Brand and Other Names:
- Classes: Corticosteroids
Dosing & Uses
Dosage Forms & Strengths
2.5-10 mg/kg/day PO divided q8hr or 25-300 mg/day PO qDay or divided q12hr
1-5 mg/kg IM qDay
0.5-0.75 mg/kg/day PO divided q8hr or 25-35 mg/day
0.25-0.35 mg/kg IM qDay
Other Indications & Uses
Adrenal insufficiency, conditions treated with immunosuppression, corticosteroid responsive dermatoses, inflammatory conditions
Dosage Forms & Strengths
2.5 mg-10 mg/kg/day PO or 20-300 mg/sq.meter/day PO divided q6-8hr
0.5-0.75 mg/kg/day PO or 20-25 mg/sq.meter/day PO divided q8hr
Serious - Use Alternative
Significant - Monitor Closely
Systemic fungal infection
Hypersensitivity to cortisone
Short acting agent
Cirrhosis, ocular herpes simplex, HTN, diverticulitis, hypothyroidism, myasthenia gravis, PUD, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy
Hydroxylated to active compound hydrocortisone
When used to treat adrenocortical insufficiency may need to use additional mineralocorticoid
Not indicated for IV use
DM, thromboembolic disorders
Long-term treatment: Risk of osteoporosis, myopathy, delayed wound healing
Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
Latent TB may be reactivated
Monitor patients with positive tuberculin test
Some suggestion of slightly increase cleft palate risk if corticosteroids used in pregnancy, but not fully substantiated
Pregnancy & Lactation
Pregnancy Category: not available
Lactation: excretion in milk unknown; use with caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Glucocorticoid; elicits mild mineralocorticoid activity and moderate anti-inflammatory effects; controls or prevents inflammation by controling the rate of protein synthesis, suppressing migration of PMNs and fibroblasts, and reversing capillary permeability
Duration: 10 days (IM); 30-36 hr (PO)
Onset: PO: 24 hr (IM); within 2 hr (PO)
Protein Bound: 90%
Extensively and rapidly in the liver to hydrocortisone (active metabolite) which is then metabolized in tissues and the liver to inactive glucuronide & sulfate metabolites
Metabolites: Hydrocortisone (active), glucuronide and sulfate metabolites (inactive)
Half-life: 0.4-2 hr
Excretion: Mainly in urine, minimally in bile
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
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