Hydrocortisone
Transcription
Hydrocortisone
Home > Martindale: The Complete Drug Reference > Drugs and Ancillary Substances > By therapeutic use > Corticosteroids > Drug Monographs Hydrocortisone Sub-sections Hydrocortisone Hydrocortisone Acetate Hydrocortisone Buteprate Hydrocortisone Butyrate Hydrocortisone Cipionate Hydrocortisone Hydrogen Succinate Hydrocortisone Sodium Phosphate Hydrocortisone Sodium Succinate Hydrocortisone Valerate Adverse Effects, Treatment, Withdrawal, and Precautions Interactions Pharmacokinetics Uses and Administration Preparations Hydrocortisone Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 30-Jan-2013) Synonyms: 17-Hydroxycorticosterone; Anti-inflammatory Hormone; Compound F; Cortisol; Hidrocortisona; Hidrokortizon; Hidrokortizonas; Hydrocortison; Hydrocortisonum; Hydrokortison; Hydrokortisoni; Hydrokortyzon; NSC-10483; ヒドロコルチゾン BAN: Hydrocortisone INN: Hydrocortisone [rINN (en)] INN: Hidrocortisona [rINN (es)] INN: Hydrocortisone [rINN (fr)] INN: Hydrocortisonum [rINN (la)] INN: Гидрокортизон [rINN (ru)] INN: 氢化可的松 [rINN (cn)] Chemical name: 11β,17α,21-Trihydroxypregn-4-ene-3,20-dione Molecular formula: C21H30O5 =362.5 CAS: 50-23-7 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QD07XA01; QH02AB09; QS01BA02; QS01CB03; QS02BA01 UNII code: WI4X0X7BPJ Chemical Structure of Hydrocortisone NOTE: Use in Sport. Hydrocortisone may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Chin., Eur. (see ), Int., Jpn, and US. Ph. Eur. 7 (Hydrocortisone). A white or almost white, crystalline powder. It shows polymorphism. Practically insoluble in water; sparingly soluble in alcohol and in acetone; slightly soluble in dichloromethane. Protect from light. USP 36 (Hydrocortisone). A white to practically white, odourless, crystalline powder. Very slightly soluble in water and in ether; soluble 1 in 40 of alcohol and 1 in 80 of acetone; slightly soluble in chloroform. Store at a temperature of 25 degrees, excursions permitted between 15 degrees and 30 degrees. Hydrocortisone Acetate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 12-Feb-2013) Synonyms: Cortisol Acetate; Hidrocortisona, acetato de; Hidrokortizon Asetat; Hidrokortizon-acetát; Hidrokortizono acetatas; Hydrocortisonacetat; Hydrocortisone, acétate d'; Hydrocortisoni Acetas; Hydrokortison-acetát; Hydrokortisonacetat; Hydrokortisoniasetaatti; Hydrokortyzonu octan; ヒドロコルチゾン酢酸エステル BAN: Hydrocortisone Acetate [BANM] INN: Hydrocortisone Acetate [rINNM (en)] INN: Acetato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Acétate d' [rINNM (fr)] INN: Hydrocortisoni Acetas [rINNM (la)] INN: Гидрокортизона Ацетат [rINNM (ru)] Chemical name: Hydrocortisone 21-acetate Molecular formula: C23H32O6 =404.5 CAS: 50-03-3 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: 3X7931PO74 NOTE: HCOR is a code approved by the BP 2013 for use on single unit doses of eye drops containing hydrocortisone acetate where the individual container may be too small to bear all the appropriate labelling information. Use in Sport. Hydrocortisone Acetate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Chin., Eur. (see ), Int., Jpn, US, and Viet. Ph. Eur. 7 (Hydrocortisone Acetate). A white or almost white, crystalline powder. Practically insoluble in water; slightly soluble in dehydrated alcohol and in dichloromethane. Protect from light. USP 36 (Hydrocortisone Acetate). A white to practically white, odourless, crystalline powder. Insoluble in water; soluble 1 in 230 of alcohol and 1 in 200 of chloroform. Hydrocortisone Buteprate Date of monograph review: 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 10-Oct-2011) Synonyms: Hidrocortisona, buteprato de; Hydrocortisone Butyrate Propionate; TS-408; 酪酸プロピオン酸ヒドロコルチゾン BAN: Hydrocortisone Buteprate [BANM] USAN: Hydrocortisone Probutate INN: Hydrocortisone Buteprate [rINNM (en)] INN: Buteprato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Butéprate d' [rINNM (fr)] INN: Hydrocortisoni Butepras [rINNM (la)] INN: Гидрокортизона Бутепрат [rINNM (ru)] Chemical name: Hydrocortisone 17-butyrate 21-propionate Molecular formula: C28H40O7 =488.6 CAS: 72590-77-3 ATC code: D07AB11 ATC code (veterinary): QD07AB11 UNII code: O6550D6K3A NOTE: Use in Sport. Hydrocortisone Buteprate may be restricted in certain sports (see as it is considered to be a member of the prohibited group, ) Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Hydrocortisone Butyrate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 30-Jan-2013) Synonyms: Cortisol Butyrate; Hidrocortisona, butirato de; Hidrokortizon Bütirat; ヒドロコルチゾン酪酸エステル BAN: Hydrocortisone Butyrate [BANM] USAN: Hydrocortisone Butyrate INN: Hydrocortisone Butyrate [rINNM (en)] INN: Butirato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Butyrate d' [rINNM (fr)] INN: Hydrocortisoni Butiras [rINNM (la)] INN: Гидрокортизона Бутират [rINNM (ru)] Chemical name: Hydrocortisone 17α-butyrate Molecular formula: C25H36O6 =432.6 CAS: 13609-67-1 ATC code: D07AB02 ATC code (veterinary): QD07AB02 UNII code: 05RMF7YPWN NOTE: Use in Sport. Hydrocortisone Butyrate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Chin., Jpn, and US. USP 36 (Hydrocortisone Butyrate). A white to practically white, practically odourless crystalline powder. Practically insoluble in water; soluble in alcohol, in acetone, and in methyl alcohol; freely soluble in chloroform; slightly soluble in ether. Hydrocortisone Cipionate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 10-Oct-2011) Synonyms: Cortisol Cypionate; Hidrocortisona, cipionato de; Hydrocortisone Cyclopentylpropionate; Hydrocortisone Cypionate; ヒドロコルチソンシピオナート BAN: Hydrocortisone Cipionate [BANM] INN: Hydrocortisone Cipionate [rINNM (en)] INN: Cipionato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Cipionate d' [rINNM (fr)] INN: Hydrocortisoni Cipionas [rINNM (la)] INN: Гидрокортизона Ципионат [rINNM (ru)] Chemical name: Hydrocortisone 21-(3-cyclopentylpropionate) Molecular formula: C29H42O6 =486.6 