Topical (cream, ointment, lotion): Relief of inflammation and itching associated with mild-to-moderate corticosteroid-responsive dermatoses such as eczema, atopic dermatitis, contact dermatitis, insect bite reactions, and mild plaque psoriasis.
Systemic (oral tablet, injection): Replacement therapy in primary or secondary adrenocortical insufficiency (Addison's disease, pituitary-related adrenal insufficiency) and for acute adrenal crisis.
Systemic: Management of severe allergic reactions and anaphylaxis (as an adjunct after epinephrine), severe asthma exacerbations, and acute exacerbations of chronic inflammatory/autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease, when a rapid-onset corticosteroid is required.
Rectal (suppository/foam): Symptomatic relief of inflammation in ulcerative proctitis and hemorrhoids.
Perioperative/stress dosing: Prevention and treatment of adrenal crisis ("stress-dose steroids") in patients with known adrenal insufficiency undergoing surgery, trauma, or severe illness.

Adjunct / combination-therapy uses

As an adjunct to standard treatment (e.g., antihistamines, epinephrine, bronchodilators, disease-modifying agents) rather than as sole therapy for anaphylaxis, asthma, or autoimmune flares.
Topical use on infected dermatoses only in combination with an appropriate antimicrobial agent, never as monotherapy for infected skin.

Off-label uses (commonly used, not formally FDA-labeled)

Septic shock unresponsive to fluids and vasopressors (stress-dose corticosteroid support), based on critical-care guideline evidence.
Congenital adrenal hyperplasia in some pediatric dosing regimens (specialist-guided).

The specific formulation, strength, and route are selected by the prescriber according to the condition being treated.

Dosage & Administration of Hydrocortisone

Dosing of Hydrocortisone is individualized according to the condition treated, the formulation used, and patient factors such as age and organ function. General guidance is summarized below; the treating physician's prescription should always be followed.

Indication	Typical Adult Dosing	Typical Pediatric Dosing
Topical (eczema, dermatitis, insect bites)	Apply a thin layer of 0.5–2.5% cream/ointment to the affected area 2–4 times daily, for the shortest effective duration (usually up to 1–2 weeks)	Apply the lowest effective strength (typically 0.5–1%) sparingly, 1–2 times daily; limit duration and area treated, especially under 2 years of age
Adrenal insufficiency (replacement therapy)	Oral: approximately 15–25 mg/day in 2–3 divided doses (higher dose in the morning), individualized to clinical response	Weight-based dosing (approximately 8–10 mg/m²/day), determined and monitored by a pediatric endocrinologist
Severe allergic reaction / anaphylaxis (adjunct), acute inflammatory flare	IV/IM: 100–500 mg initially, then repeated every 2–6 hours as needed, guided by response and tapered as soon as clinically appropriate	Weight-based IV/IM dosing under direct physician supervision
Adrenal crisis / major surgical stress	IV: 100 mg immediately, then 100–200 mg/day in divided doses, tapering as the acute stress resolves	Weight-based stress dosing under specialist supervision
Ulcerative proctitis / hemorrhoids (rectal)	1 suppository or applicatorful once or twice daily for a limited course as directed	Not generally recommended without specialist guidance

Systemic Hydrocortisone therapy that has been used for more than a few days to weeks should never be stopped abruptly; the dose must be tapered gradually under medical supervision to avoid adrenal crisis (see Precautions).

Side Effects of Hydrocortisone

Side effects of Hydrocortisone depend on the route, dose, and duration of use.

Topical use

Common: local burning, stinging, itching, dryness, or redness at the application site
With prolonged or excessive use: skin thinning (atrophy), stretch marks (striae), visible blood vessels (telangiectasia), delayed wound healing, acneiform eruptions, and (rarely) systemic absorption effects

Systemic use (oral/injectable)

Common: increased appetite, weight gain, fluid retention, mood changes, insomnia, indigestion
With prolonged use: hyperglycemia (raised blood sugar), hypertension, osteoporosis and increased fracture risk, adrenal suppression, increased susceptibility to infections, Cushingoid features (rounded face, central weight gain, thin skin, easy bruising), cataracts and glaucoma, muscle weakness, and mood or psychiatric disturbances
Less common/serious: peptic ulceration, avascular necrosis of bone, growth suppression in children with prolonged use

Patients should seek medical attention for severe or persistent side effects, signs of infection, or mood/behavioral changes while on systemic Hydrocortisone.

Contraindications of Hydrocortisone

Hydrocortisone is contraindicated in:

Patients with known hypersensitivity to Hydrocortisone or to any component of the formulation.
Systemic use (at non-replacement, immunosuppressive doses) in patients with a systemic fungal infection.
Topical use on an untreated bacterial, fungal, or viral skin infection (including herpes simplex, varicella) without concurrent, appropriate anti-infective therapy.

Hydrocortisone used as physiologic replacement therapy for adrenal insufficiency is generally continued even in the presence of infection, with dose adjustment as directed by the physician, since abrupt discontinuation can be life-threatening in these patients.

Frequently Asked Questions about Hydrocortisone

What is Hydrocortisone used for?

Hydrocortisone is a corticosteroid used topically to reduce inflammation and itching in skin conditions such as eczema and dermatitis, and systemically to replace deficient cortisol in adrenal insufficiency or to control severe allergic, inflammatory, or autoimmune flares, as directed by a physician.

Can I stop taking Hydrocortisone suddenly?

No. If you have been taking systemic Hydrocortisone for more than a few days to weeks, you should not stop it suddenly. Doing so can cause a life-threatening adrenal crisis. Your physician will taper the dose gradually.

Is Hydrocortisone safe to use during pregnancy?

Hydrocortisone should be used in pregnancy only if clearly needed, at the lowest effective dose for the shortest time, after your physician weighs the potential benefits against potential risks to the baby. Always consult your physician before use in pregnancy.

Can Hydrocortisone be used in children?

Yes, for specific approved indications such as adrenal insufficiency replacement or short-course topical treatment of dermatitis, but dosing must be determined by a physician, since children are more prone to skin thinning and, with prolonged systemic use, growth suppression.

What should I do if I miss a dose of Hydrocortisone?

Take the missed dose as soon as you remember unless it is almost time for the next dose; do not double the dose. If you are on replacement therapy and miss a dose, especially during illness, contact your physician, as adjustment or an extra dose may be needed.

What are the main side effects to watch for with Hydrocortisone?

Topical use may cause local burning, thinning, or stretch marks with prolonged use. Systemic use may cause increased appetite, weight gain, high blood sugar, high blood pressure, mood changes, weakened bones, and increased infection risk with prolonged use. Report severe or persistent side effects to your physician.

Disclaimer

The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.

Hydrocortisone: Brands, Price & Uses in Bangladesh

Cotson100 mg/2 m

Eucot100 mg/2 m

About Hydrocortisone

Indications of Hydrocortisone

Established / FDA-approved uses