Hydrocortisone
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-HYDROCORTISONE |
|---|---|
| Type | Drug |
| Aliases | CortefSolu-CortefcortisolГідрокортизон |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Corticosteroid — short-acting glucocorticoid (also significant mineralocorticoid activity) |
|---|---|
| Mechanism | Synthetic form of endogenous cortisol; binds cytoplasmic glucocorticoid receptor → translocates to nucleus → modulates transcription of hundreds of inflammatory and immune-regulatory genes. Effects relevant to oncology supportive care: anti-inflammatory (suppression of cytokine release, leukocyte trafficking, complement activation), anti-allergic (membrane stabilization in mast cells / basophils, reduced eosinophil function), immunosuppressive, and significant mineralocorticoid activity (sodium/water retention — distinguishes from dexamethasone and methylprednisolone which lack mineralocorticoid effect; clinically relevant in adrenal insufficiency replacement). In acute use for chemotherapy infusion reactions and anaphylaxis, hydrocortisone provides delayed onset (4-6 h) reduction in late- phase mediator release (preventing biphasic reaction recurrence 4-12 h after initial event). Appro... |
| Typical dosing | ANAPHYLAXIS / SEVERE INFUSION REACTION ADJUNCT (adult): 100-200 mg IV bolus over 1-2 min, may repeat every 6 h; given AFTER epinephrine IM (epinephrine is the life-saving first-line, hydrocortisone prevents biphasic reaction). Pediatric: 4-8 mg/kg IV (max 200 mg). ACUTE ADRENAL CRISIS: 100 mg IV bolus then 200-300 mg/day in divided doses or continuous infusion until stable, then taper. CHRONIC REPLACEMENT in adrenal insufficiency: 15-25 mg/day PO in divided doses (e.g., 10 mg AM + 5-10 mg early afternoon mimicking diurnal cortisol rhythm). Stress dose for surgery / acute illness: 100 mg IV/IM at induction, then 50 mg IV q6h × 24-48 h, taper. Renal: no adjustment. Hepatic: caution in severe... |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
Standard adjunct for chemotherapy infusion reactions and severe anaphylaxis — given AFTER epinephrine IM (epinephrine is first-line, no substitute). Hydrocortisone's onset is delayed (4-6 h) so it prevents biphasic anaphylaxis recurrence rather than treating the acute event. Premedication for chemotherapy (e.g., taxanes, rituximab, daratumumab): typically dexamethasone 20 mg IV is used rather than hydrocortisone — dex is more potent (×30) per mg, has longer duration, lacks mineralocorticoid effect (less fluid retention), and dosing schedule is established. Hydrocortisone preferred over dex / methylprednisolone for: (1) adrenal insufficiency / crisis (mineralocorticoid activity matches physiological need); (2) septic shock with vasopressor refractoriness (300 mg/day approximately physiologic stress dose); (3) acute high-dose adjunct for refractory infusion reaction where mineralocorticoid effect supports hemodynamics. Single bolus of 100-200 mg has minimal long-term consequences — no taper needed for ≤3 days of acute use. Ukraine: cheap, ubiquitous, NSZU- covered.
Used By
No reverse references found in the YAML corpus.