hydrocortisone topical (Rx, OTC)

Brand and Other Names:Westcort, Locoid, more...Aquanil, Calmurid Cream, Cetacort, Claritin Skin Itch Relief, Coraz, CortaGel, Cortaid, Cortate, Cortisone-10 Poison Ivy Relief Pads, Cortisone-10 Quick Shot, Cortizone, Cortoderm, Dermacort, Dermazene Cream, DermiCort, Emo Cort, Hyderm, Hydrocort, HydroSKIN, HydroVal, Hytone, LactiCare, AlaCort, Locoid Lipocream, Massengill, Neosporin Eczema Essentials Anti-Itch Cream, Nutracort, Pediaderm HC, Penecort, Preparation H Anti-Itch Cream, Prevex HC, Proctocort, Proctocream, Sarna HC, Sarnol, Texacort, Timodine, Uniroid HC, AlaScalpt
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical cream

  • 0.1%
  • 0.2%
  • 0.5%
  • 1%
  • 2.5%

topical lotion

  • 0.1%
  • 1%
  • 2%
  • 2.5%

topical gel

  • 1%
  • 10%

topical solution

  • 1%
  • 2.5%

topical ointment

  • 0.2%
  • 0.5%
  • 1%
  • 2.5%

Atopic Dermatitis

Apply thin film to affected area BID

Corticosteroid-responsive Dermatoses

Relief of inflammatory and pruritic manifestations

Hydrocortisone base: q6-12hr

Hydrocortisone acetate: q6-12hr

Hydrocortisone butyrate: q8-12hr

Hydrocortisone valerate: q8-12hr

Dosage Forms & Strengths

topical cream

  • 0.1%
  • 0.2%
  • 0.5%
  • 1%
  • 2.5%

topical lotion

  • 0.5%
  • 1%
  • 2%
  • 2.5%

topical gel

  • 1%

topical solution

  • 1%
  • 2.5%

topical ointment

  • 0.2%
  • 0.5%
  • 1%
  • 2.5%

Corticosteroid-responsive Dermatoses

Relief of inflammatory and pruritic manifestations

Infants, children, and adolescents; products for OTC use are not labeled for use in children <2 years

Hydrocortisone base: q6-12hr

Hydrocortisone acetate: q6-12hr

Hydrocortisone butyrate: q8-12hr

Dosing considerations

  • Limit to the minimum amount necessary for therapeutic efficacy

Atopic Dermatitis

<3 months: Safety and efficacy not established

≥3 months: Apply film to affected area q12hr

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Adverse Effects

Frequency Not Defined

Skin atrophy

Striae

Acneform lesions

Perioral dermatitis

Folliculitis

Itching

Pigmentation changes

HPA suppression (with higher potency used >2 wk)

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Warnings

Contraindications

Underlying infection

Hypersensitivity

Ophthalmic use

Treatment of diaper dermatitis

Cautions

Chronic topical corticosteroid therapy may interfere with growth and development in children

Use lower potency in children; may absorb proportionally larger amounts after topical application and may cause systemic effects

Occlusive dressings, prolonged use, application to large surface areas, or application to denuded skin, may increase percutaneous absorption, which may result in Cushing syndrome, glycosuria, and hyperglycemia

Prolonged use may increase risk of Kaposi's sarcoma

Prolonged use may increase risk of secondary infection, may mask acute infection, limit response to vaccines, and prolong or exacerbate viral infections; avoid exposure to measles or chickenpox while receiving therapy; not for the treatment of ocular herpes simplex, cerebral malaria, fungal infections, or viral hepatitis; observe patients with latent tuberculosis closely; restrict use in active tuberculosis

Acute myopathy reported with high dose corticosteroids, especially patients with neuromuscular transmission disorders

Psychiatric disturbances including euphoria, insomnia, mood swings, and personality changes reported with corticosteroid use

Allergic contact dermatitis may occur; diagnosed as failure to heal rather than exacerbation; discontinue therapy and treat appropriately if it occurs

May suppress hypothalamic-pituitary-adrenal axis, especially in patients receiving high doses for prolonged periods of time and younger children, which may result in adrenal crisis

