Hydrocortisone

Pronunciation: hy-droh-KOR-ti-sone.

Generic name
hydrocortisone
Drug class
Glucocorticoid corticosteroid
Form
Tablet (5 mg, 10 mg, 20 mg), or powder for injection in hospital settings
Route
Oral (tablet) or injection; this page focuses on the oral/systemic form
Legal status
Prescription-only (oral and injectable forms)

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Hysone 4; Hysone 20; Solu-Cortef (injection) (5) · Full directory

What hydrocortisone is and how it works

Hydrocortisone is a prescription corticosteroid, chemically identical to the body's own cortisol hormone. In tablet form, it is used mainly to replace a hormone the body isn't making enough of (adrenal insufficiency), and at other doses to reduce inflammation in a range of conditions. (1) (2)

Take hydrocortisone exactly as your prescriber directs, usually at specific times of day to mimic the body's natural cortisol pattern. Your dose is individually worked out for your condition -- it is not the same for everyone, and any change to your dose, including stopping treatment, should only ever be done under your prescriber's direction.

Mechanism of action: how hydrocortisone works

Hydrocortisone is identical to the endogenous glucocorticoid cortisol, produced by the adrenal cortex. It binds intracellular glucocorticoid receptors to modulate gene transcription, producing broad anti-inflammatory and immunomodulatory effects, along with effects on carbohydrate, protein, and fat metabolism, and (at replacement-relevant doses) some mineralocorticoid activity relevant to sodium/fluid balance. (1) (2)

What hydrocortisone is used for

Adrenal insufficiency (hormone replacement)

Used as replacement therapy when the adrenal glands do not produce enough cortisol on their own, including Addison's disease (primary adrenal insufficiency), secondary adrenal insufficiency, and congenital adrenal hyperplasia. (1) (2) (4)

Inflammatory, allergic, and other conditions

At higher, individually judged doses, also used for a range of inflammatory conditions (such as rheumatoid arthritis or severe skin disease), allergic reactions, severe asthma flares, and as part of treatment for certain blood cancers. (1)

Before taking hydrocortisone

Do not take / not appropriate for

  • Do not take hydrocortisone if you have a systemic fungal infection. (all countries) (1) (2)
  • Do not take hydrocortisone if you have had a serious allergic reaction to hydrocortisone or any ingredient in the product. (all countries) (1) (2)

Tell your clinician about

  • Any current infection, including tuberculosis, or recent exposure to chickenpox or measles if you have not had these before.
  • Any history of osteoporosis, peptic ulcer, diabetes, high blood pressure, glaucoma or cataracts, or mental health conditions.
  • Whether you or your child are still growing, since long-term use can affect growth.
  • Upcoming surgery, serious illness, or major stress, since your dose may need temporary adjustment.
  • All other medicines you take, especially other corticosteroids, NSAIDs/aspirin, anticoagulants, or medicines that affect liver enzymes (such as rifampicin, phenytoin, or ketoconazole).
  • Pregnancy, plans for pregnancy, or breastfeeding.
  • Whether you carry a steroid treatment card or medical alert identification, which is recommended for anyone on long-term corticosteroid therapy.
(1) (2)

How to take hydrocortisone

  • Take hydrocortisone exactly as prescribed, usually with food to reduce stomach upset.
  • For adrenal insufficiency, doses are often split through the day (e.g. a larger morning dose and smaller afternoon dose) to mirror the body's natural cortisol rhythm, as directed by your prescriber.
  • Never change your dose or stop taking hydrocortisone on your own -- any dose reduction or discontinuation after ongoing use must be planned and supervised by your prescriber, typically with a gradual taper.
  • During illness, injury, surgery, or significant stress, your prescriber may direct you to temporarily increase your dose ('sick day rules' or stress dosing) -- follow this guidance carefully and seek urgent medical help if you cannot keep medication down or are seriously unwell.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If you miss a dose, take it as soon as you remember unless it is nearly time for your next dose. Because hydrocortisone is often a critical replacement hormone, contact your prescriber or pharmacist promptly for guidance if you miss a dose, especially if you have adrenal insufficiency -- do not simply skip it without checking, since missed doses can be medically important.