CAS: 508-99-6 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: 4XDY25L70B NOTE: Use in Sport. Hydrocortisone Cipionate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Hydrocortisone Hydrogen Succinate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 30-Jan-2013) Synonyms: Cortisol Hemisuccinate; Hidrocortisona, hidrogenosuccinato de; Hidrokortizon-hidrogén-szukcinát; Hidrokortizono hemisukcinatas; Hydrocortisone Hemisuccinate; Hydrocortisone Succinate; Hydrocortisone, hydrogénosuccinate d'; Hydrocortisonhydrogensuccinat; Hydrocortisoni Hydrogenosuccinas; Hydrokortison-hydrogen-sukcinát; Hydrokortisonivetysuksinaatti; Hydrokortisonvätesuccinat; ヒドロコルチゾンコハク酸エステル; ヘミコハク酸ヒドロコルチゾン BAN: Hydrocortisone Hydrogen Succinate [BANM] INN: Hydrocortisone Hydrogen Succinate [rINNM (en)] INN: Hidrogenosuccinato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Hémisuccinate d' [rINNM (fr)] INN: Hydrocortisoni Hemisuccinas [rINNM (la)] INN: Гидрокортизона Гемисукцинат [rINNM (ru)] Chemical name: Hydrocortisone 21-(hydrogen succinate) Molecular formula: C25H34O8 =462.5 CAS: 2203-97-6 (anhydrous hydrocortisone hydrogen succinate); 83784-20-7 (hydrocortisone hydrogen succinate monohydrate) ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: LIU00Z1Z84 NOTE: Use in Sport. Hydrocortisone Hydrogen Succinate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Eur. (see ) and Jpn. US allows the anhydrous form or the monohydrate. Ph. Eur. 7 (Hydrocortisone Hydrogen Succinate). A white or almost white, hygroscopic powder. Practically insoluble in water; freely soluble in dehydrated alcohol and in acetone; dissolves in dilute solutions of alkali carbonates and alkali hydroxides. Store in airtight containers. Protect from light. USP 36 (Hydrocortisone Hemisuccinate). It contains one molecule of water of hydration or is anhydrous. Store in airtight containers. Hydrocortisone Sodium Phosphate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 12-Feb-2013) Synonyms: Cortisol Sodium Phosphate; Hidrocortisona, fosfato sódico de; ヒドロコルチゾンリン酸エステルナトリウム BAN: Hydrocortisone Sodium Phosphate [BANM] INN: Hydrocortisone Sodium Phosphate [rINNM (en)] INN: Fosfato sódico de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Phosphate Sodique d' [rINNM (fr)] INN: Natrii Hydrocortisoni Phosphas [rINNM (la)] INN: Натрия Гидрокортизона Фосфат [rINNM (ru)] Chemical name: Hydrocortisone 21-(disodium orthophosphate) Molecular formula: C21H29Na2O8P =486.4 CAS: 6000-74-4 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: 0388G963HY NOTE: Use in Sport. Hydrocortisone Sodium Phosphate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Br., Jpn, and US. BP 2013 (Hydrocortisone Sodium Phosphate). A white or almost white, hygroscopic powder. Freely soluble in water; practically insoluble in dehydrated alcohol and in chloroform. A 0.5% solution in water has a pH of 7.5 to 9.0. Protect from light. USP 36 (Hydrocortisone Sodium Phosphate). A white to light yellow, odourless or practically odourless, exceedingly hygroscopic, powder. Soluble 1 in 1.5 of water; slightly soluble in alcohol; practically insoluble in chloroform, in dioxan, and in ether. Store in airtight containers. Hydrocortisone Sodium Succinate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 30-Jan-2013) Synonyms: Cortisol Sodium Succinate; Hidrocortisona, succinato sódico de; Hydrokortyzonu bursztynianu sól sodowa; ヒドロコルチゾンコハク酸エステルナトリウム BAN: Hydrocortisone Sodium Succinate [BANM] INN: Hydrocortisone Sodium Succinate [rINNM (en)] INN: Succinato sódico de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Succinate Sodique d' [rINNM (fr)] INN: Hydrocortisoni Natrii Succinas [rINNM (la)] INN: Гидрокортизона Натрия Сукцинат [rINNM (ru)] Chemical name: Hydrocortisone 21-(sodium succinate) Molecular formula: C25H33NaO8 =484.5 CAS: 125-04-2 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: 50LQB69S1Z NOTE: Use in Sport. Hydrocortisone Sodium Succinate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In Chin., Int., It., Jpn., Pol., and US. USP 36 (Hydrocortisone Sodium Succinate). A white or nearly white, odourless, hygroscopic, amorphous solid. Very soluble in water and in alcohol; very slightly soluble in acetone; insoluble in chloroform. Store in airtight containers. Protect from light. Hydrocortisone Valerate Date of monograph review: 17-Jun-1997; 09-Jul-1998; 28-Feb-2000; 17Aug-2001; 04-Mar-2004; 19-Jul-2006; 10-Sep-2008; 28-Jul-2010; (latest modification: 14-Nov-2011) Drug Nomenclature (Latest modification: 10-Oct-2011) Synonyms: Cortisol Valerate; Hidrocortisona, valerato de; 吉草酸ヒドロコルチゾン BAN: Hydrocortisone Valerate [BANM] USAN: Hydrocortisone Valerate INN: Hydrocortisone Valerate [rINNM (en)] INN: Valerato de hidrocortisona [rINNM (es)] INN: Hydrocortisone, Valérate d' [rINNM (fr)] INN: Hydrocortisoni Valeras [rINNM (la)] INN: Гидрокортизона Валерат [rINNM (ru)] Chemical name: Hydrocortisone 17-valerate Molecular formula: C26H38O6 =446.6 CAS: 57524-89-7 ATC code: A01AC03; A07EA02; C05AA01; D07AA02; H02AB09; S01BA02; S02BA01 ATC code (veterinary): QA01AC03; QA07EA02; QC05AA01; QD07AA02; QH02AB09; QS01BA02; QS02BA01 UNII code: 68717P8FUZ NOTE: Use in Sport. Hydrocortisone Valerate may be restricted in certain sports (see ) as it is considered to be a member of the prohibited group, Glucocorticoids (topical preparations are not prohibited when used for specified disorders); competitors should check with the appropriate sports authorities. Pharmacopoeias: In US. Adverse Effects, Treatment, Withdrawal, and Precautions (Latest modification: 24-Jun-2010) As for corticosteroids in general (see , , and , respectively). When applied topically, particularly to large areas, when the skin is broken, or under occlusive dressings, corticosteroids may be absorbed in sufficient amounts to cause systemic effects. Prolonged use of ophthalmic preparations containing corticosteroids has caused raised intra-ocular pressure and reduced visual function. (last reviewed 2010-07-28; last modified 2010-06-24) Effects on fluid and electrolyte balance (Latest modification: 21-Mar-2004) A report of marked hypokalaemia and hypomagnesaemia associated with high-dose intravenous hydrocortisone therapy in an alcoholic patient with suspected immune thrombocytopenia.1 Cardiac arrhythmias developed, and prolonged infusion of magnesium and potassium was required to restore normal plasma concentrations. (last reviewed 2010-07-28; last modified 2004-03-21) 1. 