Hydrocortisone tablets

Sounds like 'HYE-droe-KOR-ti-sone'

Hydrocortisone is a steroid used to treat and prevent a variety of conditions that involve inflammation. Find out how to take it safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines called corticosteroids
  • Hydrocortisone (Douglas)®

What is hydrocortisone?

Hydrocortisone is in a class of medicines known as corticosteroids, which is similar to the steroid hormones that your body naturally makes. Steroid hormones are essential for your body and if you do not have enough of them, you can become very unwell.

In people whose adrenal glands do not produce enough steroid hormones (such as cortisol), hydrocortisone tablets are used as a replacement treatment. This can happen in conditions such as Addison's disease or it can happen in people who have had surgery to remove their adrenal glands. 

Dose

  • In New Zealand hydrocortisone tablets are available in 2 strengths: 5 mg and 20 mg. 
  • The dose of hydrocortisone tablets is different for different people. The usual dose is 10–30 mg each day.
  • Always take your hydrocortisone tablets exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much hydrocortisone to take, how often to take it and any special instructions.

How to take hydrocortisone tablets

  • Timing: Hydrocortisone  tablets are usually taken as 2 or 3 doses each day. Usually, the morning dose is larger than the other doses. Try taking your hydrocortisone doses at the same time of day each day. Hydrocortisone is best taken immediately after a meal or a snack.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Stopping hydrocortisone tablets: If you have been taking hydrocortisone tablets regularly for more than a few weeks, do not stop taking them suddenly. Stopping suddenly can cause withdrawal symptoms, which can be serious or even life-threatening. Instead, you will be given a tapering dose. This means your dose of hydrocortisone will be gradually reduced over a few days or weeks. Read more about a steroid withdrawal plan.
My hydrocortisone dose
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How to reduce my hydrocortisone dose gradually over a few weeks
Date:   Dose:
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Precautions while taking hydrocortisone tablets

  • Tell all your healthcare providers: It is important to tell all your healthcare providers that you are taking hydrocortisone.
  • Increased risk of infections: Taking hydrocortisone can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness such as chickenpox, shingles or measles, or if you feel unwell.  
  • Vaccines: It is safe to have most vaccines, including the flu vaccine, while you are taking hydrocortisone. Protecting yourself against infection is important because hydrocortisone suppresses your immune system. However, vaccination with ‘live vaccines’, such MMR (measles, mumps, rubella) or shingles vaccine, should be postponed. Ask your doctor for advice before you have any vaccines while you are taking hydrocortisone.  

Side effects

Like all medicines, hydrocortisone can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking hydrocortisone tablets for. Read more about taking steroids long term.

Changes in behaviour and mood

Hydrocortisone, especially in high doses, can cause changes in personality, behaviour and mood, such as:

  • irritability, agitation and restlessness
  • sleep problems (insomnia) and nightmares
  • mood swings and aggression
  • low mood, depression and even suicidal thoughts.

These symptoms typically develop within a few days of starting hydrocortisone, but they can occur at any time, including after stopping treatment. 

While these symptoms often go away when your dose is reduced or hydrocortisone is stopped, stopping hydrocortisone must be done under the guidance of your doctor. Stopping too quickly can make these symptoms worse. You are at higher risk of mood and behaviour changes if you have previously had similar reactions to steroids (corticosteroid-induced psychosis), or if you have a personal or family history of psychiatric disorders.  

If you have changes in mood and behaviour, especially depression and suicidal thoughts, tell your doctor immediately or phone Healthline 0800 611 116. 

Other side effects

Side effects What should I do?
  • Signs of retaining fluid such as swollen feet and ankles
  • Weight gain 
  • This is quite common when you start taking hydrocortisone.
  • Whenever possible, sit with your feet up.
  • Headache
  • Muscle weakness, feeling tired
  • These are quite common when you first start taking hydrocortisone, and usually go away with time.
  • Tell your doctor if troublesome.
  • Raised blood glucose
  • Hydrocortisone can cause an increase in blood glucose.
  • If you have diabetes, you may need to increase the dose of your diabetes medicine to control your blood glucose. Talk to your doctor about this.
  • Hydrocortisone can also cause the onset of diabetes in people who are at risk of diabetes. Your doctor will monitor your blood glucose levels regularly.
  • Blurred vision or changes in your eyesight.
  • Problems with your stomach such as pain, blood in your stool (poo) or dark coloured stool (poo)
  • Tell your doctor immediately or phone Healthline 0800 611 116.

Learn more

The following link provides more information on hydrocortisone:

Hydrocortisone New Zealand Formulary Patient Information

References

  1. Hydrocortisone (systemic) NZ Formulary
  2. Glucocorticoid therapy NZ Formulary
  3. Prednisone treatment – follow dosing recommendations Medsafe, NZ, 2021 
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Jun 2021