you to take.
- Current fungal infection that has spread throughout the body
What are alternatives to Hydrocortisone (Cortef)?
Hydrocortisone (Cortef) is used for many different conditions. Generally, it's used for autoimmune or inflammatory conditions. Some examples include:
This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:
Methylprednisolone (Medrol) is used for many different medical conditions, including:
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