1. Ramsahoye BH, et al. The mineralocorticoid effects of high dose hydrocortisone. BMJ 1995; 310: 656–7. PubMed Effects on the nervous system (Latest modification: 21-Mar-2004) For reports and comments on paraesthesia or perineal irritation associated with hydrocortisone sodium phosphate given intravenously, see (last reviewed 2010-07-28; last modified 2004-03-21) . Hypersensitivity and anaphylaxis (Latest modification: 19-Jul-2006) References to hypersensitivity reactions and anaphylaxis associated with the intravenous use of hydrocortisone;1-7 topical application can also result in hypersensitivity.8 (last reviewed 2010-07-28; last modified 2006-07-19) 1. 1. Chan CS, et al. Hydrocortisone-induced anaphylaxis. Med J Aust 1984; 141: 444–6. PubMed 2. 2. Seale JP. Anaphylactoid reaction to hydrocortisone. Med J Aust 1984; 141: 446. 3. 3. Corallo CE, Sosnin M. Bronchospasm, tachycardia following intravenous hydrocortisone. Aust J Hosp Pharm 1985; 15: 103–4. 4. 4. Al Mahdy H, Hall M. Anaphylaxis and hydrocortisone. Ann Intern Med 1988; 108: 487–8. PubMed 5. 5. Fulcher DA, Katelaris CH. Anaphylactoid reaction to intravenous hydrocortisone sodium succinate: a case report and literature review. Med J Aust 1991; 154: 210–14. PubMed 6. 6. Kawane H. Anaphylactoid reaction to intravenous hydrocortisone sodium succinate. Med J Aust 1991; 154: 782. PubMed 7. 7. Currie GP, et al. An unexpected response to intravenous hydrocortisone succinate in an asthmatic patient. Br J Clin Pharmacol 2005; 60: 342. PubMed 8. 8. Wilkinson SM, et al. Hydrocortisone: an important cutaneous allergen. Lancet 1991; 337: 761–2. PubMed Porphyria (Latest modification: 14-Nov-2011) The Drug Database for Acute Porphyria, compiled by the Norwegian Porphyria Centre (NAPOS) and the Porphyria Centre Sweden, classifies hydrocortisone as possibly porphyrinogenic; it should be used only when no safer alternative is available and precautions should be considered in vulnerable patients.1 (last reviewed 2010-07-28; last modified 2011-11-14) 1. 1. The Drug Database for Acute Porphyria. Available at: online (accessed 17/10/11) Interactions (Latest modification: 16-Jun-1998) The interactions of corticosteroids in general are described on . (last reviewed 2010-07-28; last modified 1998-06-16) Pharmacokinetics (Latest modification: 24-Jun-2010) For a brief account of the pharmacokinetics of corticosteroids, see . Hydrocortisone is readily absorbed from the gastrointestinal tract and peak blood concentrations occur in about an hour. The plasma half-life is about 100 minutes. It is more than 90% bound to plasma proteins. Following intramuscular injection, the absorption of the water-soluble sodium phosphate and sodium succinate esters is rapid, while absorption of hydrocortisone free alcohol and its lipid-soluble esters is slower. Absorption of hydrocortisone acetate after intra-articular or soft-tissue injection is also slow. Hydrocortisone is absorbed through the skin, particularly in denuded areas. Hydrocortisone is metabolised in the liver and most body tissues to hydrogenated and degraded forms such as tetrahydrocortisone and tetrahydrocortisol. These are excreted in the urine, mainly conjugated as glucuronides, with a very small proportion of unchanged hydrocortisone. Hydrocortisone readily crosses the placenta. (last reviewed 2010-07-28; last modified 2010-06-24) Uses and Administration (Latest modification: 04-Aug-2010) Hydrocortisone is a corticosteroid with both glucocorticoid and to a lesser extent mineralocorticoid activity ( ); 20 mg of hydrocortisone is equivalent in anti-inflammatory activity to about 5 mg of prednisolone. As cortisol it is the most important of the mainly glucocorticoid corticosteroids secreted by the adrenal cortex. Hydrocortisone is used, usually with a more potent mineralocorticoid, for replacement therapy in adrenocortical insufficiency ( ). It may also be used for its glucocorticoid properties in other conditions for which corticosteroid therapy is indicated ( ) but drugs with fewer mineralocorticoid effects tend to be preferred for the long-term systemic therapy of auto-immune and inflammatory disease. The dose may be expressed in terms of the base, and the following are each equivalent to about 100 mg of hydrocortisone: hydrocortisone acetate 112 mg hydrocortisone buteprate 135 mg hydrocortisone butyrate 119 mg hydrocortisone cipionate 134 mg hydrocortisone hydrogen succinate 128 mg hydrocortisone sodium phosphate 134 mg hydrocortisone sodium succinate 134 mg hydrocortisone valerate 123 mg However, esterification generally alters potency and compounds with equivalent hydrocortisone content may not have equivalent clinical effect. When given orally hydrocortisone free alcohol is usually used; the cipionate ester is used in some formulations. For replacement therapy in acute or chronic adrenocortical insufficiency the normal requirement is 20 to 30 mg daily (usually taken in 2 doses, the larger in the morning and the smaller in the early evening, to mimic the circadian rhythm of the body). Additional sodium chloride may be required if there is defective aldosterone secretion, but mineralocorticoid activity is usually supplemented by fludrocortisone acetate orally. Similar regimens have also been used to correct glucocorticoid deficiency in the salt-losing form of congenital adrenal hyperplasia ( ). Hydrocortisone may be given intravenously, by slow injection or infusion, in the form of a water-soluble derivative