Hydrocortisone Pharmacology


About Hydrocortisone
Systemic synthetic glucocorticoid, anti-inflammatory
Mechanism of Action of Hydrocortisone
The drug exerts it`s pharmacological action by penetrating and binding to cytoplasmic receptor protein and causes a structural change in steroid receptor complex. This structural change allows it`s migration in to the nucleus and then binding to specific sites on the DNA which leads to transcription of specific m-RNA and which ultimately regulates protein synthesis. It exerts both glucocorticoid and mineralocorticoid actions.
The drug exerts anti-inflammatory and immunosuppressant actions as follows: - 1) Induce lipocortins in macrophages, endothelium, and fibroblasts which inhibits phospholipase A2 and thus decreases the production of Prostaglandins, leukotriens (LT), and platelet activating factor, 2) Causes negative regulation of genes for cytokines in macrophages, endothelial cells and lymphocytes and thus decreases the production of interleukins (IL-1, IL-2, IL-3, IL-6), TNF-alpha, GM-CSF (granulocyte macrophage colony stimulating factor), Gama interferon and suppresses fibroblast proliferation and T-lymphocyte functions and interferes chemo taxis. 3) Decreases the production of acute phase reactants from macrophages and endothelial cells and interferes complement function. 4) Decreases the production of ELAM-1(Endothelial leukocyte adhesion molecule-1) and ICAM-1(intracellular adhesion molecule-1) in endothelial cells. 5) Inhibit IgE mediated histamine and LT-C4 release from basophiles and the effects of antigen-antibody reaction is not mediated 6) Reduces the production of collagenase and stromolysin and thus prevents tissue destruction.

Pharmacokinets of Hydrocortisone
Absorption: Absorption ranges from 1% to 36% after topical application. Absorption after injection varies depending up on the site of injection and blood supply to particular area.
Distribution: After topical application distributed throughout the local skin layers. Any drug absorbed in to circulation is rapidly removed from blood and distributed in to muscle, liver, kidney, skin, and intestine. Metabolism: Metabolized primarily in skin after topical application and a small amount absorbed in to circulation is metabolized in liver. Excretion: Metabolites are excreted mainly through urine and a small amount is excreted through faeces.
Onset of Action for Hydrocortisone
Duration of Action for Hydrocortisone
Half Life of Hydrocortisone
Side Effects of Hydrocortisone
1. Burning
2. Irritation
3. Pruritus
4. Dryness
5. Erythema
6. Folliculitis
7. Hypertrichosis
8. Acneiform eruptions
9. Allergic contact dermatitis
10. Secondary infections
11. Atrophy
12. Striae
13. Suppression of adrenocorticotropic hormone
14. Cushing`s syndrome
15. Glucosuria
16. Hyperglycaemia
17. Fluid retention
18. Sodium retention
19. Hypokalaemia
20. Oedema
21. Weakness
22. Muscle wasting
23. Gastrointestinal discomfort
24. Peptic ulcer
25. Haemorrhage
26. Joint damage
27. Fibrosis
28. Headache
29. Convulsions
30. Vertigo
31. Increased intracranial pressure
32. Depression
33. Local hypopigmentation

Contra-indications of Hydrocortisone
1. Hypersensitivity to the drug
2. Not to be given I.V. or I.M.
3. Local or systemic infections
4. Fungal or herpetic keratitis
5. Cataract
6. Tubercular or syphilitic lesions.

Special Precautions while taking Hydrocortisone
1. Occlusive dressings (Topical preparation)
2. Use of potent preparations should be short term or intermittent
3. Milder drugs should be used in acute lesions and stronger ones are for chronic lesions
4. Avoid sudden discontinuation of the drug
5. Hypothyroidism
6. Cirrhosis
7. Stress
8. Sepsis
9. Ocular herpes simplex
10. Peptic ulcer
11. Hypertension
12. Osteoporosis
13. Myasthenia gravis
14. Renal impairment
15. Ulcerative colitis
16. Diverticulitis
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES : Contraindicated

Indications for Hydrocortisone
Intra-articular injection :
1. Rheumatoid arthritis
2. Gouty arthritis
3. Osteoarthritis
4. Joint sequelae of fractures and dislocations
5. Other inflammatory conditions of joints.
Periarticular or soft tissue injections:
1. Bursitis
2. Synovitis
3. Tendinitis
4. Taenosinovitis
5. Cystic tumors of tendon or aponeurosis
6. Epicondylitis
7. Scapulo-humeral periarthritis
8. Periarthritis of hip
9. Tarsalgias
10. Meta-tarsalgias
11. Dupuytren`s contracture
12. Peyronie`s disease.

Intra-lesional injections:
1. Tubal stenosis in gynaecology
2. Dermatological lesions
3. Keloids
4. Hypertrophic scars
5. Localized hypertrophies
6. Inflammatory lesions of lichen
7. Lichen simplex chronicus
8. Granuloma annulare
9. Alopecia areata
10. Necrobiosis lipoidica diabeticorum
11. Discoid lupus erythematosus
12. Psoriatic plaques
Intra-thecal or epidural injections:
1. Lumbago
2. Cervico-brachial neuralgia
3. Sciatica
4. Other painful radiculopathies
5. Multiple sclerosis
6. Tuberculous meningitis.
Interactions for Hydrocortisone
Typical Dosage for Hydrocortisone
Apply 0.5% to 2.5% 1 to 4 times daily as required.
0.5% to 2.5% Apply 1 to 4 times as required.
0.5% to 2.5% Apply 1 to 4 times as required.
Intra-articular, Intra-dermal, Intra-pleural injection:
5 to 50mg depending up on the size of the joint and severity of the condition.

Schedule of Hydrocortisone
Storage Requirements for Hydrocortisone
Store at room temperature at a range of 15 to 300C. Protect from light and moisture. Keep out of reach of children.
Effects of Missed Dosage of Hydrocortisone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Hydrocortisone
Provide symptomatic treatment and supportive measures.

Home Delivery for Hydrocortisone in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including hydrocortisone.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for hydrocortisone and other medicines and health products. Home delivery services for hydrocortisone may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take hydrocortisone only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for hydrocortisone before they complete the sale. You can get this information while placing the order for hydrocortisone with the pharmacy.

Hydrocortisone is a generic medicine name and there are several brands available for it. Some of the brands for hydrocortisone might be better known than hydrocortisone itself. If the pharmacy that's willing to deliver medicines to your home doesn't have hydrocortisone in stock, you can ask for one of the branded alternatives for hydrocortisone.