Overdose

Seek urgent medical attention if you think too much hydrocortisone has been taken, or if you notice symptoms such as unusual swelling, high blood pressure, marked mood or behaviour changes, or muscle weakness. Also seek urgent care if you feel seriously unwell (vomiting, severe weakness, dizziness, confusion) since this can indicate too little cortisol (an adrenal crisis) rather than too much, particularly if a dose has been missed or stress dosing has not been followed -- both situations need prompt medical assessment. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Increased appetite and weight gain.

What to notice: Increased appetite and weight gain.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Fluid retention and swelling.

What to notice: Fluid retention and swelling.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Mood changes, irritability, or trouble sleeping.

What to notice: Mood changes, irritability, or trouble sleeping.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Raised blood sugar.

What to notice: Raised blood sugar.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Indigestion or stomach upset.

What to notice: Indigestion or stomach upset.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of adrenal crisis or worsening adrenal insufficiency — emergency

Symptoms: Severe weakness, vomiting, dizziness, low blood pressure, confusion, or collapse -- this can occur if a dose is missed, stress dosing is not followed during illness or surgery, or the medicine is stopped abruptly after prolonged use.

Action: Seek emergency medical help immediately. Never stop hydrocortisone abruptly after ongoing use -- always follow your prescriber's specific instructions for tapering, sick-day dose adjustments, and emergency injection kits if you have been given one. (1) (2) (4)

Signs of infection — high caution

Symptoms: Fever, chills, sore throat, or any new or worsening infection; exposure to chickenpox or measles if you have not previously had these.

Action: Contact your prescriber promptly, since hydrocortisone can suppress the immune system's ability to fight infection and can mask the usual warning signs. (1)

Signs of a stomach ulcer or gastrointestinal bleeding — high caution

Symptoms: Severe stomach pain, black or bloody stools, or vomiting blood.

Action: Seek prompt medical attention -- this risk is higher if you also take NSAIDs or aspirin. (1)

New or worsening mood, behaviour, or mental health changes — high caution

Symptoms: Severe mood swings, depression, unusual euphoria, or, rarely, symptoms of psychosis; these can appear within days to weeks of starting treatment.

Action: Contact your prescriber promptly if you or someone close to you notices these changes. (2)

Reduced growth in children on long-term treatment — high caution

Symptoms: No immediate symptoms; growth is assessed over time.

Action: A prescriber should regularly monitor a child's growth during long-term treatment, since growth suppression can occur and may not fully reverse. (1) (2)

Interactions

  • Medicines that speed up liver enzyme activity (such as rifampicin, phenytoin, barbiturates, or St John's wort) can reduce hydrocortisone's effect -- your prescriber may need to adjust your dose. (2)
  • Medicines that inhibit certain liver enzymes (such as ketoconazole or itraconazole) can increase hydrocortisone levels and side effects. (2)
  • NSAIDs and aspirin taken together with hydrocortisone can increase the risk of stomach ulcers or bleeding. (1) (2)
  • Hydrocortisone can reduce the effect of diabetes medicines and blood pressure medicines -- your prescriber may need to monitor and adjust these. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Standard replacement doses have not been linked to a clear increase in birth defects, but prolonged high-dose use may affect fetal growth. Tell your prescriber if you are pregnant or planning pregnancy so the dose can be reviewed for your situation -- adrenal insufficiency itself still needs treatment during pregnancy. (1) (2) (3) (4) (5) (6)

Breastfeeding

Hydrocortisone passes into breast milk in small amounts at typical replacement doses; higher doses warrant extra caution. Discuss breastfeeding plans with your prescriber. (1) (2) (3) (4) (5) (6)