such as hydrocortisone sodium succinate or hydrocortisone sodium phosphate when a rapid effect is required in emergencies: such conditions are acute adrenocortical insufficiency caused by Addisonian or post-adrenalectomy crises, by the abrupt accidental withdrawal of therapy in corticosteroid-treated patients, or by the inability of the adrenal glands to cope with increased stress in such patients; certain allergic emergencies such as anaphylaxis; acute severe asthma (status asthmaticus—see also ); and shock. The usual dose is the equivalent of 100 to 500 mg of hydrocortisone, repeated 3 or 4 times in 24 hours, according to the severity of the condition and the patient's response. Fluids and electrolytes should be given as necessary to correct any associated metabolic disorder. Similar doses to those specified above may also be given intramuscularly but the response is likely to be less rapid than that seen after intravenous doses. Corticosteroids are considered to be of secondary value in anaphylactic shock because of their relatively slow onset of action, but intravenous hydrocortisone may be a useful adjunct to adrenaline to prevent further deterioration in severely affected patients. For doses used in children, see . In patients with adrenal deficiency states supplementary corticosteroid therapy may be necessary during some surgical operations and hydrocortisone sodium succinate or sodium phosphate may be given intramuscularly or intravenously before surgery. Various regimens have been proposed (see also Surgery, ). In patients taking more than 10 mg of oral prednisolone or its equivalent daily, the BNF 59 recommends the following regimen: minor surgery under general anaesthesia, either the usual oral corticosteroid dose on the morning of surgery or hydrocortisone 25 to 50 mg (usually as the sodium succinate) intravenously at induction; the usual oral corticosteroid dose is resumed after surgery moderate or major surgery, the usual oral corticosteroid dose on the morning of surgery, plus hydrocortisone 25 to 50 mg intravenously at induction, and followed by similar doses of hydrocortisone 3 times daily, for 24 hours after moderate surgery and 48 to 72 hours after major surgery; the usual corticosteroid dose is resumed once hydrocortisone injections are stopped For local injection into soft tissues hydrocortisone is usually used in the form of the sodium phosphate or sodium succinate esters; doses in terms of hydrocortisone are usually 100 to 200 mg. For intra-articular injection hydrocortisone acetate is usually used in doses of 5 to 50 mg depending upon the size of the joint. For topical application in the treatment of various skin disorders hydrocortisone and the acetate, buteprate, butyrate, and valerate esters are normally employed in creams, ointments, or lotions. Concentrations usually used have ranged from 0.1 to 2.5%. Although it is considered that hydrocortisone has fewer adverse effects on the skin and is less liable to cause adrenal suppression than the more potent topical corticosteroids (see for a rough guide to the clinical potencies of topical corticosteroids), it should be borne in mind that this property may be considerably modified both by the type of formulation or vehicle used and by the type of esterification present; other factors that may also influence the degree of absorption include the site of application, use of an occlusive dressing, the degree of skin damage, and the size of the area to which the preparation is applied. Hydrocortisone or its esters are also available in a variety of other dosage forms including those for ophthalmic, aural, dental, and rectal application, for use in allergic and inflammatory disorders. Other esters of hydrocortisone that have occasionally been used include the aceponate, caproate, glycyrrhetinate, and propionate. Esters such as the aceponate may show modified topical activity. (last reviewed 2010-07-28; last modified 2010-08-04) Administration in children (Latest modification: 24-Jun-2010) When given orally as replacement therapy in adrenocortical insufficiency, the BNFC 2009 suggests that neonates and children aged from 1 month to 18 years of age may be given hydrocortisone in usual doses of 4 to 5 mg/m2 every 8 hours, although higher doses may be needed. Larger portions of the daily dose are given in the morning and smaller portions in the evening. In congenital adrenal hyperplasia, initial oral doses of 6 to 7 mg/m2 every 8 hours may be used in neonates, and 5 to 6.5 mg/m2 every 8 hours in children aged from 1 month to 18 years old; again, higher doses may be needed and the dose should be adjusted according to response. When used intravenously for emergencies such as acute adrenocortical insufficiency, the following doses may be given: neonates: initially 10 mg as a slow injection, then 100 mg/m2 daily as a continuous infusion or in divided doses every 6 to 8 hours; the dose should be adjusted according to response and, when stable, reduced over 4 to 5 days to an oral maintenance dose 1 month to 12 years old: initially 2 to 4 mg/kg as a slow injection or infusion, then 2 to 4 mg/kg every 6 hours; the dose should be adjusted according to response and, when stable, reduced over 4 to 5 days to an oral maintenance dose 12 to 18 years old: 100 mg every 6 to 8 hours by slow injection or infusion (last reviewed 2010-07-28; last modified 2010-06-24) Preparations (Latest modification: 01-Jul-2013) Single-ingredient Preparations (Latest modification: 01-Jul-2013) The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed. Argentina: Alfacort; Anusol-HC; Azuthidrona; Cortenem¤; Demacort; Efficort¤; Fridalit; Hidrotisona; Idenona¤; Lactid HC; Locoid; Medrocil; Microsona; Oralsone; Proavenal H; Schericur¤; Sirotamicin HC; Stiefcortil; Transderma H; Australia: Adacor¤; Colifoam; Corlan¤; Cortaid¤; Cortef; Cortic; Derm-Aid; Dermacort¤; DermAid; Efcortelan¤; Egocort; Hycor; Hydrosone¤; Hysone-A¤; Hysone; Nordicort¤; Procort¤; Sigmacort; Siguent