Elephant specific information, if available, is in blue.

Hydrocortisone

Hydrocortisone Acetate

Hydrocortisone Cypionate

Hydrocortisone Sodium Phosphate

Hydrocortisone Sodium Succinate

Note: For more information refer to the monograph: Glucocorticoids, General Information.

Chemistry – Also known as compound F  or cortisol , hydrocortisone is secreted by the adrenal gland. Hydrocortisone occurs as an odorless, white to practically white, crystalline powder. It is very slightly soluble in water and sparingly soluble in alcohol. Hydrocortisone is administered orally.

Hydrocortisone acetate  occurs as an odorless, white to practically white, crystalline powder. It is insoluble in water and slightly soluble in alcohol. Hydrocortisone acetate is ad­ministered via intra-articular, intrabursal, intralesional, intrasynovial or soft tissue injection.

Hydrocortisone cypionate  occurs as an odorless or with a slight odor, white to practically white, crystalline powder. It is insoluble in water and soluble in alcohol. It is administered orally.

Hydrocortisone sodium phosphate occurs as an odorless or practically odorless, hygroscopic, white to light yellow powder. It is freely soluble in water and slightly soluble in alcohol.

Hydrocortisone sodium phosphate may be administered via IM, SQ, or IV routes.

Hydrocortisone sodium succinate occurs as an odorless, white to nearly white, hygroscopic, amorphous solid. It is very soluble in both water and alcohol. Hydrocortisone sodium succinate injection is administered via IM or IV routes.

Storage/Stability/Compatibility – Hydrocortisone tablets should be stored in well-closed containers. The cypionate oral suspension should be stored in tight, light resistant containers. All products should be stored at room temperature (15-30°C); avoid freezing the suspensions or solutions. After reconstituting solutions, only use products that are clear. Discard unused solutions after 3 days.

Hydrocortisone sodium phosphate solution for injection is reportedly compatible with the following solutions and drugs: 10% fat emulsion, amikacin sulfate, amphotericin B (with or without heparin sodium), bleomycin sulfate, cephapirin sodium, metaraminol bitartrate, sodium bicarbonate, and verapamil HCl.

Hydrocortisone sodium succinate is reportedly compatible with the following solutions and drugs: dextrose-Ringer’s injection combinations, dextrose-Ringer’s lactate injection combinations, dextrose-saline combinations, dextrose injections, Ringer’s injection, lactated Ringer’s injection, sodium chloride injections, amikacin sulfate, aminophylline, amphotericin B (limited quantities), calcium chloride/gluconate, cephalothin sodium (not in combination with aminophylline), cephapirin sodium, chloramphenicol sodium succinate, clindamycin phosphate, corticotropin, daunorubicin HCl, dopamine HCl, erythromycin gluceptate, erythromycin lactobionate, lidocaine HCl, mephentermine sulfate, metronidazole with sodium bicarbonate, netilmicin sodium, penicillin G potassium/sodium, piperacillin sodium, polymyxin B sulfate, potassium chloride, prochlorperazine edisylate, sodium bicarbonate, thiopental sodium, vancomycin HCl, verapamil HCl and vitamin B-complex with C.

Hydrocortisone sodium succinate is reportedly incompatible with the following solutions and drugs: ampicillin sodium, bleomycin sulfate, colistemethate sodium, diphenhydrinate, diphenhydramine HCl, doxorubicin HCl, ephedrine sulfate, heparin sodium, hydralazine HCl, metaraminol bitartrate, methicillin sodium, nafcillin sodium, oxytetracy­cline HCl, pentobarbital sodium, phenobarbital sodium, promethazine HCl, secobarbital sodium and tetracycline HCl. Compatibility is dependent upon factors such as pH, concentration, temperature and diluents used. It is suggested to consult specialized references for more specific information (e.g., Handbook on Injectable Drugs by Trissel; see bibliogra­phy).

Doses –

Horses:

As a glucocorticoid:

a)   Hydrocortisone sodium succinate: 1 – 4 mg/kg as an IV infusion (Robinson 1987)

Dosage Forms/Preparations/Approval Status/Withdrawal Times–

There are no known veterinary-approved products containing hydrocortisone (or its salts) for systemic use. There are a variety of hydrocortisone veterinary products for topical use. A 10 ppb tolerance has been established for hydrocortisone (as the succinate or acetate) in milk.

Human-Approved Products (all require a prescription):

Hydrocortisone oral tablets 5 mg, 10 mg, 20 mg; Cortef®  (Upjohn), Hydrocortone® (MSD),Hydrocortisone® (Major)  generic

Hydrocortisone acetate Injection; 25 mg/ml, 50 mg/ml in 5 & 10 ml vials; Hydrocortone® Acetate (MSD); generic (Rx)

Hydrocortisone cypionate oral suspension 2 mg/ml hydrocortisone in 120 ml;Cortef® (Upjohn)

Hydrocortisone sodium phosphate Injection 50 mg/ml in 2 & 10 ml vials; Hydrocortone® Phosphate (MSD)

Hydrocortisone sodium succinate injection; 100 mg/vial, 250 mg/vial, 500 mg/vial, 1000 mg/vial; Solu-Cortef® (Upjohn), A-hydroCort®  (Abbott)

There are many OTC and Rx topical and anorectal products available in a variety of dosage forms.