Cortef (Hydrocortisone)

(℞) Prescription Required

    Cortef (Hydrocortisone) Dosage and Side Effects

    CORTEF (hydrocortisone) is used in the treatment of various conditions such as allergy or inflammation; it is used to replace corticosteroid hormone when the body does not produce enough due to problems with the adrenal glands (e.g. adrenal insufficiency).

    Proper Use of this medication

    Usual adult dose:

    Take CORTEF tablets exactly as directed by your doctor. When your condition has improved, your doctor will reduce your dose gradually. CORTEF should not be stopped abruptly. Do not stop taking CORTEF without talking to your doctor.

    If you are being treated for diabetes, high blood pressure or water retention (oedema) tell your doctor as he/she may need to adjust the dose of the medicines used to treat these conditions.

    Do not eat grapefruit or drink grapefruit juice while taking CORTEF.

    Missed dose:

    If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

    Side Effects

    The following is a list of side effects that may occur with CORTEF. This is not a complete list. Therefore, check with your doctor immediately if you notice or are bothered by any unusual symptoms.

    CORTEF may hide symptoms of infections, may cause latent infections to become active, and may induce infections by normally inoffensive organisms due to lowered body resistance.

    Potential side effects of CORTEF include:

    Allergic Reactions:

    • anaphylaxis (a severe, life-threatening allergic reaction)

    • cardiac arrest

    • bronchospasm (narrowing of the airway)

    Cardiovascular:

    • heart failure

    • heart attack

    • arrhythmia (irregular heartbeat)

    • high and low blood pressure

    • blood clots

    • thrombophlebitis (vein inflammation)

    • thrombosis (blood clot within a blood vessel)

    Dermatologic:

    • thin fragile skin

    • impaired wound healing

    • swelling

    • ecchymosis (spots caused by ruptured blood vessels)

    • petechiae (reddish spot containing blood that appears in skin)

    • stretch marks

    • dry, scaly skin

    • rash

    • redness

    • itching

    • acne

    • increased sweating

    • lightening or darkening of an area of skin

    • abscess

    • suppressed reactions to skin tests

    • thinning hair

    Endocrine and Metabolism:

    • development of Cushingoid state (abnormal bodily condition caused by excess corticosteroids)

    • moon face (enlargement of chin and forehead)

    • weight gain

    • abnormal fat deposits

    • suppression of pituitary-adrenal axis (a condition that could lead to disabling the body’s responses to physiological stress such as severe infections or trauma)

    • suppression of growth in children

    • abnormal hair growth

    • new symptoms of diabetes

    Gastrointestinal:

    • stomach ulcer

    • stomach bleeding

    • inflammation of the pancreas and esophagus

    • perforation of the bowel

    • nausea

    • vomiting or altered sense of taste (with rapid administration of large doses)

    • abdominal pain

    • bloating

    • diarrhea

    • indigestion

    • bowl/bladder dysfunction

    • increased appetite

    Hepatic:

    • enlarged liver

    Musculoskeletal:

    • loss of muscle mass

    • muscle weakness

    • muscle pain

    • malaise (feeling of general discomfort or uneasiness)

    • osteoporosis

    • pathological fractures

    • vertebral compression fractures

    • tendon rupture, (particularly of the Achilles tendon)

    • Charcot joint disease (neuropathic arthropathy)

    • joint pain

    Neurologic:

    • seizures

    • headache

    • dizziness

    • amnesia

    • vertigo

    • pain and tenderness

    • impaired sensation, strength, and reflexes

    • sensation of tingling, tickling, prickling, or burning of a person's skin

    Ophthalmologic:

    • cataracts

    • increased intraocular pressure

    • glaucoma

    Psychiatric:

    • anxiety

    • confusion

    • depression

    • hallucination

    • emotional instability

    • euphoria (intense feelings of well-being, elation, happiness, excitement and joy)

    • insomnia

    • mood swings

    • personality changes

    • suicidal ideation

    Sexual Function/Reproduction:

    • menstrual irregularities

    • increased or decreased motility and number of sperm

    Hematology:

    • above normal white blood cell count

    • abnormal blood tests

    Other:

    • fatigue, hiccups

    Warnings and Precautions

    Before taking CORTEF, talk to your doctor or pharmacist if:

    • you have or have had an infection (such as herpes simplex, chicken pox, tuberculosis, threadworm); If you or your child is exposed to measles or chickenpox during treatment with CORTEF, contact you doctor immediately.

    • you have bleeding problem; blood clotting problem;

    • you have brittle bone (osteoporosis);

    • you have high blood pressure;

    • you have heart problems such as heart failure;

    • you have kidney disease;

    • you have or have had seizures (convulsions) or other neurological problems;

    • you have thyroid problem;

    • you have muscle pain or weakness (such as myasthenia gravis);

    • you have skin cancer (Kaposi’s sarcoma), or a tumor of the adrenal glands (Pheochromocytoma);

    • you have certain eye disease such as glaucoma, cataracts, herpes infection or any problems with the retina;

    • you have liver disease such as cirrhosis;

    • you have certain mental or mood conditions (such as depression);

    • you have or have had stomach or gut problems (ulcer, ulcerative colitis);

    • you have low potassium or calcium;

    • you have a weak immune response;

    • you have Cushing’s disease (caused by an excess of cortisol hormone);

    • you are pregnant or trying to become pregnant;

    • you are breast-feeding or planning to breast-feed.

    Before you have any operation, tell your doctor, dentist or anesthetist that you are taking CORTEF.

    Children: Corticosteroids can affect growth in children.

    Interactions with this medication

    Before taking CORTEF, please talk to your doctor or pharmacist about all your other medications including those you bought without prescription, herbal or natural product and especially if are taking the following:

    • drugs to treat glaucoma and epilepsy such as acetazolamide;

    • drugs to ‘thin’ the blood (anticoagulant such as warfarin, coumadin);

    • drugs to treat myasthenia gravis (a muscle condition) such as distigmine and neostigmine;

    • antibiotics (erythromycin, clarithromycin and troleandomycin, rifampicin and rifabutin);

    • aspirin and non steroidal anti-inflammatory drugs (such as ibuprofen);

    • drugs to treat inflammatory conditions (such as methylprednisolone);

    • drugs to treat epilepsy (such as barbiturates and phenytoin);

    • drugs for antifungal infections (such as ketoconazole);

    • cyclosporine;

    • drugs for heart problems or high blood pressure as digoxin and diltiazem;

    • drugs to treat high cholesterol (cholestyramine);

    • water pills (diuretics);

    • drugs to treat HIV infections such as indinavir or ritonavir;

    • hormones, such as estrogen and somatropin;

    • drugs to treat diabetes;

    • drugs to treat tuberculosis;

    • vaccines—tell your doctor if you have recently had or are about to have any vaccination.

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    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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