Hydrocortisone

Hydrocortisone is the name for the hormone cortisol when supplied as a medication. Uses include conditions such as adrenocortical insufficiency, adrenogenital syndrome, high blood calcium, thyroiditis, rheumatoid arthritis, dermatitis, asthma, and COPD. It is the treatment of choice for adrenocortical insufficiency. It can be given by mouth, topically, or by injection. Stopping treatment after long-term use should be done slowly.

Hydrocortisone
Clinical data
Trade namesA-hydrocort, Cortef, Solu-cortef, others
Other namesCortisol; 11β,17α,21-Trihydroxypregn-4-ene-3,20-dione; 11β,17α,21-Trihydroxyprogesterone
AHFS/Drugs.comMonograph
MedlinePlusa682206
License data
Pregnancy
category
  • AU: A
Routes of
administration		By mouth (tablets), intravenous, topical, rectal
Drug classCorticosteroid; Glucocorticoid; Mineralocorticoid
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only) / S3 / S2
  • UK: POM (Prescription only) / P / GSL
  • US: OTC / Rx-only
  • EU: OTC / Rx-only
Pharmacokinetic data
BioavailabilityOral: 96 ± 20%
Protein binding92 ± 2% (92–93%)
Metabolism11β-HSDsTooltip 11β-Hydroxysteroid dehydrogenases, others
MetabolitesCortisone, others
Onset of actionOral: 1.2 ± 0.4 hours (Tmax)
Elimination half-life1.2–2.0 hours
Duration of action8–12 hours
Identifiers
  • (8S,9S,10R,11S,13S,14S,17R)-11,17-Dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-2,6,7,8,9,11,12,14,15,16-decahydro-1H-cyclopenta[a]phenanthren-3-one
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC21H30O5
Molar mass362.466 g·mol−1
3D model (JSmol)
SMILES
  • O=C4\C=C2/[C@]([C@H]1[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@H]3[C@@H]1CC2)C)(C)CC4
  • InChI=1S/C21H30O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h9,14-16,18,22,24,26H,3-8,10-11H2,1-2H3/t14-,15-,16-,18+,19-,20-,21-/m0/s1 Y
  • Key:JYGXADMDTFJGBT-VWUMJDOOSA-N Y
 NY (what is this?)  (verify)

Side effects may include mood changes, increased risk of infection, and edema (swelling). With long-term use common side effects include osteoporosis, upset stomach, physical weakness, easy bruising, and candidiasis (yeast infections). It is unclear if it is safe for use during pregnancy. Hydrocortisone is a glucocorticoid and works as an anti-inflammatory and by immune suppression.

Hydrocortisone was patented in 1936 and approved for medical use in 1941. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2021, it was the 192nd most commonly prescribed medication in the United States, with more than 2 million prescriptions.

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