Cortisol
Generic Name
Hydrocortisone
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cortisol 20 mg tablet | ৳ 6.25 | ৳ 62.50 |
Description
Overview of the medicine
Hydrocortisone is a synthetic corticosteroid used to treat a wide range of conditions including adrenal insufficiency, inflammatory disorders, and autoimmune diseases. It works by mimicking the effects of natural cortisol produced by the adrenal glands.
Uses & Indications
Dosage
Adults
Dosage varies widely based on the condition being treated. For adrenal insufficiency, typical daily dose is 20-30 mg, usually given in divided doses (e.g., 2/3 in morning, 1/3 in evening). For other conditions, dosage can range from 20 mg to several hundred milligrams daily, tapered as symptoms improve.
Elderly
Use with caution due to increased risk of side effects like osteoporosis and fluid retention. Lower doses or careful monitoring may be required.
Renal_impairment
No specific dose adjustment is typically required, but use with caution due to potential fluid retention.
How to Take
Take orally, preferably with food or milk to minimize gastrointestinal upset. Do not stop taking the medicine abruptly, especially after prolonged use; dosage should be gradually tapered.
Mechanism of Action
Hydrocortisone binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to reduced inflammation, immunosuppression, and various metabolic effects.
Pharmacokinetics
Onset
Anti-inflammatory effects typically begin within 30-60 minutes.
Excretion
Excreted mainly in the urine as inactive metabolites and, to a lesser extent, as unchanged drug.
Half life
Plasma half-life is approximately 1.5 to 2 hours, but biological half-life is 8-12 hours.
Absorption
Rapidly and well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are achieved within 1-2 hours.
Metabolism
Primarily metabolized in the liver (by CYP3A4 enzymes) to inactive metabolites. Also metabolized in the kidney and other tissues.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to hydrocortisone or any component of the formulation
- Live or live-attenuated vaccines when on immunosuppressive doses
Drug Interactions
Anticoagulants (e.g., Warfarin)
May potentiate or diminish anticoagulant effects; monitor INR.
Diuretics (e.g., Thiazides, Loop diuretics)
May enhance potassium depletion.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Increased risk of gastrointestinal bleeding and ulceration.
CYP3A4 Inducers (e.g., Rifampin, Phenytoin, Carbamazepine, Barbiturates)
May decrease hydrocortisone levels, requiring increased hydrocortisone dose.
CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir, Clarithromycin)
May increase hydrocortisone levels, requiring decreased hydrocortisone dose.
Storage
Store at room temperature (below 30°C), protected from light and moisture. Keep out of reach of children.
Overdose
Acute overdose is rare. Symptoms may include fluid retention, hypertension, hyperglycemia, and potassium loss. Treatment is supportive and symptomatic; no specific antidote exists. Chronic overdose leads to Cushing's syndrome.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Hydrocortisone is excreted in breast milk and may cause adverse effects in infants; exercise caution or discontinue nursing.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to hydrocortisone or any component of the formulation
- Live or live-attenuated vaccines when on immunosuppressive doses
Drug Interactions
Anticoagulants (e.g., Warfarin)
May potentiate or diminish anticoagulant effects; monitor INR.
Diuretics (e.g., Thiazides, Loop diuretics)
May enhance potassium depletion.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Increased risk of gastrointestinal bleeding and ulceration.
CYP3A4 Inducers (e.g., Rifampin, Phenytoin, Carbamazepine, Barbiturates)
May decrease hydrocortisone levels, requiring increased hydrocortisone dose.
CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir, Clarithromycin)
May increase hydrocortisone levels, requiring decreased hydrocortisone dose.
Storage
Store at room temperature (below 30°C), protected from light and moisture. Keep out of reach of children.
Overdose
Acute overdose is rare. Symptoms may include fluid retention, hypertension, hyperglycemia, and potassium loss. Treatment is supportive and symptomatic; no specific antidote exists. Chronic overdose leads to Cushing's syndrome.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Hydrocortisone is excreted in breast milk and may cause adverse effects in infants; exercise caution or discontinue nursing.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (FDA/DGDA)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Hydrocortisone is a well-established drug with extensive clinical trial data supporting its efficacy and safety for various indications over many decades.
Lab Monitoring
- Serum electrolytes (especially potassium)
- Blood glucose levels
- Blood pressure
- Bone mineral density (during long-term therapy)
- Adrenal function tests (after withdrawal or dose tapering)
Doctor Notes
- Always emphasize the importance of gradual tapering to prevent adrenal crisis.
- Monitor blood glucose, electrolytes, and bone mineral density in patients on long-term therapy.
- Advise patients about potential signs of infection and when to seek medical attention.
- Consider stress dosing guidelines for patients undergoing surgery or severe illness.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor, as it can cause serious withdrawal symptoms.
- Take with food or milk to minimize stomach upset.
- Report any unusual side effects, especially signs of infection, severe mood changes, or severe stomach pain.
- Avoid close contact with people who have infections (e.g., chickenpox, measles) while on this medication.
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
Cortisol may cause dizziness, vision changes, or mood disturbances in some individuals. If you experience any of these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a diet rich in calcium and vitamin D to support bone health.
- Engage in regular weight-bearing exercise, if appropriate, to help prevent osteoporosis.
- Limit sodium intake to help manage fluid retention and blood pressure.
- Avoid alcohol and tobacco use.
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