Pharmacological properties
Hydrocortisone in the composition of the drug is a natural glucocorticosteroid. It has anti-inflammatory, antiallergic, antipruritic and anti-edematous effects. Stabilizes cellular (subcellular) membranes of mast cells, lysosome membranes. Inhibits the alteration phase, reduces cellular infiltrates of inflammation, suppresses the migration of inflammatory mediators to the site of the lesion. Reduces the binding of immunoglobulins and receptors on the cell surface, blocks the synthesis and release of cytokines from macrophages and lymphocytes. Reduces the synthesis of arachidonic acid metabolites (prostaglandins, leukotrienes, thromboxane). Inhibits the exudation reaction, reduces capillary permeability. Levels the severity of the immunological response. Induces the formation of lipocortins with anti-edematous activity. It exhibits antimetabolic effect, inhibits the proliferation of connective tissue, collagen deposits, and scarring. When used in therapeutic doses, it has almost no systemic effect.
Hydrocortisone, 1%, ointment, 10 g, 1 pc.
From the endocrine system: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (including moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis , striae), delayed sexual development in children.
Metabolism: increased excretion of calcium ions, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating, fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (including hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
From the central nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.
From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle; with intracranial administration - nosebleeds.
From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups; rarely - increased activity of liver transaminases and alkaline phosphatase.
From the senses: sudden loss of vision (with parenteral administration in the head, neck, nasal turbinates, scalp, deposition of drug crystals in the vessels of the eye is possible), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, tendency to develop secondary bacterial , fungal or viral eye infections, trophic changes in the cornea, exophthalmos.
From the musculoskeletal system: slower growth and ossification processes in children (premature closure of the epiphyseal growth plates), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy); with intra-articular administration - increased pain in the joint.
Dermatological reactions: delayed wound healing, petechiae, ecchymosis, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.
Allergic reactions: generalized (including skin rash, skin itching, anaphylactic shock), local allergic reactions.
Effects due to immunosuppressive effects: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination).
Local reactions: with parenteral administration - burning, numbness, pain, paresthesia and infection at the injection site; rarely - necrosis of surrounding tissues, scar formation at the injection site; with intramuscular injection (especially into the deltoid muscle) - atrophy of the skin and subcutaneous tissue.
Other: leukocyturia, withdrawal syndrome.
With intravenous administration - blood flow to the face, convulsions.
For external use: rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stretch marks, prickly heat. With prolonged use or application to large areas of skin, systemic side effects characteristic of GCS may develop.
Contraindications
- Reactions of individual intolerance.
- Viral and fungal infectious diseases of the eyes.
- Trachoma.
- Tuberculosis.
- Violations of the integrity of the corneal epithelium.
- Vaccination period.
- Breastfeeding period.
Hydrocortisone ophthalmic ointment should be used with caution in patients with diabetes and hypertension.
For pregnant women, the drug is prescribed according to strict indications and is used for no more than 7-10 days.
Nosological classification (ICD-10)
- A41.9 Septicemia, unspecified
- A49.9 Bacterial infection, unspecified
- C95.0 Acute leukemia of unspecified cell type
- C95.9 Leukemia, unspecified
- D59 Acquired hemolytic anemia
- D69.3 Idiopathic thrombocytopenic purpura
- D70 Agranulocytosis
- E05.5 Thyroid crisis or coma
- E06 Thyroiditis
- E27.1 Primary adrenal insufficiency
- E27.2 Addison's crisis
- E83.5.0* Hypercalcemia
- G93.6 Cerebral edema
- J44 Other chronic obstructive pulmonary disease
- J45 Asthma
- J46 Status asthmaticus
- J98.8.0* Bronchospasm
- L30.9 Dermatitis, unspecified
- M13.9 Arthritis, unspecified
- M19.9 Arthrosis, unspecified
- M24.5 Joint contracture
- M35.9 Systemic connective tissue disorders, unspecified
- M65.9 Synovitis and tenosynovitis, unspecified
- M71.9 Bursopathy, unspecified
- M77.0 Medial epicondylitis
- M77.1 Lateral epicondylitis
- M79.0 Rheumatism, unspecified
- R57.9 Shock, unspecified
- T78.2 Anaphylactic shock, unspecified
- T78.4 Allergy, unspecified
Directions for use and doses
IM (deep) into the gluteal muscle at a dose of 50–300 mg to 1000–1500 mg/day. Before use, the contents of the ampoules must be shaken until a homogeneous suspension is formed.