Children

Used for congenital adrenal hyperplasia and other paediatric adrenal insufficiency at weight-appropriate doses; growth should be monitored regularly during long-term treatment. (1) (2) (3) (4) (5) (6)

Elderly

Older adults may be more prone to side effects such as osteoporosis, high blood pressure, or skin thinning, and may need closer monitoring. (1) (2) (3) (4) (5) (6)

Hepatic_impairment

Liver problems can alter how hydrocortisone is processed by the body -- tell your prescriber about any liver conditions. (1) (2) (3) (4) (5) (6)

Renal_impairment

Not specifically detailed in the sources reviewed; kidney problems can affect fluid and electrolyte balance, which is already affected by corticosteroids, so monitoring may be needed. (1) (2) (3) (4) (5) (6)

Source_ids

US-DAILYMED-HYDROCORTISONE-TABLET-2026,UK-EMC-HYDROCORTISONE-TABLET-2026 (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Baseline blood pressure and blood sugar
  • Screening for active infection, including tuberculosis where relevant
  • Bone health assessment if long-term use is anticipated
  • Growth baseline in children

During treatment

  • Regular review of blood pressure, blood sugar, and electrolytes.
  • Bone density monitoring with long-term use, particularly in postmenopausal women and the elderly.
  • Growth monitoring in children.
  • Watching for mood or behavioural changes, especially early in treatment.
  • Reinforcement of sick-day/stress-dosing rules and when to seek emergency care.
(1) (2)

Storage

Store at controlled room temperature, about 20-25C (68-77F) per the US label, or protected from light in the original packaging per the UK SmPC. New Zealand labelling recommends storage at or below 30C, protected from light.

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information and UK SmPC; verify against the current full label before prescribing.

United States

Indication: Adrenocortical insufficiency and a range of inflammatory/allergic/haematological conditions

Dose summary: Individualised, roughly 20-240 mg/day depending on the condition treated; lowest effective dose for shortest duration; gradual tapering recommended after long-term therapy rather than abrupt discontinuation; increased 'stress dosing' during acute illness, surgery, or trauma.

Renal context: Not specifically detailed in the source reviewed. (1)

United Kingdom

Indication: Adrenocortical insufficiency (replacement) and emergency/inflammatory conditions

Dose summary: Chronic adrenal insufficiency: 20-30 mg/day; paediatric congenital adrenal hyperplasia: 10-30 mg/day in divided doses; acute emergencies: 60-80 mg every 4-6 hours for 24 hours, then gradually reduced. Doses above ~160 mg/day or courses beyond ~3 weeks require gradual, supervised withdrawal.

Renal context: Not specifically detailed in the source reviewed. (2)

Mechanism of action

Hepatic guidance

Hepatic impairment can alter hydrocortisone metabolism; use with appropriate monitoring.

Overdose note

Acute overdose is rarely life-threatening on its own but can worsen fluid retention, blood pressure, blood sugar, and mood/behavioural effects; the more clinically urgent risk in practice is under-replacement or abrupt discontinuation after prolonged therapy, which can precipitate an acute adrenal crisis requiring emergency parenteral corticosteroid and supportive treatment. (1) (2)

Frequently asked questions

Is hydrocortisone available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, oral hydrocortisone is approved and available in all of these regions, as generic tablets and/or branded products such as Cortef, Hysone, or the modified-release Plenadren in the EU. (1) (2) (3) (4) (5) (6)

Can I stop taking hydrocortisone suddenly if I feel better?

No -- after ongoing use, hydrocortisone should never be stopped suddenly on your own. Your body's own cortisol production can be suppressed during treatment, and stopping abruptly can trigger a life-threatening adrenal crisis. Any dose reduction or stopping must be planned and supervised by your prescriber, usually with a gradual taper. (1) (2)

Is oral hydrocortisone the same as the hydrocortisone cream used for skin rashes?