Anaphylactoid reactions reported in patients receiving corticosteroids

Local desensitization (irritation, redness) reported; discontinue if it occurs

Use caution in patients with diabetes, cardiovascular disease, hepatic impairment, myocardial infarction, myasthenia gravis, osteoporosis, ocular disease, renal impairment, or thyroid disease

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Pregnancy & Lactation

Pregnancy

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids; corticosteroids generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels; topical corticosteroids should be used during pregnancy only if potential benefits justify potential risk to fetus; should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time

Lactation

Not know whether topical administration could result in sufficient systemic absorption to produce detectable quantities in breast milk; systemically administered corticosteroids are secreted into breast milk in quantities not likely to have deleterious effect on infant; nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman

Pregnancy Categories

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.

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Pharmacology

Mechanism of Action

Decreases inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes

Inhibits macrophage accumulation in inflamed areas

Reduces leukocyte adhesion to capillary endothelium

Reduces capillary wall permeability and edema formation

Decreases complement components and antagonizes histamine activity and release of kinin from substrates

Reduces fibroblast proliferation, collagen deposition, and subsequent scar tissue formation

Absorption

Percutaneous; extent of absorption in dependent on formulation, epidermal integrity (intact vs abraded), and the use of occlusive dressings

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
Procto-Med HC topical
-
2.5 % cream
hydrocortisone rectal
-
100 mg/60 mL enema
hydrocortisone oral
-
5 mg tablet
hydrocortisone oral
-
10 mg tablet
hydrocortisone oral
-
20 mg tablet
hydrocortisone oral
-
5 mg tablet
hydrocortisone oral
-
10 mg tablet
hydrocortisone oral
-
20 mg tablet
hydrocortisone oral
-
10 mg tablet
hydrocortisone oral
-
20 mg tablet
hydrocortisone oral
-
5 mg tablet
hydrocortisone oral
-
5 mg tablet
Cortef oral
-
20 mg tablet
Cortef oral
-
10 mg tablet
Cortef oral
-
5 mg tablet
Anusol-HC topical
-
2.5 % cream
Proctosol HC topical
-
2.5 % cream
Proctocort topical
-
1 % cream
Anusol-HC rectal
-
25 mg suppos
Anusol-HC rectal
-
25 mg suppos
Pramosone topical
-
2.5-1 % cream
Pramosone topical
-
2.5-1 % cream
Pramosone topical
-
1-1 % lotion
Pramosone topical
-
1-1 % lotion
Pramosone topical
-
2.5-1 % lotion
Pramosone topical
-
2.5-1 % lotion
Pramosone topical
-
1-1 % cream
Pramosone topical
-
1-1 % cream
Aquanil HC topical
-
1 % lotion
ITCH-X topical
-
1-10 % gel
ITCH-X topical
-
1-10 % liquid
Texacort topical
-
2.5 % solution
Ala-Scalp topical
-
2 % lotion
hydrocortisone topical
-
0.5 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % lotion
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
0.5 % cream
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
0.5 % cream
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
2.5 % lotion
hydrocortisone topical
-
2.5 % lotion
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
2.5 % ointment
hydrocortisone topical
-
2.5 % ointment
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
0.5 % ointment
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
2.5 % ointment
hydrocortisone topical
-
2.5 % ointment
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
0.5 % ointment
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % cream
hydrocortisone topical
-
1 % ointment
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
2.5 % cream
hydrocortisone topical
-
1 % cream
Cortenema rectal
-
100 mg/60 mL enema
Cortenema rectal
-
100 mg/60 mL enema
Proctozone-HC topical
-
2.5 % cream
Proctozone-HC topical
-
2.5 % cream
Cortizone-10 topical
-
1 % lotion
Cortizone-10 topical
-
1 % cream
Cortizone-10 topical
-
1 % gel
Scalpicin Anti-Itch topical
-
1 % solution
Procto-Pak topical
-
1 % cream
Cortisone (hydrocortisone) topical
-
1 % cream
Cortizone-10 Plus topical
-
1 % cream
Scalacort topical
-
2 % lotion
Cortaid topical
-
1 % cream