For acute, life-threatening conditions, 100–150 mg is administered every 4 hours for 48 hours; then - every 8-12 hours. Children - every 4 hours 1-2 mg/kg, the optimal daily dose is 6-9 mg/kg.
5–25 mg (0.1–1 ml (depending on the size of the joint)) is injected into the joint cavity once a week. 3–5 injections per course. The effect of the drug begins 6–25 hours after administration and lasts several days or weeks
Reviews of Hydrocortisone
Ointments and creams containing corticosteroids have antiallergic, anti-inflammatory and antipruritic effects. What is Hydrocortisone ointment for and for what skin diseases is it used? This is primarily eczema, neurodermatitis, psoriasis, itchy and allergic dermatoses, skin manifestations of lupus erythematosus. Most often, hormonal therapy is resorted to only if other local treatments are ineffective. Indeed, the use of this ointment gives a rapid anti-inflammatory effect; after a few days, itching and swelling disappear.
Reviews of Hydrocortisone ointment are most often positive, and this applies to people who tried to use hormonal ointment for the first time. Those who have extensive experience in using hormone-based ointments say that prednisolone is significantly superior in anti-inflammatory activity to hydrocortisone, and also retains water to a lesser extent in the body. And ointments containing dexamethasone and betamethasone are even more active. Hydrocortisone and prednisolone belong to the first generation of corticosteroids, which are relatively weakly active substances. Ointments and creams with these substances are used in pediatric practice, in addition, they can be applied to the skin of the face. Judging by the reviews, for any form of eczema, treatment began with the use of this ointment; in case of an unexpressed effect, more potent agents were used - Fluorocort or Polcortolone. Skin atrophy , acne, hypopigmentation, and striae are common local adverse reactions of corticosteroids that occur on the face and groin area, so low-potency corticosteroids should be used in these areas.
What else can the ointment be used for? It is used in physiotherapeutic procedures, for example, in the treatment with ultrasound of diseases of the joints and spine, scar contractures, heel spurs. Under the influence of ultrasound, exudates are absorbed, analgesic, anti-inflammatory and vasodilating effects are manifested. Phonophoresis using a suspension has a similar effect. Almost everyone who underwent treatment left positive reviews about phonophoresis with hydrocortisone. High efficiency, rapid disappearance of pain and recovery were noted. This procedure was prescribed after gynecological diseases, as well as for sinusitis. Some patients noted an exacerbation after the first sessions.
Information has appeared on the Internet about the use of this ointment for wrinkles. What is this based on and is it harmful to use the ointment for this purpose? Topical application of hydrocortisone causes fluid retention and some swelling, which hides wrinkles and makes them visually invisible. But this is a temporary effect; after the “procedures” are stopped, the liquid is lost and the wrinkles appear again. Doctors are categorically against the use of hydrocortisone for cosmetic purposes. First of all, it is a hormonal drug that has a systemic effect on the body (in the form of changes in metabolic processes) and a local effect - skin atrophy, it becomes thinner and the aging process accelerates. In addition, hormonal ointment causes skin addiction and a decrease in effect when applied topically. Considering the contraindications and possible complications, isn’t the price of such imaginary rejuvenation too high? Hydrocortisone ointment and eye ointment should be prescribed only by a doctor according to strict indications; you cannot treat them yourself. Eye ointment was prescribed to patients with keratitis, chemical burns and after surgical interventions. Some patients experienced burning, redness of the sclera and itching of the eyelids during the first days of using it, but after examination by a doctor, treatment was continued. There are no eye drops containing the active ingredient hydrocortisone. If you are interested in hormonal eye drops, then these are: Oftan Dexamethasone, Dexapos, Maxitrol, Maxidex, Dexamethasone, which includes dexamethasone.