Hycor; Solu-Cortef; Squibb-HC¤; Austria: Colifoam; Ekzemsalbe F; Hydoftal sine neomycino¤; Hydrocortone; Hydroderm; Locoidon¤; Retef¤; Schericur¤; Belgium: Azacortine; Buccalsone¤; Colifoam¤; Cortril¤; Cremicort-H; Locoid; Nozema¤; Pannocort; Sential Hydrocortisone¤; SoluCortef; Brazil: Androcortil; Ariscorten; Benzenil; Berlison; Cortisonal; Cortiston; Cortizol; Cortizon¤; Flebocortid¤; Hicortin¤; Hidrocol¤; Hidrocortex; Hidyn H; Locoid; Nutracort; Solu-Cortef; Stiefcortil; Therasona; Westcort¤; Canada: A-Hydrocort¤; Alocort¤; Aquacort¤; Barriere-HC; Claritin Skin Itch Relief; Cortacet¤; Cortamed; Cortate; Cortef; Cortenema; Corticreme¤; Cortifoam; Cortiment¤; Cortoderm; Dermaflex HC; Dermarest Dricort Anti-Itch¤; Emo-Cort; Hycort; Hyderm; Hydrosone; HydroVal; Lanacort¤; Neo-HC¤; Novo-Hydrocort; Prevex HC; Rectocort¤; Sarna HC; Solu-Cortef; Soothing Cream; Texacort¤; Unicort¤; Westcort¤; Chile: Aquanil HC¤; Calmurid; Cortisol; Efficort; Hipoge; Lacticare-HC¤; Locoid; Nutracort; Nutralona¤; Pandel; Solu-Cortef; Vitulpas¤; China: Efficort; Locoid; Youzhouer; Czech Republic: Laticort¤; Locoid; Solu-Cortef¤; Denmark: Colifoam; Dermil¤; Hyderm; Locoid; Mildison; Plenadren; SoluCortef; Uniderm¤; Finland: Ampikyy; Apocort; Bucort; Colifoam; Cortril¤; Dermacort¤; Hyderm; Kyypakkaus; Locoid; Mildison¤; Nutracort¤; SoluCortef; Uniderm¤; France: Aphilan; Calmicort; Colofoam; Cortapaisyl; Cortisedermyl; Dermaspraid Demangeaison¤; Dermaspray demangeaison¤; Dermofenac; Efficort; Hydracort¤; Locoid; Mitocortyl¤; Proctocort¤; Germany: Alfason; Colifoam; Cordes H¤; Dermallerg¤; Dermo Posterisan¤; Ebenol; Ekzesin¤; Fenistil Hydrocort¤; Ficortril; Glycocortison¤; HydroWolff¤; Hydrocort Mild¤; Hydrocort¤; Hydrocutan mild¤; Hydrocutan; Hydroderm HC¤; Hydrogalen; Laticort; Latimit¤; Linola Akut; Linolacort Hydro; Muni; Munitren¤; Neuroderm Akut; Pandel¤; Posterine Corte¤; Posterisan cort; ratioAllerg¤; Remederm HC¤; Retef; Sagittacortin¤; Sanatison Mono¤; Schericur¤; Scheroson F¤; Soventol HC¤; Soventol HydroCort; Soventol HydroSpray; Systral Hydrocort; velopural¤; Greece: Colifoam; Filocot; Lyo-Cortin; Nutracort; Rolak; Solu-Cortef; Hong Kong: BF-Hycort¤; Cortef; Corticreme¤; Cortosone¤; Derm-Aid; Dhacort; Efficort¤; Egocort; Hycortin¤; Hydrosone; Hytisone; Lacticare-HC¤; Rectocort¤; Sigmacort; Solu-Cortef; Uni-Cort¤; Hungary: Cortef; Laticort; Locoid; SoluCortef; India: Arvisone; Cardol; Cipcorlin; Cort-H; Cort-S; Cortygard; Cutisoft; Efcorlin; Eldercoid; Entofoam; Geocort; H-Cort; Hisone; Hobutide; HS; Hy-Sone; Hycort; Hycoson; Hyss; Hyver; Intacorlin; Irays; Labocort; Lacticare-HC; Locoid; Lycor; Lycortin-S; M-Cort; Multicort; Niscort; Novacort; Wycort; Indonesia: Berlicort; Calacort¤; Enkacort; Lexacorton; Locoid¤; Steroderm¤; Ireland: Colifoam; Corlan; Cortopin; Dioderm; Efcortelan Soluble¤; Emucream HC¤; Hc45; Hydrocortisyl; Hydrocortone; Locoid; Mildison¤; Plenadren; Solu-Cortef; Israel: Colifoam¤; Cortifoam; Cortizone; Efficort; Hydrocort¤; Lanacort; Solu-Cortef; Italy: Algicortis¤; Colifoam; Cortaid¤; Cortidro; Cortop; Dermirit; Dermocortal; Efficort¤; Flebocortid; Foille Insetti; Idracemi; Idrocortigamma¤; Lanacort; Lenirit; Locoidon; Novocortal¤; Paro¤; Rapicort¤; Sintotrat; Solu-Cortef; Urecortyn¤; Japan: Pandel; Saxizon; Malaysia: Derm-Aid; Dhacort¤; Efficort; Egocort; H-Cort; Hycort; Hydrocort; Solu-Cortef; Mexico: Aquanil HC; Collicort¤; Efficort; Fadol¤; Flebocortid; Flemex; Icorsan; Lacticare-HC; Locoid; Microsona; Nositrol; Nutracort; Solhidrol; Vicortin¤; Westcort; Netherlands: Buccalsone¤; Cremicort; Hydro-Adreson¤; Locoid; Mildison¤; Plenadren; Solu-Cortef; Zure oordruppels met hydrocortison; Norway: Apocortal¤; Colifoam¤; Locoid; Mildison; Plenadren; Solu-Cortef; New Zealand: BK HC; Colifoam; Cortaid¤; Derm-Aid; DP Hydrocortisone¤; Egocort; Lemnis Fatty Cream HC; Lipocort; Locoid; Mildison; Skincalm; Solu-Cortef; Philippines: Biocort; Clovisone; Cortin; Cortizan; Costeron-H; Droxiderm; Efficort; Hovicor; Hycort; Hycortil; Hydrotopic; Lacticare-HC; Ocecor; Pharmacort; Primacort; Solu-Cortef; Sorvilor; Stericort; Syntesor; Poland: Corhydron; Hydrocort; Laticort; Locoid; Procortin; Portugal: Colifoam; Dermimade Hidrocortisona¤; Hidalone; Hydrocortone; Lactisona; Locoid; Pandel; Pandermil; Rapicort; Solu-Cortef; Russia: Cortef (Кортеф); Laticort (Латикорт); Locoid (Локоид); Solu-Cortef (Солу-кортеф)¤; Sopolcort N (Сополькорт Н)¤; South Africa: Biocort; Colifoam¤; Covocort; Cutaderm¤; Dilucort; Locoid; Mezzoderm; Mylocort; Procutan; Skincalm; Solu-Cortef; Stopitch; Singapore: Cortisone; Derm-Aid; Dhacort; Efficort; Egocort; H-Cort; Hydro-Adreson¤; Hydrocort; Hydroderm; Nu-Derm Tolereen¤; Solu-Cortef; Spain: Actocortina; Aftasone; Calmiox; Ceneo; Crema Transcutan Astier¤; Derminovag¤; Dermosa Hidrocortisona; Hemodren; Hemorrane; Hidroaltesona; Hidrocisdin; Isdinium; Lactisona; Nutrasona; Oralsone; Picosyl¤; Scalpicin Capilar¤; Schericur; Suniderma; Supralef¤; Sweden: Amberin¤; Colifoam; Ficortril; Hyderm; Locoid; Mildison; Solu-Cortef; Solu-Glyc¤; Uniderm¤; Switzerland: Alfacortone; Colifoam¤; Dermacalm¤; Glycocortisone H¤; Hydrocortone; Locoid; Sanadermil; Solu-Cortef; Thailand: H-Cort; HC; Hydro-Adreson¤; Hytisone; Lacticare-HC; Prevex HC¤; Solu-Cortef; Turkey: Cortimycine; Hipokort; Locoid; United Arab Emirates: Alfacort; United Kingdom: Anflam¤; Colifoam; Corlan¤; Cortacream Bandage¤; Cortenema¤; Cortopin; Cortropin; Dermacort; Dioderm; Efcortelan Soluble¤; Efcortelan¤; Efcortesol; Exe-Cort; Hc45; Hydrocortistab; Hydrocortisyl¤; Hydrocortone¤; Jungle Formula Sting Relief Cream¤; Lanacort; Locoid; Mildison; Plenadren; Solu-Cortef; Timocort¤; Waspeze Hydrocortisone¤; Zenoxone; Ukraine: Laticort (Латикорт); Locoid (Локоид); Solu-Cortef (Солу-Кортеф); United States: A-Hydrocort; Acticort; Aeroseb-HC¤; Ala-Cort; Anucort-HC; Anuprep HC¤; Aquanil HC; Bactine; CaldeCort; Carmol HC; Cetacort; Colocort; Cort-Dome; CortaGel¤; Cortaid; Cortef Feminine