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What is hydrocortisone acetate-injection, and how does it work (mechanism of action)?
Hydrocortisone is a corticosteroid (steroid
medicine) that is used to treat inflammation due to a number of diseases and
conditions. The medicine in hydrocortisone is similar to cortisol, a natural
hormone produced by our adrenal glands. Corticosteroids have potent
anti-inflammatory actions and also suppress the immune response. The FDA
approved hydrocortisone injection in April, 1955.
What brand names are available for hydrocortisone acetate-injection?
Is hydrocortisone acetate-injection available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for hydrocortisone acetate-injection?
Yes
What are the side effects of hydrocortisone acetate-injection?
Side effects of corticosteroids include:
- Headache
- Nausea
- Vomiting
- Dizziness
- Difficulty falling asleep or staying asleep
- Restlessness
- Depression
- Anxiety
- Depression
- Increased
sweating - Increased hair growth
- Moon face
- Acne
- Thinning of the skin
- Easy bruising or bleeding
- Tiny purple spots on the skin
- Irregular periods
- Eye problems
-
Muscle pain or
weakness - Water retention (swollen feet, ankles, or
legs) - Black or tarry stool
- High blood pressure
- High blood sugar
- Osteoporosis
- Bone fractures
Hydrocortisone side effects depend on the dose, the duration and the
frequency of administration. Short courses of hydrocortisone usually are well
tolerated with few and mild side effects. Long term, high doses of
hydrocortisone usually will produce predictable and potentially serious side
effects. Whenever possible, the lowest effective doses of hydrocortisone should
be used for the shortest possible length of time to minimize side effects.
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,
chickenpox
and measles viruses can produce serious and even fatal illnesses in patients on high doses
of hydrocortisone. Live virus vaccines, such as the
smallpox 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 illness.
Patients with dormant TB may require anti-TB medications while undergoing
prolonged corticosteroid treatment. 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 is gradually tapered.
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 many 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 impairs calcium absorption and new bone formation. Patients on
prolonged treatment with hydrocortisone and other corticosteroids can develop
osteoporosis
and an increased risk of bone
fractures. Supplemental calcium and vitamin D are encouraged to slow this
process of bone thinning. More aggressive treatment may be necessary if
osteoporosis occurs.
In rare individuals, destruction of large joints (aseptic
necrosis) can occur while undergoing treatment with hydrocortisone or other
corticosteroids. These patients experience severe pain in the joints involved,
and can require joint replacements. The reason behind such destruction is not
clear.
What is the dosage for hydrocortisone acetate-injection?
Hydrocortisone injection may be administered into a large muscle such
as the buttock or hip, into a vein, or added to the intravenous (IV) fluid bag.
Dosing varies and is based on the condition being treated. The intravenous or
intramuscular injection dose range for adults is 100-500 mg given every 2, 4, or
6 hours as needed.
Is hydrocortisone acetate-injection safe to take if I’m pregnant or breastfeeding?
Birth defects including cleft palate, still birth, and premature
abortion have been reported in some patients taking corticosteroids. Therefore,
hydrocortisone injection should be used during pregnancy only if the potential
benefit justifies the potential risk to the fetus.
NURSING MOTHERS: Hydrocortisone is excreted into human milk and should be
used with caution in nursing mothers.
What else should I know about hydrocortisone acetate-injection?
What preparations of hydrocortisone acetate-injection are available?
Powder for injection: 100, 250, 500, and 1000 mg
How should I keep hydrocortisone acetate-injection stored?
Unopened products should be stored at room temperature between 20 C
to 25 C (68 F to 77 F).
