Indications & Dose:
Thyrotoxic crisis (thyroid storm)
Adult: 100 mg every 6 hours, to be administered as sodium succinate
Adrenocortical insufficiency resulting from septic shock
Adult: 50 mg every 6 hours, given in combination with fludrocortisone
Acute hypersensitivity reactions such as angioedema of the upper respiratory tract and anaphylaxis (adjunct to adrenaline)
Adult: 100–300 mg, to be administered as sodium succinate
Corticosteroid replacement, in patients who have taken more than 10 mg prednisolone daily (or equivalent) within 3 months of minor surgery under general anaesthesia
Adult: Initially 25–50 mg, to be administered at induction of surgery, the patient’s usual oral corticosteroid dose is recommenced after surgery
Corticosteroid replacement, in patients who have taken more than 10 mg prednisolone daily (or equivalent) within 3 months of moderate or major surgery
Adult: Initially 25–50 mg, to be administered at induction of surgery (following usual oral corticosteroid dose on the morning of surgery), followed by 25–50 mg 3 times a day for 24 hours after moderate surgery and for 48–72 hours after major surgery
Adrenocortical insufficiency in Addison’s disease or following adrenalectomy
Adult: 20–30 mg daily in 2 divided doses, the larger dose to be given in the morning and the smaller in the evening, mimicking the normal diurnal rhythm of cortisol secretion, the optimum daily dose is determined on the basis of clinical response
Adrenocortical insufficiency
Adult: 100–500 mg 3–4 times a day or when required
Severe inflammatory bowel disease
Adult: 100–500 mg 3–4 times a day or when required
Replacement in adrenocortical insufficiency
Adult: 20–30 mg once daily, adjusted according to response, dose to be taken in the morning
¶Adult: 20–30 mg daily in divided doses, adjusted according to response
Ulcerative colitis | Proctitis | Proctosigmoiditis
Adult: Initially 1 metered application 1–2 times a day for 2–3 weeks, then reduced to 1 metered application once daily on alternate days, to be inserted into the rectum
Acute hypersensitivity reactions | Angioedema
Child 1–5 months: Initially 25 mg 3 times a day, adjusted according to response
Child 6 months–5 years: Initially 50 mg 3 times a day, adjusted according to response
Child 6–11 years: Initially 100 mg 3 times a day, adjusted according to response
Child 12–17 years: Initially 200 mg 3 times a day, adjusted according to response
Severe acute asthma | Life-threatening acute asthma
Child 1 month–1 year: 4 mg/kg every 6 hours (max. per dose 100 mg), alternatively 25 mg every 6 hours until conversion to oral prednisolone is possible, dose given, preferably, as sodium succinate
Child 2–4 years: 4 mg/kg every 6 hours (max. per dose 100 mg), alternatively 50 mg every 6 hours until conversion to oral prednisolone is possible, dose given, preferably, as sodium succinate
Child 5–11 years: 4 mg/kg every 6 hours (max. per dose 100 mg), alternatively 100 mg every 6 hours until conversion to oral prednisolone is possible, dose given, preferably, as sodium succinate
Child 12–17 years: 4 mg/kg every 6 hours (max. per dose 100 mg), alternatively 100 mg every 6 hours until conversion to oral prednisolone is possible, dose given, preferably, as sodium succinate
Adult: 100 mg every 6 hours until conversion to oral prednisolone is possible, dose given, preferably, as sodium succinate
Adult and Child
Otitis externa:
With head tilted for 2 min instill 4 gtt 3-4 x/day
Contraindications:
Systemic fungal infections.
Side Effects:
Cautions:
Precautions:
Psychosis, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcerative colitis (intestinal perforation), CHF, hypertension, myesthenia gravis (if used with anticholinesterase agents), renal disease, esophagitis, peptic ulcer, latent tuberculosis or amebiasis (reactivation of disease).
Topical: use on face, groin, or axilla, ocular herpes simplex.
Pregnancy: Weigh benefits against poten-tial hazard to mother and foetus.
Breast-feeding: Use with caution.
Old age: Use with caution.
Interaction:
Drugs
Aminoglutethamide: Enhanced elimination of hydrocortisone; reduction in corticosteroid response
Antidiabetics: Increased blood glucose in patients with diabetes
Barbiturates: Reduction in the serum concentrations of corticosteroids
Cholestyramine, colestipol: Possible reduced absorption of corticosteroids
Cyclosporine: Increased levels of both drugs increases the risk of seizures
Estrogens: Enhanced effects of corticosteroids Isoniazid (INH): Reduced INH levels, enhanced corticosteroid effect
IUDs: Inhibition of inflammation may decrease contraceptive effect
NSAIDs: Increased risk GI ulceration
Phenytoin: Reduced therapeutic effect of corticosteroids
Rifampin: Reduced therapeutic effect of corticosteroids
Salicylates: Enhanced elimination of salicylates; subtherapeutic salicylate concentrations possible
Warnings:
Adverse Effects:
Lactations:
Special Precautions:
Counselling:
Side Effects Or Adverse Reactions:
CNS: Depression, mood changes, seizures
CV: CHF, hypertension, tachycardia,thromboembolism, thrombophlebitis
EENT: Blurred vision,cataract, increased intraocular pressure
GI: Abdominal distension, diarrhea, GI hemorrhage,increased appetite, nausea, pancreatitis
GU: Menstrual irregularities
HEME: Inreased neutrophils
METAB: Alkalosis, Cushingoid state, decreased glucose tolerance, growth suppression in children, HPA suppression
MS: Aseptic necrosis of femoral and humeral heads; fractures, muscle mass loss, osteoporosis, tendon rupture, weakness
SKIN: Acne, allergic contact dermatitis, atrophy, bruising, burning, dryness, ecchymosis, folliculitis.hypertrichosis, hypopigmentation, irritation, itching, miliaria, perioral dermatitis, petechiae, poor wound healing, secondary infection, striae suppression of skin test reactions, thin fragile skin
Patient And Carer Advice:
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team