Hydrocortisone can be used for inhalation for laryngitis for decongestant purposes. If a suspension is used for inhalation, it must be diluted. How to dilute for inhalation? Take 1 ml of suspension and 2-3 ml of physiological solution, fill the inhaler, breathe for 5 minutes. Inhalation is carried out in the morning and evening. Reviews about inhalations are positive, since swelling and spasm quickly stop, cough decreases, and breathing becomes easier.
Nasal suspension is sometimes prescribed as an instillation for hypertrophic rhinitis, but, as a rule, this is not effective and surgical treatment cannot be avoided. Otolaryngologists often prescribe pharmaceutical drops, which include a solution of dioxidine, adrenaline and a suspension of hydrocortisone or Miramistin, Nazivin and a suspension. There are good results in the treatment of allergic rhinitis and sinusitis.
Analogs
Level 4 ATX code matches:
Lokoid Krelo
Lokoid
Lokoid Lipocrem
Tablets Cortef , powder in vials for injection Solu-Cortef , solution for injection Sopolkort N.
Analogs of ointments that contain hydrocortisone: Ascortin , Hyoxysone , Cortade , Laticort , Lokoid Lipokrem .
special instructions
In cases of use of the drug in children, on the face area under occlusive dressings, the duration of the course of treatment should be reduced to two weeks. In childhood, suppression of adrenal function may develop more quickly. In addition, a decrease in the secretion of growth hormone somatropin may be observed. For children from 2 to 12 years of age, the drug should be used only after consultation with a doctor and then under medical supervision.
Avoid contact of the ointment with the eyes and mucous membranes.
If after 7 days of use there is no improvement or worsening of the condition, the use of the drug should be stopped and consult a doctor. If symptoms recur a few days after stopping the drug, you should consult your doctor.
For long-term treatment and/or application to large surfaces, it is recommended to prescribe a diet with limited sodium and high potassium content; introduce a sufficient amount of protein into the body. It is necessary to monitor blood pressure, blood glucose, blood clotting, diuresis, the patient’s body weight, and plasma cortisol concentration.
To prevent infectious lesions, the drug is recommended to be prescribed in combination with antibacterial and antifungal agents.
Impact on the ability to drive vehicles and operate machinery
During treatment with the drug, caution should be exercised when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Indications for use
Systemic use for replacement therapy and treatment of inflammatory processes:
- adrenal insufficiency;
- arterial hypotension;
- cardiogenic and traumatic shock ;
- thyrotoxic crisis;
- hepatic coma;
- collapse in Addison's disease ;
- status asthmaticus;
- serum sickness;
- hay fever;
- swelling of the larynx;
- nephrotic syndrome;
- acute liver failure;
- exacerbation of ulcerative colitis and Crohn's disease ;
- psoriatic and rheumatoid arthritis ;
- acute gouty arthritis ;
- juvenile arthritis;
- systemic lupus erythematosus;
- dermatomyositis;
- spondylitis;
- glenohumeral periarthritis;
- rheumatic carditis.
Intra-articular and periarticular administration:
- reactive synovitis;
- acute bursitis ;
- rheumatoid arthritis;
- epicondylitis;
- acute tenosynovitis ;
- post-traumatic osteoarthritis ;
- carpal tunnel syndrome.
Local application of ointment:
- eczema;
- allergic dermatitis;
- exfoliative dermatitis;
- seborrheic dermatitis;
- itchy dermatoses;
- anogenital itching;
- photodermatoses;
- neurodermatitis;
- psoriasis;
- insect bites;
- prurigo;
- erythroderma.
Application of eye ointment
- allergic conjunctivitis , blepharitis ;
- blepharoconjunctivitis;
- eyelid dermatitis;
- keratitis and condition after keratitis;
- iridocyclitis (acute and subacute);
- iritis;
- posterior uveitis and choroiditis ;
- thermal and chemical burns;
- condition after surgical interventions.