Itch; Cortef; Cortenema¤; Corticaine¤; Cortifair¤; Cortifoam; Cortizone; Cortril¤; Delcort¤; Dermacort¤; Dermarest Dri-Cort; Dermol HC; Dermolate; EarSolHC; Gynecort; Hemril-HC; Hi-Cor; Hycort¤; Hydrocortone; HydroSkin; HydroTex¤; Hytone; Itch-X; Lacticare-HC¤; Lanacort; Locoid; Massengill Medicated; Maximum Strength Dermarest Dricort¤; Maximum Strength KeriCort-10¤; Neutrogena T/Scalp; no more itchies¤; NuCort; Nutracort; Orabase HCA; Pandel; Penecort; Preparation H Hydrocortisone¤; Procort¤; Proctocort; Proctocream HC 2.5%¤; Recort Plus; Rectacort-HC; S-T Cort¤; Scalacort DK; Solu-Cortef; Synacort; Tegrin-HC; Texacort; U-Cort; Westcort; Xerese; Venezuela: Corticina; Efficort; Hidrocort; Hidrozona; Histasona¤; Lacticare-HC¤; Liocort; Nutracort; Pantocort¤; Solu-Cortef; Stricort; Multi-ingredient Preparations (Latest modification: 27-Jun-2013) The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed. Argentina: Aeromicrosona C¤; Alercortil¤; Altus; Antibiocort; Anusol Duo S; Anusol Duo; Anusol-HC; Atomoderma Plus; Bactisona¤; Bexon; Biocortin¤; Butimerin Complex; Cipro HC; Ciprocort; Ciprocort; Ciproflox-Otic¤; Cirflox Otic; Ciriax Otic L; Ciriax Otic; Colirio Antibiotico CNH; Cristalomicina NF; Cristalomicina; Delos Otic; Dercotex; Derivoco¤; Dermoperative; Disel Hidrocortisona; Epiprocto¤; Epiprocto; Fucidin H; Gargadrin-R; Gentacler; Gramicortil¤; Gripace; Griseoplus; Hidrocortin¤; Hipoglos con Hidrocortisona; Irigal; Labsa Otic L; Labsa Otic; Lactiderm HC¤; Lidocort Proct; Linfol Dermico; Magicrem; Magnal; Masivol Urea; Micozol Compuesto¤; Microsona C; Microsona Otica; Monizol Cort; Otex HC; Oto Biotaer¤; Otobiotic; Otocipro; Otolef HC; Otoseptil; Otosporin C; Otosporin L; Otosporin; Procto-Ikatral; Proctocrem; Proctyl HC; Prootocipro; Prurisedan Biotic¤; Quemicetina con Hidrocortisona; Reacur¤; Start NP¤; Terra-Cortril Nistatina¤; Terra-Cortril; Tocorectal; Tricur; Tridermal; Triefect¤; Vagicural; Xilocler; Xyloprocto; Australia: Acne-Sol¤; Aerocortin¤; Anusol-HC¤; Chlorocort¤; Ciproxin HC; Hydroform; Hydrozole; Neo Hycor¤; Neo-Cortef¤; Plegettes¤; Proctocort¤; Proctosedyl; Rectinol HC¤; Resolve Plus; Soov It; Vioform-Hydrocortisone¤; Xyloproct; Austria: C-Bildz¤; Calmurid HC¤; Ciproxin HC¤; Cortison Kemicetin¤; Daktacort¤; Ecomytrin-Hydrocortison¤; Endomethazone¤; Hydoftal; Hydrocortimycin¤; Hydrodexan¤; Ichtho-Cortin¤; Otosporin; Systrason¤; Terra-Cortril mit Gentamicin¤; Terra-Cortril mit Polymyxin B-Sulfat¤; Terra-Cortril¤; Tropoderm¤; Belgium: Alphaderm¤; Daktacort; Dolanal¤; Eoline¤; Fucidin Hydrocortisone; Onctose a l'Hydrocortisone¤; Otosporin¤; Pimafucort¤; Sulfo-Selenium¤; Terra-Cortril + Polymyxine B; Terra-Cortril; Xyloproct¤; Brazil: Anusol-HC; Cipro HC; Cliotisona; Dermilan¤; Elocort¤; Furazolon¤; Gingilone; Hemodase; Hemodotti¤; Hermodotti¤; Hidrocorte; Hidroneo¤; Hipoglos Oftalmico¤; Infladerm¤; Nitrolerg¤; Otociriax; Otosporin; TerraCortril com Polimixina B¤; Terra-Cortril; Vioformio-Hidrocortisona; Xyloproct; Canada: Actinac¤; Anodan-HC; Anugesic-HC; Anusol-HC; Anuzinc HC Plus; Anuzinc HC; Calmurid HC¤; Cipro HC¤; Coly-Mycin Otic¤; Cortimyxin; Cortimyxin; Cortiphenol H¤; Cortisporin; Cortisporin; Diospor HC¤; Egozinc-HC; Endomethasone; Fucidin H; HC-Atropine¤; Neo-Cortef¤; Ophthocort¤; Otizol-HC¤; Pentamycetin-HC; Pramox HC; Proctodan-HC; Proctofoam-HC; Proctol; Proctomyxin HC; Proctosedyl; ratio-Hemcort-HC; ratio-Proctosone; Rectogel HC; Rivasol HC; Sential¤; Sopamycetin/HC¤; Spor-HC; Sterex Plus¤; Ti-U-Lac HC¤; Uremol-HC; Vanoxide-HC¤; VioformHydrocortisone; VoSoL HC¤; Chile: Cortifenol H¤; Fucidin H; Otex HC; China: Posterisan; Czech Republic: Ciprobay HC Otic¤; Dobexil Plus¤; Fucidin H; Ophthalmo-Framykoin Compositum; Otosporin¤; Pimafucort; Proctosedyl¤; Septomixine; Xerclear; Denmark: Brentacort; Ciflox; FucidinHydrocortison; Hydrocortison med Terramycin og Polymyxin-B; Hydrocortison med Terramycin; Locoidol¤; Proctosedyl; Xerclear; Finland: Ciproxin-Hydrocortison; Daktacort; Duocort; Fucidin-Hydrocortison; Locoidol¤; Oftan C-C; Pantyson; Pimafucort; Proctosedyl; Sibicort; TerraCortril P; Terra-Cortril; Trosycort; Xyloproct¤; France: Actidilon Hydrocortisone¤; Anti-Hemorroidaires¤; Anusol a l'Hydrocortisone¤; Arthrisone¤; Auriswell¤; Bacicoline; Biocidan-Hydrocortisone¤; Carbo-Cort¤; Cortexan Framycetine; Cortibiotique¤; Cortneo¤; Cutisan a l'Hydrocortisone¤; Daktacort¤; Dermiclone¤; Dermocalm¤; Dermokalixan¤; Dulcicortine¤; Jadit-Hydrocortisone¤; Locoide N¤; Madecassol Neomycine Hydrocortisone¤; Onctose Hydrocortisone; Phleboidine¤; Rhinosterine a l'Hydrocortisone et a la Framycetine¤; Rhinosterine a l'Hydrocortisone¤; Septomixine; Soframycine Hydrocortisone Gramicidine¤; Soframycine Hydrocortisone¤; Stovalone¤; Terramycine Hydrocortisone¤; VitaseptineHydrocortisone¤; Germany: Achromycin¤; Alfason-Fucidine¤; Antiprurit¤; Anusol + H¤; Baycuten HC; Bykomycin F¤; Calmurid HC¤; Canesten HC¤; Condilan¤; Corti Jaikal¤; Corti-Flexiole¤; Corti-Refobacin¤; Cortiphenol H¤; Daktar-Hydrocortison¤; Dermaethyl-H¤; Ecomytrin H¤; Efisol-H¤; Eksalb¤; Ekzemex¤; Farco-Tril¤; Ficortril Lotio m. Neomycin¤; Fucidine H; Fucidine plus¤; Fungisalb¤; Hydrodexan; Ichthocortin; Kolpicortin¤; Novifort¤; Nubral 4 HC¤; Nystaderm comp; Otosporin¤; Pantocrinale¤; Pigmanorm; Pimafucort¤; Pimarektal¤; Poloris HC¤; Polycid N¤; Polyspectran HC; Polyspectran OS¤; Posterisan Forte¤; Potanal¤; Proctofoam-HC¤; Psoil¤; Soorphenesin-H¤; Tampovagan C-N N¤; Terracortril¤; Topoderm N¤; TrichoKolpicortin¤; Tropoderm¤; Xylocain¤; Greece: Ciprobay; Ciprofloxacin HY¤; Cortiphenol H; Daktodor; Endomethasone¤; Eyecort; Fucidin H; Fusindac-H; Hemorroidal-H; Hydrofusin; Ichthocortex; Neo-Otil; Proctosedyl-N; TerraCortril; Xyloproct; Hong Kong: Anusol-HC¤; Axcel Fungicort¤; Candacort; Canesten HC; Cipro HC; Cliocort¤; Corticin¤; Cortiphenol H¤; Cortison Kemicetine¤; Daktacort; Fucidin H; Hemcort HC¤; Hydro-Funga¤; HydrocinN¤; Hydrocort & Neomycin Biorex¤; Micosone; Neosone¤; Otosporin; Posterisan