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 Download Hydrocortisone Pamphlet.pdf (451.70 KB)
What is Hydrocortisone?Hydrocortisone is a steriod hormone produced by the adrenal gland. It plays a complex role in regulating body functions and is essential for survival. Hydrocortisone is taken as a replacement for the natural hormone where this is deficient, either because of pituitary deficieny of ACTH (the hormone that stimulates the production of hydrocortisone by the adrenal gland) or failure of hydrocortisone production by the adrenal gland (Addison's Disease - for more information on Addison's Disease, visit the website www.adshg.org.uk ). How do I take it? The usual dose is 15-20mg orally split over two or three times daily, and depending on your individual Endocrinologist's recommendations, e.g., 10mg before rising, 5mg at mid-day and 5mg no later than 6 p.m. When would I need to take more hydrocortisone? If you become ill then the body would naturally increase the output of steroid from your adrenals. Therefore if you are taking replacement steriod (hydrocortisone) it is essential to mimic the natural response by increasing yoru dose appropriately. How can I let others know I take replacement hydrocortisone? When you are prescribed your medication you will be given a 'blue steroid card' from the hospital to carry. The Pituitary Foundation suggests that you purchase and wear a medical necklace or bracelet, such as MedicAlert, to show your Cortisol replacement therapy. Further, we can provide you with a Pituitary Foundation 'Patient Care Card' which is small enough to fit in your bag, or pocket, and displays your hydrocortisone needs and information on emergency replacement should you need this - please click here for more information. It is advisable for all patients on hydrocortisone replacement to have a 100mg injection pack at home and for them or their partners to be taught how to administer it. If you don't have one of these already, you can ask your GP or endocrinologist if they will prescribe this for you. Please check regularly that these preparations are not expired. Some endocrine clinics will help to show you how to inject in an emergency. Download Hydrocortisone Injection Instructions.pdf (227.61 KB) Recommendations for Changes in Dose | Illness or Stress Situation | Increase of Usual Dose | For how long? | Is this an emergency, or when do I seek help? | | Cold with no fever | None Necessary | | | Vomiting - more than once Also, diarrhoea and severe illness | Emergency 100mg injection if extra dose of 10mg-20mg tablets can't be kept down | For duration of fever | See GP if still unwell after 48 hours | | Surgical Procedures | - Minor (e.g. tooth extraction) 20 mg before procedure
- Small op (e.g., hernia) 100mg injection every 6 hours for 24 hours
- Major op (abdomen/chest) 100mg injection or iv every 6 hours for 24-72 hours depending on op, or at least until patient adequately eating and drinking but in any doubt continue for 72 hours
| (Minor/Small op) Resume on usual dose immediately after (Major Op) Reduce rapidly to usual dose | Phone GP, or go to A&E. If you have injection at home, you, a relative (if able) or GP can adminsiter this. Also an anti-sickness injection may be needed | | Colonoscopy and Barium Enema | Double your usual dose the day before, when the bowel is cleaned out. For colonoscopy only - 100mg injection 30 minutes before procedure to be given by doctor. Double dose day after. | Take usual dose on morning of procedure | Drink lots of water to prevent dehydration. Tell the doctor before procedure that you take hydrocortisone | | Cystoscopy | Double your usual dose day of procedure | Resume as normal | Tell the doctor before procedure that you take hydrocortisone | | Severe shock, e.g., bereavement or road traffic accident | 100mg injection, or take 20mg as tablets if able | See GP or hospital for further advice | Sudden and severe shock may be classed as emergency - seek medical attention if in doubt | | Long haul flight over 12 hours | Double usual dose on day of flight | Extra dose every 6-8 hours when day is lengthened / Usual dose in timing with sleep/wake cycle when day is shortened | We suggest you speak to your consultant before travel | | General stress, exams, etc. | Not usually required | | As GP if concerned | | | | |
If you are going on holiday abroad, you should ask your GP or endocrinologist for a letter about your medication and your doses prescribed. This letter will be helpful should you become unwell and have to see a doctor. It is also useful for you to have this letter whilst going through airport security, in the event that they question your medication. If you have a repeat copy prescription, this can also be shown. It is suggested that you have a 100mg injection kit - see above -whilst you are travelling abroad, in case of emergency. this injection should be placed in a small cool bag, labelled with your name and kept with you at all times during your journey. At check-in, they will ask you if you are carrying anything sharp, i.e., needles; please mention you are carrying injection needles for your medical condition. At your destination, if there is no refrigerator in your accommodation, the hotel may freeze your freezer blocks for you, so do take some spare in your luggage to change around regularly in your cool bag. It is wise to take an extra two weeks supply of hydrocortisone tablets with you in case you need to increase your usual dose whilst away. All medication should be kept in your hand luggage. The Pituitary Foundation suggests you make enquiries/arrangements with aiport, airline and hotel staff prior to travel (i.e., sharps, refrigeration available, etc.). It is important to note that airport security rules and regulations take precedence over airline policy - security guidelines are not the same in all countries and may even vary day-to-day. Therefore, it is recommended that you check well in advance of your date of departure. If you cannot absorb your tablets, or your usual replacement wasn't sufficient for an acute shock or illness, then gradually or perhaps quite quickly you would feel weak, sickly and light-headed.
This page provides general information only. All patients are different and if you have any questions, please contact your consultant or GP. ©2009 The Pituitary Foundation. This material may not be stored or reproduced in any form or by any means without the permission of the authors and The Pituitary Foundation.
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