Hydrocortisone

Hydrocortisone is a corticosteroid (glucocorticoid) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Topical treatment of mild to moderate steroid-responsive inflammatory skin conditions such as eczema, dermatitis, and allergic rashes.
• Replacement therapy in adrenal insufficiency, including primary or secondary adrenal insufficiency, when prescribed.
• Emergency treatment of adrenal crisis by injection under medical supervision.
• Adjunctive treatment of severe allergic reactions, asthma exacerbations, and other severe inflammatory conditions when a corticosteroid is clinically indicated.
• Management of selected autoimmune, rheumatic, gastrointestinal, respiratory, or other inflammatory disorders as prescribed by a doctor.

Dosage depends on the condition being treated, severity, patient age, and the dosage form. For skin preparations, a thin layer is usually applied to the affected area for the shortest time needed, avoiding eyes, broken skin, and large areas unless advised. Tablets and injections require individualized dosing and monitoring by a doctor. Do not increase the dose, use for longer than prescribed, or stop long-term systemic treatment suddenly without medical advice.

• Topical use: burning, stinging, itching, dryness, irritation, acne-like rash, skin thinning, stretch marks, or changes in skin colour, especially with prolonged use.
• Systemic use: increased appetite, weight gain, indigestion, mood changes, sleep disturbance, raised blood sugar, fluid retention, raised blood pressure, and increased susceptibility to infection.
• Serious effects: adrenal suppression, Cushingoid features, severe infection, stomach ulcer or bleeding, muscle weakness, osteoporosis, glaucoma, cataract, severe mood or psychiatric symptoms, and allergic reactions.
• Children may be more sensitive to growth suppression and systemic absorption, especially with strong or prolonged topical use.

Use caution in people with current or recent infections, diabetes, high blood pressure, heart failure, kidney or liver disease, stomach ulcer, osteoporosis, glaucoma, cataract, thyroid disorders, epilepsy, mental health conditions, or a history of tuberculosis. Avoid covering treated skin with airtight dressings unless advised, and avoid use on the face, groin, or underarms unless specifically prescribed. Systemic corticosteroids may mask infection symptoms and should not be stopped abruptly after prolonged use. Use Hydrocortisone under the guidance of a registered doctor or pharmacist.

• NSAIDs such as ibuprofen, diclofenac, or aspirin may increase the risk of stomach irritation, ulcer, or bleeding.
• Blood thinners such as warfarin may have altered effects and may require monitoring.
• Diabetes medicines, including insulin and oral antidiabetics, may need adjustment because corticosteroids can raise blood glucose.
• Diuretics that lower potassium and digoxin may increase the risk of low potassium and heart rhythm problems.
• Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin, ritonavir, or cobicistat may increase corticosteroid effects.
• Enzyme inducers such as rifampicin, carbamazepine, phenytoin, or phenobarbital may reduce corticosteroid effect.
• Live vaccines should generally be avoided during immunosuppressive systemic corticosteroid therapy.
• Other immunosuppressive medicines may increase infection risk.

• Known hypersensitivity to hydrocortisone or any ingredient of the product.
• Systemic use in untreated systemic fungal infections.
• Use of live vaccines in patients receiving immunosuppressive systemic corticosteroid doses.
• Topical use on untreated bacterial, fungal, viral, or parasitic skin infections, including herpes simplex, chickenpox, shingles, or ringworm, unless appropriate anti-infective treatment is also used.
• Topical use for acne, rosacea, or perioral dermatitis unless specifically advised by a doctor.

During pregnancy, hydrocortisone should be used only when clearly needed and at the lowest effective dose for the shortest suitable time, as advised by a doctor. Topical limited-area use is generally preferred when appropriate. Hydrocortisone can pass into breast milk in small amounts; breastfeeding mothers should seek medical advice, avoid applying it to the nipple area before feeding, and monitor the infant if high-dose or prolonged systemic therapy is required.

Store at room temperature away from excess heat, moisture, and direct sunlight. Keep the container tightly closed and out of reach of children. Do not freeze unless the product label says otherwise. Do not use after the expiry date, and discard any injection preparation that is discoloured, cloudy, or contains particles.