Cortan
Generic Name
Hydrocortisone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cortan 1 suspension | ৳ 100.00 | N/A |
Description
Overview of the medicine
Cortan-1-suspension contains Hydrocortisone, a corticosteroid hormone used to treat a wide range of inflammatory and autoimmune conditions, as well as adrenal insufficiency. It acts as an anti-inflammatory and immunosuppressant agent.
Uses & Indications
Dosage
Adults
Dosage varies widely based on condition. For adrenocortical insufficiency, typically 20-30 mg daily in divided doses. For other conditions, doses range from 20-240 mg daily, tailored to individual response.
Elderly
Similar to adult dosage, but use with caution due to increased risk of side effects (e.g., osteoporosis, diabetes) and monitor for comorbidities.
Renal_impairment
No specific dosage adjustment is usually required in renal impairment; however, monitor for fluid retention and electrolyte disturbances.
How to Take
Take orally, preferably with food or milk to minimize gastrointestinal irritation. For chronic use, take in divided doses, mimicking the natural diurnal rhythm (e.g., two-thirds in the morning and one-third in the late afternoon).
Mechanism of Action
Hydrocortisone binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to the synthesis of anti-inflammatory proteins and inhibition of pro-inflammatory mediators, thereby reducing inflammation and suppressing immune responses.
Pharmacokinetics
Onset
The anti-inflammatory effects usually begin within a few hours of administration.
Excretion
Excreted mainly in the urine as inactive metabolites and, to a lesser extent, as unmetabolized drug.
Half life
Plasma half-life is approximately 80-118 minutes, but its biological half-life is 8-12 hours due to tissue binding.
Absorption
Hydrocortisone is well absorbed orally, with peak plasma concentrations occurring within 1-2 hours after administration.
Metabolism
Primarily metabolized in the liver by the cytochrome P450 3A4 (CYP3A4) enzyme system, and also in the kidney.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to hydrocortisone or any component of the suspension
- Live or live attenuated vaccines in patients receiving immunosuppressive doses
Drug Interactions
Warfarin
Increased or decreased anticoagulant effect; monitor INR.
NSAIDs (e.g., Ibuprofen)
Increased risk of gastrointestinal ulcers and bleeding.
Insulin/Oral hypoglycemics
Corticosteroids can increase blood glucose, requiring dose adjustments of antidiabetic medications.
Diuretics (e.g., Furosemide)
Increased potassium loss and risk of hypokalemia.
Oral contraceptives/Estrogens
May increase corticosteroid levels and effects.
Phenobarbital, Rifampin, Phenytoin
May reduce corticosteroid effects by increasing metabolism.
Storage
Store at controlled room temperature (20°C to 25°C), away from direct light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Acute overdose is rare and generally does not lead to life-threatening situations. Chronic overdose can lead to severe adverse effects of Cushing's syndrome, including fluid retention, hypertension, hyperglycemia, and adrenal suppression. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Hydrocortisone is excreted in breast milk; caution should be exercised when administered to a nursing mother. Monitor infants for signs of adrenal suppression.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to hydrocortisone or any component of the suspension
- Live or live attenuated vaccines in patients receiving immunosuppressive doses
Drug Interactions
Warfarin
Increased or decreased anticoagulant effect; monitor INR.
NSAIDs (e.g., Ibuprofen)
Increased risk of gastrointestinal ulcers and bleeding.
Insulin/Oral hypoglycemics
Corticosteroids can increase blood glucose, requiring dose adjustments of antidiabetic medications.
Diuretics (e.g., Furosemide)
Increased potassium loss and risk of hypokalemia.
Oral contraceptives/Estrogens
May increase corticosteroid levels and effects.
Phenobarbital, Rifampin, Phenytoin
May reduce corticosteroid effects by increasing metabolism.
Storage
Store at controlled room temperature (20°C to 25°C), away from direct light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Acute overdose is rare and generally does not lead to life-threatening situations. Chronic overdose can lead to severe adverse effects of Cushing's syndrome, including fluid retention, hypertension, hyperglycemia, and adrenal suppression. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Hydrocortisone is excreted in breast milk; caution should be exercised when administered to a nursing mother. Monitor infants for signs of adrenal suppression.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when unopened. Refer to the manufacturer's label for specific expiry date. Once opened, use within a specified period (e.g., 28 days) as per manufacturer's guidelines.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available (Off-patent)
WHO Essential Medicine
YesClinical Trials
Hydrocortisone has been extensively studied for decades, and its efficacy and safety profile are well-established through numerous clinical trials and widespread clinical use for a broad range of indications.
Lab Monitoring
- Blood glucose levels
- Electrolyte levels (especially potassium)
- Blood pressure
- Bone mineral density (for long-term users)
- Growth in pediatric patients
- Adrenal function tests (after prolonged therapy)
Doctor Notes
- Emphasize the importance of gradual tapering when discontinuing the drug to prevent adrenal crisis.
- Monitor patients for signs of infection, blood glucose levels, blood pressure, and bone health, especially with prolonged therapy.
- Advise patients about potential psychiatric effects and to report any significant mood changes.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor and do not stop abruptly without medical advice.
- Report any unusual side effects, especially severe mood changes, swelling, or signs of infection.
- Avoid contact with people who have infections like chickenpox or measles if you are on high doses, as your immune system might be suppressed.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Hydrocortisone generally does not impair driving ability. However, if you experience side effects like dizziness, vision changes, or confusion, avoid driving or operating machinery until these symptoms resolve.
Lifestyle Advice
- Maintain a low-sodium, high-potassium diet to minimize fluid retention and electrolyte imbalance.
- Consider calcium and vitamin D supplementation to help prevent osteoporosis, especially with long-term use.
- Engage in regular weight-bearing exercise to support bone health.
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