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Hydrocortisone

Hydrocortisone
Clinical data
Trade namesA-hydrocort, Cortef, Solu-cortef, others[1]
Other namesCortisol; 11β,17α,21-Trihydroxypregn-4-ene-3,20-dione; 11β,17α,21-Trihydroxyprogesterone
AHFS/Drugs.comMonograph
MedlinePlusa682206
License data
Pregnancy
category
Routes of
administration		By mouth (tablets), intravenous, topical, rectal
Drug classCorticosteroid; Glucocorticoid; Mineralocorticoid
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: 96 ± 20%[11][12]
Protein binding92 ± 2% (92–93%)[11][12]
Metabolism11β-HSDsTooltip 11β-Hydroxysteroid dehydrogenases, others[12]
MetabolitesCortisone, others[12]
Onset of actionOral: 1.2 ± 0.4 hours (Tmax)[11]
Elimination half-life1.2–2.0 hours[11][12]
Duration of action8–12 hours[13]
Identifiers
  • (8S,9S,10R,11S,13S,14S,17R)-11,17-Dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-2,6,7,8,9,11,12,14,15,16-decahydro-1H-cyclopenta[a]phenanthren-3-one
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC21H30O5
Molar mass362.466 g·mol−1
3D model (JSmol)
  • O=C4\C=C2/[C@]([C@H]1[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@H]3[C@@H]1CC2)C)(C)CC4
  • InChI=1S/C21H30O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h9,14-16,18,22,24,26H,3-8,10-11H2,1-2H3/t14-,15-,16-,18+,19-,20-,21-/m0/s1 checkY
  • Key:JYGXADMDTFJGBT-VWUMJDOOSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Hydrocortisone is the name for the hormone cortisol when supplied as a medication.[14] Uses include conditions such as adrenocortical insufficiency, adrenogenital syndrome, high blood calcium, thyroiditis, rheumatoid arthritis, dermatitis, asthma, and COPD.[1] It is the treatment of choice for adrenocortical insufficiency.[15] It can be given by mouth, topically, or by injection.[1] Stopping treatment after long-term use should be done slowly.[1]

Side effects may include mood changes, increased risk of infection, and edema (swelling).[1] With long-term use common side effects include osteoporosis, upset stomach, physical weakness, easy bruising, and candidiasis (yeast infections).[1] It is unclear if it is safe for use during pregnancy.[16] Hydrocortisone is a glucocorticoid and works as an anti-inflammatory and by immune suppression.[1]

Hydrocortisone was patented in 1936 and approved for medical use in 1941.[17][18] It is on the World Health Organization's List of Essential Medicines.[19] It is available as a generic medication.[1] In 2021, it was the 192nd most commonly prescribed medication in the United States, with more than 2 million prescriptions.[20][21]

  1. ^ a b c d e f g h "Hydrocortisone". Drugs.com. American Society of Health-System Pharmacists. 9 February 2015. Archived from the original on 20 September 2016. Retrieved 30 August 2016.
  2. ^ "Prescribing medicines in pregnancy database". Therapeutic Goods Administration (TGA). Archived from the original on 20 December 2016. Retrieved 21 February 2021.
  3. ^ "Hydrocortisone Notice of enforcement policy" (PDF). FDA. Archived (PDF) from the original on 12 March 2023. Retrieved 31 December 2022.
  4. ^ "Ala-cort- hydrocortisone cream". DailyMed. Archived from the original on 27 October 2020. Retrieved 21 February 2021.
  5. ^ "Ala-scalp- hydrocortisone lotion". DailyMed. Archived from the original on 21 April 2021. Retrieved 21 February 2021.
  6. ^ "Alkindi Sprinkle- hydrocortisone granule". DailyMed. Archived from the original on 10 February 2022. Retrieved 21 February 2021.
  7. ^ "Anusol HC- hydrocortisone acetate suppository". DailyMed. Archived from the original on 10 February 2022. Retrieved 21 February 2021.
  8. ^ "Cortef- hydrocortisone tablet". DailyMed. Archived from the original on 17 April 2021. Retrieved 21 February 2021.
  9. ^ Cite error: The named reference Efmody EPAR was invoked but never defined (see the help page).
  10. ^ "Efmody Product information". Union Register of medicinal products. Archived from the original on 5 March 2023. Retrieved 3 March 2023.
  11. ^ a b c d Czock D, Keller F, Rasche FM, Häussler U (2005). "Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids". Clinical Pharmacokinetics. 44 (1): 61–98. doi:10.2165/00003088-200544010-00003. PMID 15634032. S2CID 24458998.
  12. ^ a b c d e Lennernäs H, Skrtic S, Johannsson G (June 2008). "Replacement therapy of oral hydrocortisone in adrenal insufficiency: the influence of gastrointestinal factors". Expert Opinion on Drug Metabolism & Toxicology. 4 (6): 749–758. doi:10.1517/17425255.4.6.749. PMID 18611115. S2CID 73248541.
  13. ^ Cite error: The named reference pmid23947590 was invoked but never defined (see the help page).
  14. ^ Becker KL (2001). Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. p. 762. ISBN 978-0-7817-1750-2. Archived from the original on 14 September 2016.
  15. ^ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 202. ISBN 978-1-284-05756-0.
  16. ^ "Hydrocortisone Pregnancy and Breastfeeding Warnings". Drugs.com. Archived from the original on 20 September 2016. Retrieved 1 September 2016.
  17. ^ U.S. patent 2,183,589
  18. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 484. ISBN 978-3-527-60749-5. Archived from the original on 10 January 2023. Retrieved 7 September 2020.
  19. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  20. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  21. ^ "Hydrocortisone - Drug Usage Statistics". ClinCalc. Archived from the original on 12 April 2020. Retrieved 14 January 2024.

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