Description
Hydrocortisone is a short-acting corticosteroid that decreases inflammation by suppressing migration of leukocytes and reverses increased capillary permeability. It is used both systemically and topically and is most commonly indicated for allergic-type reactions and itching; however, it does also have numerous uses in disease management for patients with various gastrointestinal, respiratory, and endocrine diseases.
Hydrocortisone is available orally, IV, and topically as creams, foams, lotions, and suppositories, both rectal and vaginal. Patients who need specific concentrations of hydrocortisone or who are allergic to different fillers can have their product compounded at a specialty pharmacy.
This drug should be used with caution in elderly and pediatric populations. It is advised for these patients to use the lowest dose possible for the shortest duration of therapy. Additionally, formulations including preservatives such as benzyl alcohol and propylene glycol should be avoided or used with extreme caution in neonates and small children due to increased risk for toxicities.
Common adverse effects include skin irritation/burning, angioedema, hyperglycemia, and increased susceptibility to infection. Patients should be advised to contact their doctor if they are experiencing any signs of allergic reaction while taking hydrocortisone because it will need to be discontinued. Patients on systemic hydrocortisone who are diabetic need to make sure to be monitoring their blood glucose levels due to the increased risk of hypoglycemia. Since hydrocortisone suppresses the body’s leukocytes, it causes immunosuppression and should be used with caution if taken concomitantly with other drugs that also suppress the immune system.
References
– Hydrocortisone (Systemic). Lexicomp Online, Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc.; 2019; July 9, 2019.
– Hydrocortisone (Topical). Lexicomp Online, Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc.; 2019; July 9, 2019.

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