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
hydrocortisone oral

HYDROCORTISONE - ORAL

(HYE-droe-KOR-ti-sone)

COMMON BRAND NAME(S): Cortef

USES: Hydrocortisone is a man-made version of a natural substance (cortisol) made by the adrenal gland. It is used to treat conditions such as arthritis, blood/hormone/immune system disorders, skin and eye conditions, breathing problems, cancer, and severe allergies. It decreases your immune system's response to various diseases to reduce symptoms such as pain, swelling and allergic-type reactions.Hydrocortisone is also used to treat low cortisol levels caused by diseases of the adrenal gland (such as Addison's disease, adrenocortical insufficiency). Corticosteroids are needed in many ways for the body to function well. They are important for salt and water balance and keeping blood pressure normal.

HOW TO USE: Take this medication by mouth, with food or milk to prevent stomach upset, exactly as directed by your doctor. Take this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.Follow the dosing schedule carefully. The dosage and length of treatment are based on your medical condition and response to treatment. Your doctor may direct you to take hydrocortisone 1 to 4 times a day or take a single dose every other day. It may help to mark your calendar with reminders or use a pill box.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.If you suddenly stop using this medication, you may have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used hydrocortisone for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.Tell your doctor if your condition persists or worsens.

SIDE EFFECTS: Nausea, heartburn, headache, trouble sleeping, increased sweating, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Because this drug works by weakening the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as cough, sore throat, fever, chills). Use of this medication for prolonged or repeated periods may result in oral thrush or a yeast infection. Contact your doctor if you notice white patches in your mouth or a change in vaginal discharge.This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Tell your doctor right away if you have any serious side effects, including: unusual tiredness, swelling ankles/feet, unusual weight gain, vision problems, easy bruising/bleeding, puffy face, unusual hair growth, mental/mood changes (such as depression, mood swings, agitation), muscle weakness/pain, thinning skin, slow wound healing, menstrual period changes, bone pain, seizures, symptoms of stomach/intestinal bleeding (such as stomach/abdominal pain, black/tarry stools, vomit that looks like coffee grounds).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking hydrocortisone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts, glaucoma), heart problems (such as heart failure, recent heart attack), high blood pressure, liver disease, kidney disease, thyroid problems, diabetes, stomach/intestinal problems (such as diverticulitis, ulcer), brittle bones (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, blood clots, mental/mood conditions (such as psychosis, anxiety, depression), low salts in the blood (such as low potassium or calcium), seizures.This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. Limit alcoholic beverages. Consult your doctor or pharmacist for more information.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.Hydrocortisone may cause vaccines not to work as well. Therefore, do not have any immunizations/vaccinations while using this medication without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).This medication may slow down a child's growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child's height and growth can be checked.Older adults may be more sensitive to the effects of this drug, especially bone loss/pain, stomach/intestinal bleeding, and mental/mood changes (such as confusion).During pregnancy, hydrocortisone should be used only when clearly needed. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended period of time may have hormone problems. Tell your doctor right away if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.It is unknown if this drug passes into breast milk. However, this drug is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aldesleukin, mifepristone, other drugs that can cause bleeding/bruising (such as antiplatelet drugs like clopidogrel, NSAIDs like ibuprofen/naproxen, "blood thinners" like warfarin/dabigatran).Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.This medication may interfere with certain lab tests (such as skin tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.If this medication is used for an extended time, laboratory and/or medical tests (such as blood sugar/mineral levels, blood counts, blood pressure, bone density tests, eye exams, height/weight measurements, X-rays) should be performed regularly to check for side effects. Consult your doctor for more details.This medication may cause bone problems (osteoporosis). Lifestyle changes that may help reduce the risk of bone problems while taking this drug for an extended time include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. Discuss with your doctor lifestyle changes that might benefit you.

MISSED DOSE: If you are taking this medication once daily and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. If you are taking this medication every other day, ask your doctor or pharmacist what you should do if you miss a dose.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Information last revised March 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.