From FDA website. Hydrocortisone was not mutagenic in bacterial assays but induced chromosome aberrations in human lymphocytes in vitro and in mice in vivo. Prophylaxis with normal intramuscular immuneglobulin may be needed. What is the equivalent dose of oral prednisolone to intravenous (IV) hydrocortisone? Any unused medicinal product or waste material should be disposed of in accordance with local requirements. Other glucocorticoids (e.g., oral prednisone, parenteral methylprednisolone) generally are preferred. Whitehouse Station, NJ; 2001 Nov. e. Abbott Laboratories. It allows continued monitoring of the benefit/risk balance of the medicinal product. Adverse effects on fertility in rats with corticosterone were observed in males only and were reversible. Patients/carers should be encouraged to seek medical advice if worrying psychological symptoms develop, especially if depressed mood or suicidal ideation is suspected. Manifestations of peritoneal irritation following GI perforation may be minimal or absent in patients receiving corticosteroids. If the disease is unlikely to relapse on withdrawal of systemic corticosteroids, but there is uncertainty about HPA suppression, the dose of systemic corticosteroid may be reduced rapidly to physiological doses. Since Hydrocortisone is normally employed on a short-term basis it is unlikely that side-effects will occur; however, the possibility of side-effects attributable to corticosteroid therapy should be recognised (see Section 4.4). By continuing to browse the site you are agreeing to our policy on the use of cookies. For instructions on administration, see section 4.2. McEvoy GK, ed. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2886-98. c. Pharmacia & Upjohn. Longitudinal measurements may be repeated as often as every 6 months to detect possible bone loss. Corticosteroids have been shown to reduce fertility when administered to rats. Expert panel report II: guidelines for the diagnosis and management of asthma. Abrupt withdrawal of systemic corticosteroid treatment, which has continued up to 3 weeks is appropriate if it considered that the disease is unlikely to relapse. High dosages may be required for acute situations of certain rheumatic disorders and collagen diseases; after a response has been obtained, drug often must be continued for long periods at low dosage.b, High or massive dosages may be required in the treatment of pemphigus, exfoliative dermatitis, bullous dermatitis herpetiformis, severe erythema multiforme, or mycosis fungoides.b Early initiation of systemic glucocorticoid therapy may be life-saving in pemphigus vulgaris.b Reduce dosage gradually to the lowest effective level, but discontinuance may not be possible.b, Massive dosages may be required for the treatment of shock.b, If used orally for prolonged anti-inflammatory therapy, consider an alternate-day dosage regimen.a Following long-term therapy, withdraw gradually.a, Base pediatric dosage on severity of the disease and the response of the patient rather than on strict adherence to dosage indicated by age, body weight, or body surface area.a, Hydrocortisone: 0.56–8 mg/kg daily or 16–240 mg/m2 daily, administered in 3 or 4 divided doses.a, Hydrocortisone sodium succinate: 0.16–1 mg/kg or 6–30 mg/m2 IV 1 or 2 times daily.a, Hydrocortisone sodium succinate: 0.16–1 mg/kg or 6–30 mg/m2 IM 1 or 2 times daily.a, Hydrocortisone: Initially, 10–320 mg daily (usually administered in 3 or 4 divided doses), depending on the disease being treated.a, Hydrocortisone sodium succinate: 100 mg to 8 g daily.a 100–500 mg IV initially, and every 2–10 hours as needed.a, Hydrocortisone sodium succinate: 100 mg to 8 g daily.a 100–500 mg IM initially and every 2–10 hours as needed.a, Life-threatening shock: Massive doses of hydrocortisone sodium succinate such as 50 mg/kg by direct IV injection (over a period of one to several minutes) initially and repeated in 4 hours and/or every 24 hours if needed.a, Alternatively, 0.5–2 g by direct IV injection (over a period of one to several minutes) initially and repeated at 2- to 6-hour intervals as required.a, In such cases, administer by direct IV injection over a period of one to several minutes.a, Continue high-dose therapy only until the patient’s condition has stabilized and usually not beyond 48–72 hours.a, If massive corticosteroid therapy is needed beyond 72 hours, use a corticosteroid which causes less sodium retention (e.g., methylprednisolone sodium succinate or dexamethasone sodium phosphate) to minimize the risk of hypernatremia.a, Known hypersensitivity to hydrocortisone, any ingredient in the respective formulation, or any other corticosteroid.b, Systemic fungal infectionsb unless needed to control drug reactions due to amphotericin B.d, Concurrent administration of live virus vaccines in patients receiving immunosuppressive doses of corticosteroids.g.