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Hydrocortisone

Supportive Care Pain Relief

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What is hydrocortisone?

Hydrocortisone (also called Cortef® or Solu-Cortef®) is a man-made steroid medicine that works like a natural steroid produced by the adrenal gland in your body. This medicine is used to relieve inflammation (swelling, heat, redness, and pain). It is also used to treat allergies, itching, asthma, and ACTH deficiency. Hydrocortisone is available in these forms:

  • 5 mg, 10 mg, and 20 mg white tablets taken by mouth
  • A liquid suspension taken by mouth that is made by a compounding pharmacy
  • A clear liquid given by vein (IV)
  • An ointment or cream applied to the skin (topical)
  • A suppository, cream, or foam used in the rectum
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Possible side effects

  • Irritated stomach (burning)

Possible side effects of hydrocortisone (topical form)

  • Irritated skin, mild stinging
  • Skin redness

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

Symptoms of an allergic reaction include: rash, hives, itching, chills, fever, headache, muscle ache, shortness of breath, coughing, tightness in the throat, swelling of the face or neck.

Not all patients who take hydrocortisone will experience these side effects. Common side effects are bolded, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

Find more information on side effects.

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Possible late effects

  • Headache
  • Feeling dizzy
  • Changes in personality and mood
  • Increased appetite
  • Problems sleeping
  • Acne
  • Weight gain, mainly in the face and abdomen
  • Retaining water, which can increase blood pressure
  • Increased white blood cell count, but decreased infection-fighting cells
  • Increased blood sugar levels
  • Decreased potassium levels, especially if you are taking other medicines that also decrease potassium levels
  • Muscle weakness, decreased muscle mass, impaired wound healing, thin fragile skin, and weakened bones (after taking hydrocortisone for a long time)
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Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist. 

Special instructions for hydrocortisone (by mouth and IV forms)

  • Do not stop taking this medicine until the doctor tells you to do so.
  • Always take this medicine with food or milk to decrease stomach burning.
  • Hydrocortisone can hide a fever. Watch for signs of infection, and tell the doctor or nurse as soon as possible if you see such signs (refer to “Do you know… The signs of infection”).
  • Wash your face twice daily with soap and water to decrease the chance that temporary acne will develop.
  • Your doctor may put you on a low-sodium, high-protein diet. Sodium (salt) will make you retain water. The nutritionist will tell you what foods to avoid and will suggest snacks to help you deal with increased appetite.
  • Shake the liquid suspension very well before you take each dose. Store the liquid in the refrigerator. Discard after the expiration date printed on the label.
  • Urine and blood tests may be needed to check for high sugar levels.
  • Blood tests may also be needed to check potassium levels. You may need to take potassium by mouth to keep the potassium level normal in the blood.
  • Store hydrocortisone tablets at room temperature in a dry place.
  • Hydrocortisone may affect the way some medicines work. Some medicines may also affect the way hydrocortisone works. These medicines include: insulin, digoxin, warfarin, phenytoin, phenobarbital, ketoconazole, aspirin, ibuprofen, furosemide, and rifampin. Always tell your doctor if you are taking any of these medicines, or if you start taking any new medicine while you are taking hydrocortisone.

Special instructions for hydrocortisone (topical and rectal forms)

  • Wash hands before and after use.
  • Wash the area of skin to be treated. Then apply a thin layer of hydrocortisone ointment or cream to the skin. Rub the medicine gently into the skin until it has been absorbed.
  • Avoid direct exposure to sunlight when you are using topical hydrocortisone. Your skin will burn more easily.
  • Store hydrocortisone ointment, cream, foam, and suppositories at room temperature in a dry place.
  • Unwrap hydrocortisone suppositories before inserting them into the rectum.
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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency. 

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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Reviewed: June 2024