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Hydrocortisone tablets

Sounds like 'HYE-droe-KOR-ti-sone'

Key points about hydrocortisone tablets

Hydrocortisone is a steroid used to replace natural steroid hormones in people that don't produce enough of them.
It belongs to a group of medicines called corticosteroids.
The dose of hydrocortisone tablets is different for different people.
Find out how to take it safely and possible side effects.

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Hydrocortisone is in a class of medicines known as corticosteroids, which is similar to the steroid hormones that your body naturally makes. Steroid hormones are essential for your body and if you do not have enough of them, you can become very unwell.

In people whose adrenal glands do not produce enough steroid hormones (such as cortisol), hydrocortisone tablets are used as a replacement treatment. This can happen in conditions such as Addison's disease or it can happen in people who have had surgery to remove their adrenal glands.

In New Zealand hydrocortisone tablets are available in 2 strengths: 5 mg and 20 mg.
The dose of hydrocortisone tablets is different for different people. The usual dose is 10–30 mg each day.
Always take your hydrocortisone tablets exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much hydrocortisone to take, how often to take it and any special instructions.

Timing: Hydrocortisone tablets are usually taken as 2 or 3 doses each day. Usually, the morning dose is larger than the other doses. Try taking your hydrocortisone doses at the same time of day each day. Hydrocortisone is best taken immediately after a meal or a snack.
Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
Stopping hydrocortisone tablets: If you have been taking hydrocortisone tablets regularly for more than a few weeks, do not stop taking them suddenly. Stopping suddenly can cause withdrawal symptoms, which can be serious or even life-threatening. Instead, you will be given a tapering dose. This means your dose of hydrocortisone will be gradually reduced over a few days or weeks. Read more about a steroid withdrawal plan.

My hydrocortisone dose
I am taking hydrocortisone for:
My dose is:	For how long:
How to reduce my hydrocortisone dose gradually over a few weeks
Date:	Dose:
Date:	Dose:
Date:	Dose:
Date:	Dose:
Date:	Dose:
Notes:

Here are some things to know when you're taking hydrocortisone. Other things may be important as well, so ask your healthcare provider what you should know about.

Other medicines: Hydrocortisone interacts with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting hydrocortisone and before starting any new products.
Tell all your healthcare providers: It is important to tell all your healthcare providers that you are taking hydrocortisone.
Increased risk of infections: Taking hydrocortisone can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness such as chickenpox, shingles or measles, or if you feel unwell.
Vaccines: It is safe to have most vaccines, including the flu vaccine, while you are taking hydrocortisone. Protecting yourself against infection is important because hydrocortisone suppresses your immune system. However, vaccination with ‘live vaccines’, such MMR (measles, mumps, rubella) or shingles vaccine, should be postponed. Ask your doctor for advice before you have any vaccines while you are taking hydrocortisone.

Like all medicines, hydrocortisone can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking hydrocortisone tablets for. Read more about taking steroids long term.

Changes in behaviour and mood

Hydrocortisone, especially in high doses, can cause changes in personality, behaviour and mood, such as:

irritability, agitation and restlessness
sleep problems (insomnia) and nightmares
mood swings and aggression
low mood, depression and even suicidal thoughts.

These symptoms typically develop within a few days of starting hydrocortisone, but they can occur at any time, including after stopping treatment.

While these symptoms often go away when your dose is reduced or hydrocortisone is stopped, stopping hydrocortisone must be done under the guidance of your doctor. Stopping too quickly can make these symptoms worse. You are at higher risk of mood and behaviour changes if you have previously had similar reactions to steroids (corticosteroid-induced psychosis), or if you have a personal or family history of psychiatric disorders.

If you have changes in mood and behaviour, especially depression and suicidal thoughts, tell your doctor immediately or phone Healthline 0800 611 116.

Other side effects

Side effects	What should I do?
Signs of retaining fluid such as swollen feet and ankles Weight gain	This is quite common when you start taking hydrocortisone. Whenever possible, sit with your feet up.
Headache Muscle weakness, feeling tired	These are quite common when you first start taking hydrocortisone, and usually go away with time. Tell your doctor if troublesome.
Raised blood glucose	Hydrocortisone can cause an increase in blood glucose. If you have diabetes, you may need to increase the dose of your diabetes medicine to control your blood glucose. Talk to your doctor about this. Hydrocortisone can also cause the onset of diabetes in people who are at risk of diabetes. Your doctor will monitor your blood glucose levels regularly.
Blurred vision or changes in your eyesight. Problems with your stomach such as pain, blood in your stool (poo) or dark coloured stool (poo)	Tell your doctor immediately or phone Healthline 0800 611 116.