About hydrocortisone

Hydrocortisone belongs to a group of medicines called corticosteroids. It is sometimes referred to simply as an oral steroid. It is used as a replacement treatment for people whose adrenal glands are not producing enough natural corticosteroid - a condition known as adrenal insufficiency, or Addison's disease. It is also used for people who have had surgery to remove their adrenal glands and who therefore no longer produce natural hydrocortisone (cortisol).

Before taking hydrocortisone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking hydrocortisone it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have high blood pressure.
• If you have had a heart attack or have any other heart problems.
• If you have liver or kidney problems.
• If you or anyone in your family has diabetes mellitus or glaucoma (increased pressure in your eyes).
• If you have osteoporosis (weakened bones).
• If you have an underactive thyroid.
• If you have ever had mental health problems such as depression.
• If you have epilepsy.
• If you have had a stomach ulcer or an inflammatory bowel disorder.
• If you have recently had, or are about to have, any vaccinations.
• If you have any kind of infection, or if you have ever had tuberculosis (TB).
• If you (or anyone you are in close contact with) have recently had chickenpox, measles or shingles.
• If you have ever had blood clots in your arteries or veins.
• If you have myasthenia gravis (this is a condition causing muscle weakness).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic reaction to a medicine, or if you have ever developed muscle pain after taking a steroid medicine.

How to take hydrocortisone

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about hydrocortisone and a full list of side-effects which you may experience from taking it.
• Your doctor or pharmacist will tell you how many tablets to take and when to take them. This information will also be on the label of the packet of tablets to remind you. It is important that you take hydrocortisone exactly as your doctor has told you. As a guide, if you are taking immediate-release tablets, it is likely that you will be prescribed two or three doses to take each day. It is usual for your morning dose to be larger than the other doses. Take immediate-release tablets with a snack or just after eating a meal. If you have been prescribed Plenadren®, this is a tablet which releases hydrocortisone to your body throughout the day. It is usual to take one dose a day, 30 minutes before your breakfast. Swallow the tablets whole (this means do not break, crush, or chew them), with a drink of water.
• Try to take your doses at the same times each day, as this will help you to remember to take them. If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose). Do not take two doses together to make up for a forgotten dose.
• Continue to take hydrocortisone unless your doctor tells you to stop. Stopping taking these tablets suddenly will cause problems.

Getting the most from your treatment

• You will be given a 'steroid treatment card' which says that you are on steroids and contains some important advice for you. It is important that you read this card and carry it with you at all times. It also contains details about your dose, how long you have been taking hydrocortisone for, and who prescribed it for you. Please make sure that this information is kept up to date. If you are having an operation or dental treatment or any treatment for an injury, tell the person carrying out the treatment that you are taking hydrocortisone and show them your treatment card.
• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have tests from time to time to make sure you remain free from some of the unwanted side-effects of treatment.
• Hydrocortisone may suppress your immune system, so it is important if you become ill that you make an appointment to see your doctor straightaway. Also, if you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have them), you must see your doctor as soon as possible.
• Do not drink grapefruit juice, if you are taking Plenadren® tablets. This is because it will interfere with the way the tablets work.
• Some vaccines are not suitable for you while you are being treated with hydrocortisone. If you need any immunisations, make sure you mention that you are taking hydrocortisone.
• If you buy any medicines, check with a pharmacist that they are suitable to take with hydrocortisone.

Can hydrocortisone cause problems?

Along with its useful effects, hydrocortisone can cause unwanted side-effects which your doctor will discuss with you. The benefits of taking hydrocortisone usually outweigh the side-effects; however, they can sometimes be troublesome. Although not everyone experiences side-effects, and some will improve as your body adjusts to the new medicine, speak with your doctor or pharmacist if you become concerned about any of the following:

For more information about side-effects which are possible when hydrocortisone is taken long-term, see the separate condition leaflet called Oral Steroids.

How to store hydrocortisone

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines