Hydrocortisone is primarily indicated in conditions like Adrenal insufficiency, Anaphylactic reactions, Apthous ulcers, Atopic eczema, Collagen disease, Congenital adrenal hyperplasia, Contact allergic dermatitis, Discoid eczema. Flexural psoriasis. Graft reiection. Hypercalcaemia, Infantile eczema, Inflammation, Irritant dermatitis, Itching, Joint inflammation, Perineal trauma, Seborrheic dermatitis, Shock, Soft tissue inflammation, Status asthmaticus, Ulcerative protocolitis, and can also be given in adjunctive therapy as an alternative drug of choice in Anaphylactic shock, Insect bites, Otitis externa, Sunburn, Ulcerative colitis.
Hydrocortisone is contraindicated in conditions like Ulcers,Systemic infections, Hypersensitivity.
The severe or irreversible adverse effects of Hydrocortisone, which give rise to further complications include Convulsions, Gi bleeding, Telangiectasia, Striae, Glaucoma, Cataract, Pancreatitis, Hypersensitivity reactions, Osteoporosis, Psychosis, Increased intracranial pressure, Growth retardation, Glucose intolerance, Epidermal thinning, Vertebral fractures, Avascular necrosis, Papilloedema, Opthalmic fungal or viral disease, Dendritic corneal ulcers, Thromboembolic disorder, Long bone fractures, Hypokalemic alkalosis, Reduced visual function, Tendon rupture, Intestinal perforation, Opportunistic infections, Addisonian crises, Adrenal atrophy, Increased TOP (intraocular pressure), Subcutaneous atrophy.Hydrocortisone produces potentially life-threatening effects which include Anaphylactoid reactions, Addisonian crises, CHF, Opportunistic infections, Acute pancreatitis, Gl hemorrhage, which are responsible for the discontinuation of Hydrocortisone therapy. The signs and symptoms that are produced after the acute overdosage of Hydrocortisone include hypomagnesaemia, Hyperkalemia, Adrenal suppression. The symptomatic adverse reactions produced by Hydrocortisone are more or less tolerable and if they become severe, they can be treated symptomatically, these include Insomnia, Irritation, Allergic reactions, Itching, Burning, Depression, Weight gain, Acne, Euphoria, Menstrual irregularity, Perioral dermatitis, Cushingoid facies, Mood swings, Dryness, Local hypopigmentation, Stinging.
Hydrocortisone should be used with caution in patients with active tuberculosis infection of respiratory tract or in untreated fungal, bacterial or systemic viral infections. Corticosteroids should only be used systemically with great caution in the presence of congestive heart failure (CHF), recent myocardial infraction (MI), hypertension, diabetes mellitus, epilepsy, glaucoma, hypothyroidism, liver failure, osteoporosis, peptic ulceration or renal impairment. Children may be at increase risk of some adverse effects, corticosteroid causes growth retardation and prolonged use is rarely justified. Passive immunization is recommended to non-immune patients who do come in contact with chickenpox or measles. Live vaccine should not be given to patients receiving high dose systemic corticosteroid therapy nor for atleast 3 months afterwards, killed vaccine or toxoids may be given, although the response may be attenuated. During prolong treatment with corticosteroids, patients should be examined regularly, sodium intake may need to be reduced and calcium and potassium supplement may be necessary. Patient should carry cards given full details of their corticosteroid therapy. Avoid use during pregnancy. Use nasal steroids with caution until healing has occurred. Donot take Hydrocortisone if you are allergic to it. Donot exceed recommended dose. Avoid getting this medication in your eyes. Caution is required in children.