$Unique_ID{BRK01980}
$Pretitle{}
$Title{HYDROCORTISONE (SYSTEMIC)}
$Subject{Cortef (Upjohn)
hydrocortisone (various manufacturers)
Hydrocortone (Merck Sharp & Dohme)}
$Volume{}
$Log{}

Copyright (C) 1991 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.

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
drug 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 will mimic the body's normal production of this type
of chemical.
     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 it 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 stating that you are taking an
adrenocorticosteroid.
     * 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.
