In April 2026, we shared the news that the liquid hydrocortisone injection had been permanently discontinued, following a prolonged shortage across the UK. We understand that the discontinuation of any medication can be frustrating and worrying, and we are here to support you with this.
We encourage anyone who is not familiar with the powder hydrocortisone injection to learn how to use this version, and ask family, friends, coworkers and neighbours to do the same. You can find videos and step-by-step instructions on our website on how to do this. See more on this below.
This news has reignited calls from our community for a simpler injection method, such as an EpiPen-type device. Historically, we have pushed for action on this through petitions and contact with MPs and pharmaceutical companies. We are working on raising the profile of this issue, collaborating with other patient support organisations, and pushing for concrete, positive change to support our community.
What do we want to see happen?
In the short term, we want to see simpler powder hydrocortisone options made available in the UK.
In Europe, Ireland and elsewhere, options like ACT-O-VIAL® remove some of the additional preparation steps that come with using the powder. We want to understand why this is not available in the UK and what can be done to change this.
We have written to the Department of Health and Social Care (DHSC) to find out what can be done.
We want assurances that the loss of the liquid formula will not lead to knock-on shortages of the powder version.
We have been reassured by our Medical Committee that the powder version is widely available, and we have not heard anything to the contrary from our community. However, we have asked for assurance from the DHSC that there will be no impact on the supply of powder hydrocortisone as a knock-on effect of the discontinuation of the liquid formula.
We have asked the DHSC and MHRA to confirm that supplies of the powder hydrocortisone will not be affected by this change.
Looking ahead, we want simpler injection devices made available in the UK.
The need for simpler injection devices is clear. These devices are still in development and not ready for public use yet, but we hope they will be in the future. We want to know that the UK government and relevant companies are doing everything they can to bring these devices to UK patients as quickly as possible.
We have asked the DHSC what they are doing to prepare for this, and to offer our support.
What have we done so far?
We have written to the relevant bodies, to ask them to:
- Provide assurance that the supply of powder hydrocortisone is secure
- Make ACT-O-VIAL® available in the UK
- Do everything to bring forward the approval and access of new injection devices, when available
We have collaborated with other patient support charities to co-sign an impact statement that has been shared with over 70 MPs, the Minister for Health and Social Care, the Minister for Rare Disease and the Patient Safety Commissioner.
This makes clear the need for new injection options to support patient safety and wellbeing.
We are currently exploring ideas for how we can involve our community in an advocacy campaign on this issue.
The voice of our community is a powerful tool for change, and we want to give you the opportunity to have your say. We are currently exploring how best to do this.
We are calling for the licensing of ACT-O-VIAL® in the UK.
We have written to Advanz Pharma (the company who used to produce liquid hydrocortisone) to ask them why they discontinued their product and to ask what they are doing to remedy this. Currently, they have no plans to make liquid hydrocortisone available again, but we hope they will bring new products to the market in the future.
We are creating new information and support resources to help you feel confident using powder hydrocortisone. You can see more on this below.
How you can get involved
We know many of you are keen to get involved with this work and share your experiences. In the past, when our community has come together to raise its voice and push for change, it has led to great things.
We are currently exploring options for how we can involve our community in a wider campaign on this issue. We hope to share updates on this soon. We know there is more work to do here to make simpler injection options available in the UK, and we won’t stop until we see this happen. It’s time for change, to help everyone affected by secondary adrenal insufficiency feel confident managing emergency situations.
What to do if you are unsure how to use the hydrocortisone powder injection
It is completely understandable if you don’t feel confident using the hydrocortisone powder. It is important that you familiarise yourself with how to mix and inject this version of hydrocortisone. There are several ways you can build your skills and ensure you are prepared.
Watch our how-to video
Watch this NHS video on how to mix and use the hydrocortisone powder
Watch the video
Read our step-by-step instructions
Our emergency information page has step-by-step instructions on how to mix and use the powdered hydrocortisone injection.
See more
Talk to your endocrine team or GP
Ask your endocrine team or GP to prescribe you the powder version, and show you how to use it.
Catch up on our injection training event
Our injection training event went through step-by-step how to mix and use the powdered hydrocortisone. You can watch the recording of this event now.
Watch now
Tell your loved ones what to do!
Talk to friends, family, neighbours and people at work about what to do if you have a crisis and how to use your emergency injection.
Download or order our Adrenal Insufficiency Action Plan
Use this handy leaflet to tell others about your condition and what to do if you have a crisis.
Download or order nowInjection FAQs
A lot of people with secondary adrenal insufficiency may have only ever been prescribed the powdered version of hydrocortisone. Historically, the liquid hydrocortisone was subject to frequent shortages and stock issues. The liquid version also has a shorter shelf life than the powder. For these reasons, a lot of hospitals and endocrine teams preferred to prescribe the powder. If you have always been prescribed the powder and are comfortable using this, then there is nothing you need to do right now.
We understand that many people feel worried about not being able to use the powder injection when having a crisis. We know that other medical conditions and situations can make it harder to mix and use your injection, and the added steps of the powder version may cause further anxiety. We recommend that you learn how to use the powder version, so you are able to inject yourself if you need to. We also suggest asking a friend or neighbour who lives nearby to learn how to inject you, in case you aren’t able to yourself.
You should always call 999 if you are having an adrenal crisis. This is even more important if you don’t have your injection with you, or are not able to inject yourself. By saying the key phrases, ‘adrenal crisis’ and ‘steroid-dependant’, the call handlers will know to prioritse your call and get help to you as soon as possible.
