Hydrocortisone Cream: Uses, Benefits, and Side Effects Explained

Summary of Key Points

Hydrocortisone is a corticosteroid commonly used to treat a variety of conditions, including allergic reactions, asthma, eczema, and inflammatory diseases such as rheumatoid arthritis and lupus. It works by reducing inflammation and suppressing the immune system. Hydrocortisone is available in several forms, including creams, tablets, and injections. Always consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Names: Cortef, Solu-Cortef, Anusol-HC, Locoid

Generic Name: Hydrocortisone

The generic name refers to the active ingredient in the medication and is listed in parentheses after the brand name.

Pharmacologic Category

Glucocorticoid

Corticosteroid

Hydrocortisone Dosing

Hydrocortisone is prescribed for a range of conditions, with the dosage tailored to the specific illness being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also reach out to one of our telemedicine providers for further guidance.

Allergic Reactions

Dosage: 20-240 mg per day, depending on the severity of the reaction.

Frequency: Once daily or divided into multiple doses.

Length of Treatment: Typically short-term, until symptoms improve.

Asthma

Dosage: 20-240 mg per day, depending on the severity of the asthma attack.

Frequency: Once daily or divided into multiple doses.

Length of Treatment: Short-term use during asthma exacerbations.

Eczema and Psoriasis

Dosage: Apply a thin layer of hydrocortisone cream (0.5% to 2.5%) to the affected area.

Frequency: 1-4 times daily, depending on the severity of the condition.

Length of Treatment: Use as directed by your doctor, typically for short-term flare-ups.

Inflammatory Bowel Disease (Ulcerative Colitis)

Dosage: 100 mg rectally (enema) once or twice daily.

Length of Treatment: Typically used for short-term flare-ups, as directed by your healthcare provider.

Rheumatoid Arthritis and Lupus

Dosage: 20-240 mg per day, depending on the severity of the disease.

Frequency: Once daily or divided into multiple doses.

Length of Treatment: Long-term use may be necessary, with close monitoring by your doctor.

Adrenal Insufficiency

Dosage: 15-30 mg per day, divided into 2-3 doses.

Length of Treatment: Long-term replacement therapy is required.

Dermatitis

Dosage: Apply a thin layer of hydrocortisone cream (0.5% to 2.5%) to the affected area.

Frequency: 1-4 times daily, depending on the severity of the condition.

Length of Treatment: Use as directed by your doctor, typically for short-term flare-ups.

Dosage Forms and Strengths

Tablets: 5 mg, 10 mg, 20 mg

Creams and Ointments: 0.5%, 1%, 2.5%

Injectable Solution: 100 mg/2 mL, 250 mg/2 mL

Rectal Enema: 100 mg/60 mL

How to Use Hydrocortisone: Administration Instructions

Hydrocortisone should be taken exactly as prescribed by your healthcare provider. For oral forms, take with food to minimize stomach upset. When using topical forms, such as hydrocortisone cream, apply a thin layer to the affected area and avoid covering it unless instructed by your doctor. For injections, your healthcare provider will administer the dose. If you miss a dose, take it as soon as you remember, but do not double up on doses. Always consult your doctor for specific instructions.

Contraindications

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. If you have any of the following conditions, taking Hydrocortisone may not be safe. Always consult your healthcare provider before starting or stopping any medication, including Hydrocortisone.

1. Systemic fungal infections: Hydrocortisone can weaken your immune system, making it harder for your body to fight infections. If you have a systemic fungal infection, Hydrocortisone can worsen it.
2. Untreated bacterial or viral infections: Like fungal infections, Hydrocortisone can suppress your immune system. If you have an untreated infection, Hydrocortisone may allow it to spread or worsen.
3. Allergy to Hydrocortisone: If you have had an allergic reaction to Hydrocortisone or any of its ingredients, you should not take this medication as it could cause a severe allergic reaction.
4. Peptic ulcers: Hydrocortisone can increase the risk of gastrointestinal bleeding or worsen existing ulcers. If you have a history of ulcers, your healthcare provider may recommend an alternative treatment.
5. Severe liver disease: Hydrocortisone is processed by the liver, and severe liver disease can affect how the medication is metabolized, leading to potential toxicity or reduced effectiveness.

