HYDROCORTISONE SODIUM SUCCINATE
|Reviewed by Dr
Jane Harding, Brenda Hughes, and Dorothy Cooper
Dose and Administration
- For adrenal crisis: 1mg/kg IM/IV q 4 hourly.
- For maintenance: 1mg/kg/day PO
- Replacement therapy in acute and chronic adrenocortical insufficiency.
Contraindication and Precautions
- Abrupt discontinuation in longterm therapy may result in withdrawal-like symptoms.
- CAUTION concurrent use with amphotericin, potassium depleting diuretics,
Hydrocortisone is the principle glucorticoid of the human
adrenal cortex. The rate of secretion follows a characteristic diurnal rhythm.
Secretion increases in the early hours of the morning and gradually declines
toward late evening.
The three major effects of adrenal steroids are on
metabolism, mineral metabolism and inflammation.
Hydrocortisone is about 25-30 times less potent than
Possible Adverse Effects
- Increased susceptibility to and suppression of the usual symptoms and signs of infection.
- Hyperglycaemia, glycosuria.
- Sodium and water retention.
- Poor growth.
- Gastrointestinal disturbance, aggravation of peptic ulcers, bleeding.
- Interferes with tissue granulation and repair, wound healing.
- Prolonged use may produce posterior subcapsular cataracts.
- The manufacturer recommends that Solu-Cortef is
contraindicated in premature infants because it contains benzyl alcohol. Benzyl
alcohol has been reported to be associated with the fatal gasping syndrome in
premature infants. However, no other preparation is currently available.
- Dangerous to stop if using for adrenal crisis.
- Infants born to mothers receiving this drug need to be monitored for signs of hypoadrenalism.
- Phenobarbitone and
phenytoin may increase the clearance of corticosteroids.
- Hydrocortisone may increase or decrease theophylline levels.