Forte; Proctosedyl¤; Proctosone¤; Protozone¤; Uni-Cort-N¤; UniMizole-HC¤; Uni-Rax-HC¤; Xyloproct; Zaricort¤; Hungary: Chlorocid-H¤; Ciprobay¤; Fucidin H; Otosporin; Oxycort; Pimafucort; Posterisan Forte; Tetran-Hydrocortison; India: A-Ret HC; Acsolve-H; Anaproct; Anomex; Bell Diono Resolvent¤; Bell Resolvent¤; Belmycetin-C¤; Cortecyclin; Cortison Kemicetine¤; Cortola-M; Cortoquinol; Crotorax-HC; Daktacort; Derobin-HC; Drocort; Efcorlin; Fucidin H; Furacin-S¤; Fuson-H; Gentasporin-HC; Genticyn HC; Hydrozole; Keralin; Medithane; Melalite Plus; Melanorm-HC; Multifungin H; Neosporin-H; Neosporin-H; Pino-Cort¤; Proctosedyl; Shield; Wycort with Neomycin; Indonesia: Anusol-HC¤; Brentan; Chloramphecort; Dermacort; Enpicortyn; Haemocaine; Indoson; Kemiderm; Nufacort; Particol¤; Ramicort; Sancortmycin; Terra-Cortril; Thecort; Viohydrocort; Visancort; Zolacort; Ireland: Actinac¤; Alphaderm; Alphosyl HC¤; Anugesic-HC; Anugesic-HC; Anusol-HC; Calmurid HC; Canesten HC; Cortucid¤; Daktacort; Eurax-Hydrocortisone; Fucidin H; Genticin HC¤; Gentisone HC; Hydrocal¤; Locoid C¤; Multifungin H¤; Neo-Cortef¤; Nystaform-HC¤; Otosporin; Perinal; Proctofoam-HC; Proctosedyl; Quinocort¤; Terra-Cortril Nystatin¤; TerraCortril¤; Timodine; Vioform-Hydrocortisone¤; Xyloproct¤; Israel: Alphosyl HC¤; Benzantine H; Calmurid HC¤; Ciproxin HC¤; Daktacort; Epifoam; Fucidin H; Hycocin; Hycomycin; Hydroagisten; Otosporin¤; Panthisone; Perinal; Procto-Glyvenol¤; Proctofoam-HC; Proctosedyl¤; Proctozorin-N; Xyloproct¤; Italy: Antiemorroidale Milanfarma¤; Argisone; Cort-Inal; Cortilen TC¤; Cortison Chemicetina; Daktacort¤; Emorril; Epartisone¤; Flogosone¤; Fucidin H; Idracemi Eparina; Idracemi; Idrocet¤; Idroneomicil¤; Kinogen; Mediflox; Mictasone¤; Mixotone; Mobilat¤; Molidex¤; Nasomixin¤; Neocortigamma¤; Neocortovol¤; Nevacort; Oftalmosporin¤; Otobiotic¤; Pimafucort¤; Pomata Midy HC¤; Prepacort H; Preparazione Antiemorroidaria¤; Proctidol¤; Proctofoam-HC; Proctosedyl; Proctosedyl; Proctosoll; Reumacort; Scalpicin; Sedalen Cort¤; Sinrinal¤; Sinsurrene¤; Vasosterone Antibiotico¤; Vasosterone Collirio¤; Vasosterone¤; Xyloproct¤; Malaysia: Becacort¤; Candacort; Cipro HC¤; Crotamiton H; Daktacort; Decocort; Foban-Hydro; Fucidin H; Liproct; Miconazole H¤; Neo-Hydro¤; Pocin H; Proctosedyl; Proctosone¤; Setarin H¤; Ucort; Xyloproct; Zaricort; Mexico: Angenovag; Biotarson N¤; Ciproxina HC; Clioderm-H¤; Cortisporin; Daktacort; Dermanol; Dermucor-H; Hidrofenil¤; Hidropolicin¤; Litiset; Ofodex; Orecil NF; Otifar; Otiser; Oto Eni; Otolone¤; Poral; Sodrimax; Soldrin; Sulfa Hidro¤; Ultracortin¤; Vioformo-Cort; Xyloderm; Xyloproct Plus; Netherlands: Alphacortison¤; Bacicoline-B; Calmurid HC; Daktacort; Fucidin + Hydrocortisone¤; Otosporin; Pimafucort; Proctofoam-HC¤; Proctosedyl; Terra-Cortril Gel Steraject met polymyxine-B¤; Terra-Cortril met polymyxine-B; Terra-Cortril¤; Xyloproct¤; Norway: Corticyklin¤; Cortikinol¤; Cortimyk¤; Daktacort; Ecomytrin-Hydrocortison¤; FucidinHydrocortison; Locoidol¤; Proctosedyl; Salvizol med Hydrocortison¤; TerraCortril Polymyxin B; Terra-Cortril; Xyloproct¤; New Zealand: Ciproxin HC; Coly-Mycin S Otic¤; Daktacort; DP Lotion - HC; Fungocort¤; Locoid C; Micreme H; Pimafucort; Proctosedyl; Resolve Plus; Xyloproct; Philippines: Candacort; Cortisporin; Daktacort; Fucidin H; Hydrospor; Ircos; Isonep H; Proctosedyl; Trimycin-H; Poland: Atecortin; Chlorchinaldin H; Daktacort¤; Hemcort HC¤; Hemkortin-HC; Laticort-CH¤; Oxycort; Pimafucort; Posterisan H; Proctosone¤; Proktosedon; Portugal: Alphosyl HC¤; Anucet¤; Anucet; Clorcorticil¤; Corticil T¤; Daktacort; Davimicina¤; Fucidine H; Leuco Hubber¤; Locoid C¤; Otolys¤; Otosporin; Pimafucort; Proctonostrum¤; Russia: Cortomycetin (Кортомицетин); Fucidin H (Фуцидин Г); Gioxyson (Гиоксизон); Oxycort (Оксикорт); Pimafucort (Пимафукорт); Posterisan Forte (Постеризан Форте); Proctosedyl (Проктоседил); Proctosedyl M (Проктоседил М); Relief Ultra (Релиф Ультра); Sulfodecortem (Сульфодекортэм); South Africa: Anusol-HC¤; Calmurid HC¤; Chloramex H¤; Ciprobay HC; Corti-Flexiole¤; Daktacort; Elozart; Fucidin H; Locoid C¤; Manoderm¤; Nasomixin¤; Neoderm; Otoseptil¤; Otosporin; Proctofoam¤; Proctosedyl; Quinoderm-H¤; Terra-Cortril¤; Viocort; Singapore: Axcel Fungicort; Candacort; Canesten HC; Ciprobay HC; Cortaid with Aloe¤; Crotorax-HC; Daktacort; Decocort; Fucidin H; Hydroderm-C; Micon-H; NeoCortisone; Neo-Hydro; Otosporin; Proctosedyl; Ucort; Xyloproct¤; Zaricort; Spain: Aftajuventus; Aftasone B C; Alantomicina Complex¤; Anginovag; Antialergico¤; Antiblef Eczem¤; Antihemorroidal¤; Antihemorroidal; Antiinflamat¤; Bacisporin; Brentan; Cilinafosal Hidrocortisona¤; Cinfaotin¤; Ciproxina; Cohortan Antibiotico¤; Cohortan¤; Cohortan; Cortenema¤; Cortison Chemicet Topica; Cortos¤; Dermacortine¤; Dermisone Hidroc Neomic¤; Dermo Hubber; Detraine; Ecomitrin¤; Eczemacort¤; Edifaringen; Euraxil Hidrocort¤; Fucidine H; Ginesona¤; Gingilone Comp¤; Grietalgen Hidrocort¤; Grinal Hidrocortisona¤; Halibut Hidrocortisona¤; Hemodren Compuesto¤; Hepro; Heridasone¤; Hidroc Clora¤; Hidroc Cloranf¤; Hidroc Neomic¤; Hidrocort Neom¤; Indertal¤; Leuco Hubber; Milrosina Hidrocort¤; Milrosina Nistatina¤; Nasal Rovi¤; Nasokey¤; Neo Bacitrin Hidrocortis¤; Neo Hubber; Neo Visage¤; Oftalmo¤; Ophtacortine¤; Oto Difusor¤; Oto Neomicin Calm¤; Oto Vitna¤; Otocaina Hidrocort¤; Otogen Hydrocortisona¤; Otorrilan¤; Otosporin¤; Polirino¤; Puodermina Hidrocor¤; Rino Vitna¤; Rinocusi Descong¤; Roberfarin; Sulfo Selenio¤; Syner Atom¤; Terra-Cortril; Terra-Cortril; Tetra Hubber Otico¤; Tisuderma; Tododermil¤; Tyroneomicin¤; Xilorroidal¤; Sweden: Calmuril-Hydrokortison¤; Chloromycetin Hydrocortison¤; Cortimyk; Daktacort; EcomytrinHydrocortison¤; Fenuril-Hydrokortison; Fucidin-Hydrocortison; Proctosedyl¤; Sterosan-Hydrocortisone¤; Terracortril med polymyxin B; Terracortril; Xerclear; Xyloproct; Switzerland: Antiprurit¤; Bacicoline¤; Calmurid HC¤; Ciproxin HC; Cortifluid N; Cortimycine¤; Cortiphenol H¤; Daktacort; Dermacalm-d; Ecomytrin-Hydrocortison¤; Endomethasone¤; EuraxHydrocortisone¤; Fucidin