Drug Interactions with Hydrocortisone

Hydrocortisone can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of either drug. It’s important to inform your healthcare provider of all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Hydrocortisone:

1. Warfarin (Coumadin): Hydrocortisone may affect how your body responds to blood thinners like Warfarin, increasing the risk of bleeding.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can increase the risk of gastrointestinal bleeding when taken with Hydrocortisone.
3. Diuretics (water pills): Medications such as furosemide (Lasix) can increase the risk of low potassium levels when taken with Hydrocortisone.
4. Antidiabetic drugs: Hydrocortisone can raise blood sugar levels, making it harder to control diabetes. This includes medications like metformin (Glucophage) or insulin.
5. Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Hydrocortisone by speeding up its metabolism in the liver.

Hydrocortisone in Pregnancy

Is it safe to take Hydrocortisone during pregnancy? The use of Hydrocortisone during pregnancy requires careful consideration. Hydrocortisone is classified as a Category C drug by the FDA, meaning animal studies have indicated potential risks to the fetus, but there are no well-controlled studies in humans. If you are pregnant or planning to become pregnant, it is essential to consult your healthcare provider before using Hydrocortisone. In some cases, the benefits may outweigh the potential risks, but this decision should always be made in collaboration with your doctor.

Hydrocortisone While Breastfeeding

Is it safe to take Hydrocortisone while breastfeeding? Hydrocortisone can pass into breast milk in small amounts. Short-term use of low doses is generally considered safe, but prolonged use or higher doses could impact milk production or cause side effects in the nursing infant. If you are breastfeeding, it’s important to discuss the risks and benefits of Hydrocortisone with your healthcare provider. They may suggest alternative treatments or adjust your dosage to minimize any potential risks.

Estimated Cost of Hydrocortisone

The cost of Hydrocortisone can vary depending on the dosage and form (oral, topical, or injectable). Without insurance, a 30-day supply of oral Hydrocortisone using a GoodRx coupon is estimated to cost between $10 and $20. Prices may differ based on location and pharmacy. Topical forms, such as Hydrocortisone cream, are typically less expensive, usually ranging from $5 to $15 for a tube of cream or ointment.

Possible Alternatives to Hydrocortisone

If Hydrocortisone is not suitable for you, there are alternative treatments available for many of the conditions it treats. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.

1. Allergic reactions: Alternatives include antihistamines like diphenhydramine (Benadryl) or loratadine (Claritin). For severe reactions, epinephrine (EpiPen) may be necessary.
2. Asthma: Inhaled corticosteroids such as fluticasone (Flovent) or bronchodilators like albuterol (ProAir) may be used instead of oral Hydrocortisone.
3. Eczema: Topical calcineurin inhibitors like tacrolimus (Protopic) or moisturizers can help manage symptoms. Hydrocortisone cream for eczema is also a common treatment option.
4. Psoriasis: Topical treatments like calcipotriene (Dovonex) or systemic medications such as methotrexate may be used as alternatives.
5. Inflammatory bowel disease: Other corticosteroids like budesonide (Entocort) or immunosuppressants such as azathioprine (Imuran) may be considered.
6. Rheumatoid arthritis: Disease-modifying antirheumatic drugs (DMARDs) like methotrexate or biologics such as adalimumab (Humira) are common alternatives.
7. Lupus: Immunosuppressants like mycophenolate (CellCept) or hydroxychloroquine (Plaquenil) may be used instead of corticosteroids.
8. Adrenal insufficiency: Fludrocortisone (Florinef) is often used alongside or instead of Hydrocortisone to manage this condition.
9. Dermatitis: Topical treatments like pimecrolimus (Elidel) or over-the-counter moisturizers may be effective.
10. Ulcerative colitis: Mesalamine (Asacol) or biologics like infliximab (Remicade) may be considered as alternatives.

Recent Updates on Hydrocortisone Research

Recent research on Hydrocortisone has focused on its role in treating COVID-19-related inflammation. Studies have shown that corticosteroids, including Hydrocortisone, can help reduce the risk of death in critically ill COVID-19 patients by controlling the body’s inflammatory response. However, Hydrocortisone is not recommended for mild COVID-19 cases and should only be used in hospital settings under medical supervision.

Ongoing studies are also investigating the long-term effects of Hydrocortisone in patients with adrenal insufficiency, with the goal of optimizing dosing strategies to minimize side effects while maintaining effectiveness. If you have questions about how new research might affect your treatment plan, consider scheduling a telemedicine appointment with one of our providers to discuss the latest findings.

James Kingsley

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