Hydrocortisone price, where to buy
All forms of this drug are available in the pharmacy chain at affordable prices, so you can buy them without any problems. The price of Hydrocortisone ointment is 30-37 rubles, the price of eye ointment ranges from 121 to 133 rubles. The price of Hydrocortisone in ampoules (Farmak, Ukraine) is 147-155 rubles. (for 10 ampoules) A suspension of hydrocortisone with lidocaine (Gedeon Richter) costs more - 215-251 rubles for 1 bottle.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
LuxPharma* special offer
- Hydrocortisone France tablets 10 mg No. 25
RUB 1,990 order - Hydrocortisone (analogue of Cortef) table. 20 mg No. 20
RUB 1,750 order
ZdravCity
- Hydrocortisone ointment for eyes. 0.5% 3gPharmzavod Elfa A.O.
130 rub. order
- Hydrocortisone eye ointment 0.5% 3g JSC Tatkhimfarmpreparaty
32 RUR order
- Hydrocortisone-Richter Susp. for intravenous and peri-ost. input 25mg+5mg/ml 5ml 1 pc. JSC Gedeon Richter
RUB 223 order
- Hydrocortisone-POS eye ointment. 2.5% 2.5gUrsapharm Arzneimittel GmbH
83 RUR order
- Hydrocortisone-AKOS ointment for external use 1% 15gOJSC Sintez
63 RUR order
Pharmacy Dialogue
- Hydrocortisone ointment (tube 0.5% 3g)Jelfa SA
127 RUR order
- Hydrocortisone-POS ointment (tube 1% 2.5 g (eye)) Ursapharm
68 RUR order
- Hydrocortisone ointment (tube 0.5% 3g) Tatkhimpharmpreparaty JSC
29 RUR order
- Hydrocortisone ointment (tube 1% 10g)Nizhpharm JSC
33 rub. order
- Hydrocortisone ointment (tube 0.5% 5g) TCPP
40 rub. order
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Pharmacy24
- Hydrocortisone Acetate 25 mg/ml N10 suspension for injection PAT "Pharmstandard-Biolik", Kharkiv, Ukraine
98 UAH.order - Hydrocortisone acetate 2.5% 2 ml No. 10 PAT "Farmak", Ukraine
159 UAH order
- Hydrocortisone 0.5% 3 g eye ointment Elfa A.T. Pharmaceutical Plant, Poland
68 UAH order
- Hydrocortisone 1% 10 g ointment VAT "Nizhpharm", Nizhny Novgorod, Russian Federation
40 UAH order
- Hydrocortisone-POS 1% 2.5 g eye ointment Ursafarm Arznaimittel GmbH, Nimecchina
92 UAH order
PaniPharmacy
- Hydrocortisone ointment Hydrocotisone ointment-pos. 1% 2.5g Germany, Ursapharm
105 UAH order
- Hydrocortisone ointment Hydrocortisone eye ointment 0.5% 3g Poland, Jelfa
89 UAH order
- Hydrocortisone ampoule Hydrocortisone acetate d/in. 2.5% 2ml No. 10 Ukraine, Pharmstandard-Biolek
114 UAH order
- Hydrocortisone ampoule Hydrocortisone acetate d/in. 2.5% 2ml No. 10 Ukraine, Farmak OJSC
174 UAH order
- Hydrocortisone ointment Hydrocortisone ointment 1% 10g Russia, Nizhpharm
42 UAH order
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Interaction
The effect of the drug when administered intramuscularly or intravenously is weakened by barbiturates, antihistamines and antiepileptics, and diuretics - they increase hypokalemia. The effect of hypoglycemic agents is reduced with this method of administration.
Use with NSAIDs increases the risk of ulcer formation, and with paracetamol - hepatotoxicity.
Hydrocortisone reduces the concentration of salicylates in the blood and the activity of hypoglycemic agents. Cardiac glycosides and diuretics increase hypokalemia. When prescribed with amphotericin B, heart failure occurs.
The simultaneous use of eye ointment and drugs that cause an increase in intraocular pressure contributes to a greater increase in intraocular pressure.