Hydrocortisone 20 mg: Uses, Dosage, Side Effects & Warnings”

✅What Is Hydrocortisone?

Hydrocortisone is a synthetic version of cortisol, a glucocorticoid hormone naturally produced by the adrenal glands. It is classified as a systemic corticosteroid and is commonly prescribed to treat a variety of conditions involving inflammation, immune response, and adrenal insufficiency.

• Brand names: Cortef, Hydrocortone (oral)
• Drug class: Glucocorticoid (corticosteroid)

✅Hydrocortisone 20 mg Tablet – Purpose & Indications

Hydrocortisone 20 mg tablets are used to replace or supplement natural cortisol in the body or to suppress inflammation and immune responses.

✅Mechanism of Action

Hydrocortisone works by:

• Binding to glucocorticoid receptors in cells
• Modulating gene expression to reduce production of pro-inflammatory substances (cytokines, prostaglandins)
• Suppressing immune system activity, particularly T-cell activation
• Maintaining cardiovascular, metabolic, and stress response functions (especially in adrenal insufficiency)

✅Dosage & Administration

🔹Typical Dosage for Adults:

• Adrenal insufficiency (replacement):
  • 15–30 mg/day divided into 2–3 doses
  • Commonly: 20 mg in the morning, 10 mg in the afternoon

🔹Anti-inflammatory/Immunosuppressive Use:

• Varies widely based on condition (can range from 20–240 mg/day)

🔹Route of Administration:

• Oral tablets
• Also available in injectable and topical forms

Note: Always take under the supervision of a physician. Doses must often be tapered to avoid adrenal crisis.

✅Side Effects

🔹Common Side Effects:

• Insomnia
• Mood changes (euphoria, anxiety, irritability)
• Increased appetite and weight gain
• Acne
• High blood sugar (hyperglycemia)

🔹Long-Term/High-Dose Effects:

• Cushingoid features (moon face, buffalo hump)
• Osteoporosis
• Hypertension
• Muscle wasting
• Immune suppression → increased infection risk
• Adrenal suppression

🔹Serious Risks:

• Peptic ulcers
• Psychosis
• Cataracts or glaucoma
• Adrenal crisis if abruptly stopped

✅Warnings & Precautions

• Do NOT stop suddenly after prolonged use—must taper gradually.
• Monitor blood pressure, blood glucose, electrolytes, and bone density in long-term use.
• May mask signs of infection.
• Use with caution in:
  • Diabetes
  • Osteoporosis
  • Mental health disorders
  • Hypertension or heart failure
  • Pregnancy & breastfeeding (use only if clearly needed)

✅Drug Interactions

• NSAIDs (e.g., ibuprofen): Increased risk of GI bleeding
• Diuretics: Can worsen electrolyte imbalances (hypokalemia)
• Antidiabetic medications: May reduce effectiveness
• Vaccines: Live vaccines should be avoided
• CYP3A4 inducers/inhibitors (e.g., rifampin, ketoconazole) affect hydrocortisone levels

✅Special Considerations

• Stress Dosing: Patients with adrenal insufficiency require higher doses during illness, surgery, or trauma.
• Emergency Card/Bracelet: Patients on chronic therapy should carry medical identification.
• Monitoring Required: Regular monitoring of HPA axis function, especially during withdrawal or dose changes.