H; Haemocortin¤; Hydrocortisone compositum¤; Neo-Hydro; Otosporin¤; Proctosedyl¤; Quinoderm Hydrocortisone¤; Rocanal Permanent Gangrene¤; Septomixine; Terracortril¤; Thailand: Antergan; Candacort; Daktacort; Decocort¤; Dermasol; Doproct; Fucidin H; Ladocort; Neo-Hytisone¤; Otosporin¤; Proctosedyl; Xyloproct¤; Turkey: Cormisin¤; Fucidin H; Hipokort Arti; Kortos; Kortos; Ma-Ka-Ta; Ureacort; United Kingdom: Actinac¤; Alphaderm; Alphosyl HC¤; Anugesic-HC¤; AnugesicHC; Anusol-HC, Plus HC; Barquinol HC¤; Calmurid HC; Canesten HC; CarboCort¤; Chloromycetin Hydrocortisone¤; Cobadex¤; Cortucid¤; Daktacort HC; Daktacort; Econacort¤; Eczederm with Hydrocortisone¤; Epifoam¤; Eurax Hc; Framycort¤; Fucidin H; Genticin HC¤; Gentisone HC; Germoloids HC; Gregoderm¤; Hydrocal¤; Hydroderm¤; Hydromol HC Intensive; Locoid C¤; Neo-Cortef¤; Nystaform-HC; Otosporin; Perinal; Proctocream HC¤; Proctofoam-HC; Proctosedyl; Quinocort¤; Quinoderm with Hydrocortisone¤; Sential HC¤; Tarcortin¤; Terra-Cortril Nystatin¤; Terra-Cortril¤; TerraCortril; Timodine; Tri-Cicatrin¤; Uniroid-HC; Uniroid¤; VioformHydrocortisone¤; Xyloproct; Ukraine: Anginovag (Ангиноваг); Oxycort (Оксикорт); Pimafucort (Пимафукорт); Proctosedyl (Проктоседил); Relief Ultra (Релиф Ультра); United States: 1 + 1-F; AA-HC Otic¤; Acetasol HC; Ak-Spore HC¤; Ala-Quin¤; Albaform HC¤; Alcortin A; Alphaderm¤; Analpram E; Analpram-HC; AnaMantle HC¤; AntibiOtic¤; Anumed HC; Bacticort¤; Bencort; Chloromycetin Hydrocortisone¤; Cipro HC; Coly-Mycin S Otic; Coracin¤; Corque; Cortamox¤; Cortane-B; Cortatrigen; Cortic ND; Corticaine¤; Cortimycin; Cortimycin; Cortisporin-TC; Cortisporin¤; Cortisporin; Cyotic; Dermtex HC with Aloe; Drotic¤; Ear-Eze¤; Emergent-Ez; EndaRoid; Enzone; Epifoam; First Duke's Mouthwash; First Mary's Mouthwash; Fungoid HC; HC Derma-Pax; HC Pram; HC Pramoxine; HydroIodoquinol; Hysone; Iodo-Cortifair¤; Keratol HC; LazerSporin-C; LidaMantle HC¤; LidoCort; Mantadil¤; Mayotic¤; Medicone Derma-HC¤; Mediotic-HC; Neo-Cortef¤; Neotricin HC¤; Novacort; Octicair¤; Ophthocort¤; Oti-Med¤; Otic-Care; Oticin HC; OtiTricin; Oto-End; Otobiotic; Otocort; Otomar-HC; Otomycin-HPN; Otosporin; Pedi-Cort V¤; Pediotic¤; Pram-HCA; PramCort; Pramosone; ProCort; Proctofoam-HC; Pyocidin-Otic¤; Terra-Cortril; TriOtic¤; TriOxin; UAD Cream or Lotion¤; UAD-Otic; Vanoxide-HC; Vioform- Hydrocortisone¤; VoSoL HC; Vytone; Xolegel CorePak; Xyralid; Zone-A; Zoto-HC; ZyPram; Venezuela: Hipoglos con Hidrocortisona¤; Otalex; Quinotic HC; Terra-Cortril¤; Pharmacopoeial Preparations (Latest modification: 06-Feb-2013) BP 2013: Gentamicin and Hydrocortisone Acetate Ear Drops; Hydrocortisone Acetate and Neomycin Ear Drops; Hydrocortisone Acetate and Neomycin Eye Drops; Hydrocortisone Acetate and Neomycin Eye Ointment; Hydrocortisone Acetate Cream; Hydrocortisone Acetate Injection; Hydrocortisone Acetate Ointment; Hydrocortisone Acetate Oral Suspension; Hydrocortisone and Clioquinol Cream; Hydrocortisone and Clioquinol Ointment; Hydrocortisone and Neomycin Cream; Hydrocortisone Cream; Hydrocortisone Ointment; Hydrocortisone Oromucosal Tablets; Hydrocortisone Sodium Phosphate Injection; Hydrocortisone Sodium Phosphate Oral Solution; Hydrocortisone Sodium Succinate Injection; Miconazole and Hydrocortisone Acetate Cream; Miconazole and Hydrocortisone Cream; Miconazole and Hydrocortisone Ointment; USP 36: Chloramphenicol and Hydrocortisone Acetate for Ophthalmic Suspension; Chloramphenicol, Polymyxin B Sulfate, and Hydrocortisone Acetate Ophthalmic Ointment; Clioquinol and Hydrocortisone Cream; Clioquinol and Hydrocortisone Ointment; Colistin and Neomycin Sulfates and Hydrocortisone Acetate Otic Suspension; Hydrocortisone Acetate Cream; Hydrocortisone Acetate Injectable Suspension; Hydrocortisone Acetate Lotion; Hydrocortisone Acetate Ointment; Hydrocortisone Acetate Ophthalmic Ointment; Hydrocortisone Acetate Ophthalmic Suspension; Hydrocortisone and Acetic Acid Otic Solution; Hydrocortisone Butyrate Cream; Hydrocortisone Cream; Hydrocortisone Gel; Hydrocortisone Injectable Suspension; Hydrocortisone Lotion; Hydrocortisone Ointment; Hydrocortisone Rectal Suspension; Hydrocortisone Sodium Phosphate Injection; Hydrocortisone Sodium Succinate for Injection; Hydrocortisone Tablets; Hydrocortisone Valerate Cream; Hydrocortisone Valerate Ointment; Neomycin and Polymyxin B Sulfates and Hydrocortisone Acetate Cream; Neomycin and Polymyxin B Sulfates and Hydrocortisone Acetate Ophthalmic Suspension; Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension; Neomycin and Polymyxin B Sulfates and Hydrocortisone Otic Solution; Neomycin and Polymyxin B Sulfates and Hydrocortisone Otic Suspension; Neomycin and Polymyxin B Sulfates, Bacitracin Zinc, and Hydrocortisone Acetate Ophthalmic Ointment; Neomycin and Polymyxin B Sulfates, Bacitracin Zinc, and Hydrocortisone Ointment; Neomycin and Polymyxin B Sulfates, Bacitracin Zinc, and Hydrocortisone Ophthalmic Ointment; Neomycin and Polymyxin B Sulfates, Bacitracin, and Hydrocortisone Acetate Ointment; Neomycin and Polymyxin B Sulfates, Bacitracin, and Hydrocortisone Acetate Ophthalmic Ointment; Neomycin and Polymyxin B Sulfates, Gramicidin, and Hydrocortisone Acetate Cream; Neomycin Sulfate and Hydrocortisone Acetate Cream; Neomycin Sulfate and Hydrocortisone Acetate Lotion; Neomycin Sulfate and Hydrocortisone Acetate Ointment; Neomycin Sulfate and Hydrocortisone Acetate Ophthalmic Ointment; Neomycin Sulfate and Hydrocortisone Acetate Ophthalmic Suspension; Neomycin Sulfate and Hydrocortisone Cream; Neomycin Sulfate and Hydrocortisone Ointment; Neomycin Sulfate and Hydrocortisone Otic Suspension; Oxytetracycline Hydrochloride and Hydrocortisone Acetate Ophthalmic Suspension; Oxytetracycline Hydrochloride and Hydrocortisone Ointment; Polymyxin B Sulfate and Hydrocortisone Otic Solution; Martindale: The Complete Drug Reference © 2013 The Pharmaceutical Press. MedicinesComplete © The Pharmaceutical Press 2013