They contain the same active ingredient, but oral (and injectable) hydrocortisone is absorbed throughout the body and used at much higher effective doses, carrying real risks such as adrenal suppression, infection risk, osteoporosis, and growth effects in children with prolonged use. Low-strength topical hydrocortisone applied to a small area of skin acts mainly locally and has a much lower risk profile, though prolonged or excessive use can still cause skin thinning. (1)

What is the mechanism of action of hydrocortisone?

Hydrocortisone is identical to the endogenous glucocorticoid cortisol, produced by the adrenal cortex. It binds intracellular glucocorticoid receptors to modulate gene transcription, producing broad anti-inflammatory and immunomodulatory effects, along with effects on carbohydrate, protein, and fat metabolism, and (at replacement-relevant doses) some mineralocorticoid activity relevant to sodium/fluid balance. (1) (2)

What is the generic name of Hydrocortisone?

The generic name is hydrocortisone. (1) (2)

What class of drug is hydrocortisone?

Hydrocortisone is classed as: Glucocorticoid corticosteroid. (1) (2)

References

  1. HYDROCORTISONE tablet -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-30 · source 1
  2. Hydrocortisone 10 mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Dexcel Pharma Ltd · United Kingdom · accessed 2026-07-30 · source 2
  3. Plenadren (hydrocortisone, modified-release tablet) -- European Public Assessment Report (EPAR)European Medicines Agency (EMA) · European Union · accessed 2026-07-30 · source 3
  4. CORTEF (hydrocortisone) Product Monograph, Pfizer CanadaHealth Canada product monograph · Canada · accessed 2026-07-30 · source 4
  5. HYSONE hydrocortisone tablets -- ARTG entries (ARTG 27926, 27923); SOLU-CORTEF hydrocortisone sodium succinate injection -- ARTG entriesTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
  6. Hydrocortisone Tablets -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 6

Brand names by country

Single-ingredient hydrocortisone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Hydrocortisone with aloe1 g00g, 10.2 mg/g · encube ethicals, inc.
  • Solu-Cortef100 mg/2mL, 250 mg/2mL, 1000 mg/8mL, 500 mg/4mL · propharma distribution
  • PROCTOZONE-HC25 mg/g · preferred pharmaceuticals, inc.
  • Hydrocortisone Plus 12 Moisturizers1 g00g · target corporation
  • CAREALL Hydrocortisone Maximum Strength.01 g/g, 1 g/g · new world imports, inc.
  • Hydroxym20 mg/g, 2 g00g · puretek corporation
  • FifthPulse Hydrocortisone10 mg/g, 1 g00g · wecare products llc
  • ProCure Hydrocortisone 1%1 g00g, 10 mg/g · twin med llc
  • Hydrocortisone Cream with Aloe1 g00g · rugby laboratories
  • Family Wellness1 g00g · zhejiang jingwei pharmaceutical co., ltd.

United Kingdom

  • Hydrocortisone tablets (generic) (2)MHRA licensed emc smpc confirmed · 10 mg, 20 mg · Dexcel Pharma Ltd (this presentation); other holders

Canada

  • CORTEF
  • HYDROVAL
  • CORTAMED ONT 25 MG/GM
  • CORTENEMA
  • SOLU-CORTEF 100 MG ACT-O-VIAL
  • SOLU-CORTEF 250 MG ACT-O-VIAL
  • SOLU-CORTEF 500 MG ACT-O-VIAL
  • SOLU-CORTEF 1 GM ACT-O-VIAL
  • EMO CORT
  • CORTIFOAM

Australia

  • Hysone 4; Hysone 20; Solu-Cortef (injection) (5)TGA ARTG registered confirmed · 4 mg, 20 mg tablets · Alphapharm Pty Ltd (Viatris)

New Zealand

  • Hydrocortisone Tablets (generic) (6)Medsafe approved confirmed · 5 mg, 20 mg · multiple
View brands in additional countries.

European Union

Plenadren (centrally authorised); standard hydrocortisone tablets (nationally authorised) (3)

This page provides general reference information about hydrocortisone and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions, including any change or discontinuation, should be made with your prescriber.

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