Hydrocortisone belongs to the family of medications known as corticosteroids. It is used to treat many different conditions. It works by reducing swelling, inflammation, and irritation or as a replacement when the body does not make enough cortisol. Hydrocortisone is more commonly used to treat allergic reactions, some skin conditions, severe asthma, lupus, and arthritis.

It can also be used to treat steroid deficiency in the body, certain blood disorders, certain types of cancer, multiple sclerosis, and ulcerative colitis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The dose of hydrocortisone (tablets) varies greatly according to the condition being treated and individual circumstances. This medication should be taken with food to reduce the chance of an upset stomach. Once the condition being treated is controlled, the lowest dose needed to control symptoms should be used.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

10 mg
Each white-to-off-white, round tablet, with score line on the side and debossed with “HC10” on the other side, contains 10 mg of hydrocortisone. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, copovidone, sodium starch glycolate, colloidal silicon dioxide, and magnesium stearate.

20 mg
Each white-to-off-white, round tablet, plain on one side and debossed with “HC20” on the other side, contains 20 mg of hydrocortisone. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, copovidone, sodium starch glycolate, colloidal silicon dioxide, and magnesium stearate.

Do not take hydrocortisone tablets if you:

• are allergic to hydrocortisone or any ingredients of the medication
• have a fungal infection in the lungs or other organs within the body
• have herpes simplex of the eye, except as short-term or emergency therapy as in acute sensitivity reactions
• have vaccinia or varicella, except when used for short-term or emergency therapy as in acute sensitivity reactions
• will be given a live virus vaccine (e.g., measles, mumps, rubella, yellow fever, BCG) and are taking large immunosuppressive doses of hydrocortisone

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloating
• changed sense of taste
• diarrhea
• dizziness
• dry skin
• general feeling of being unwell
• hair thinning
• headache
• heartburn
• hiccups
• increased appetite
• increased sweating
• itching
• nausea
• redness of face or cheeks
• skin changes (discolouration, stretch marks, thinning)
• unusual hair growth
• upset stomach or stomach irritation
• vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal or stomach pain
• acne
• anxiety
• behaviour changes or mood swings
• bone fractures
• burning or tingling sensation of hands or feet
• changes in vision
• confusion
• decreased or blurred vision
• excitement
• false sense of well-being
• filling or rounding out of the face
• hallucinations
• high blood pressure
• irregular heartbeat
• joint or bone pain
• menstrual problems
• muscle cramps or spasms
• muscle weakness
• pain in arms, back, hips, legs, ribs, or shoulders
• rash
• reddish-purple lines on arms, face, groin, legs, or trunk
• signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worst when breathing in, coughing, coughing up blood, sweating, or passing out)
• signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
• signs of infections (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• skin infection or slowed healing of cuts or wounds
• spinning sensation
• swelling of the feet, ankles, or legs
• symptoms of decreased adrenal gland function (e.g., abdominal pain, diarrhea, nausea, vomiting, weakness, fatigue)
• symptoms of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of a stomach ulcer (e.g., persistent abdominal or stomach pain or burning, bloody or black, tarry stools)
• symptoms of too much cortisol in the body (e.g., thinning skin, easy bruising, dry skin, fat deposits between the shoulder blades)
• symptoms of tuberculosis reactivation (e.g., coughing blood, chest pain)
• unusual tiredness or weakness
• weight gain (rapid)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures
• signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
• signs of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, tongue, or throat)
• thoughts of self-harm

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood pressure: This medication can increase blood pressure, especially when high doses are used. Your doctor will monitor your blood pressure closely while you are taking this medication. Your doctor may suggest diet changes or other measures to keep your blood pressure under control. People with high blood pressure should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Diabetes: This medication may worsen blood sugar control for people with diabetes. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/dizziness: Hydrocortisone may affect the mental or physical abilities needed to drive or operate machinery by causing dizziness, tiredness, spinning sensations or changes in vision. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.

Fluid and electrolyte balance: Like other corticosteroids, hydrocortisone may cause the levels of electrolytes such as potassium and sodium in the blood to change while taking this medication. If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible.

Increased sodium causes fluid to build up in the body. This increases the amount of work the heart must do to circulate the blood, causing increased blood pressure, stress on the heart, kidneys, and other organs. Let your doctor know if you experience puffy hands, ankles, or feet.

Heart disease: Hydrocortisone may cause blood pressure to increase. Hydrocortisone may also cause cholesterol levels to increase.  If you have a heart condition or are at risk of developing heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Illness and surgery: People who take this medication, or have taken other corticosteroids (e.g., prednisone) in the last several months, may need additional corticosteroids during times of any unusual stress, such as trauma, surgery, or infection.

Infections: When taken by mouth, this medication may mask some signs of infection and put people at increased risk for new infections. Viral infections such as chickenpox, measles, or herpes can be more serious for people who are taking hydrocortisone. Children and adults who have not had these diseases should take particular care to avoid exposure. If you are exposed to these infections, contact your doctor.

Kidney disease: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lactose: Some formulations of this medication contain lactose. If you have a lactose allergy, talk to your doctor about whether this medication is appropriate for you.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Medical records: Let all health professionals involved in your care know that you have been taking a corticosteroid.

Mental health: Like other corticosteroids, hydrocortisone may cause behaviour and personality changes and mood swings. These reactions are most likely to occur when you first start taking this medication. If you experience these symptoms or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Myasthenia gravis: Myasthenia gravis is a condition that causes specific muscle weakness. Hydrocortisone can cause muscle wasting, decreasing muscle. If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Osteoporosis: This medication can increase the risk of osteoporosis (brittle bones). Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you take this medication for a long period of time.

Seizures: If you have a seizure disorder or a history of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Steroid medication use: If you have taken or are still taking an oral steroid medication (e.g., prednisone) during the last several months, consult your doctor before using this medication. If you experience symptoms such as tiredness, headache, nausea, or vomiting while taking this medication, contact your doctor.

Stomach and intestinal problems: If you have or have had a stomach or intestinal ulcer, or have ulcerative colitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping the medication: When stopping this medication after having used it for a long time, reduce the dose slowly as prescribed by your doctor. Stopping the medication too quickly could lead to symptoms including fever, muscle, and joint pain, and a general feeling of being unwell.

Thyroid disease: Decreased thyroid function may affect how your body handles this medication. If you have a history of thyroid disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Tuberculosis: Corticosteroids, such as hydrocortisone, can cause tuberculosis infection to flare up. If you have had tuberculosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vaccines: Live vaccines (e.g., BCG, yellow fever, measles, mumps, rubella) should not be given to people taking doses of this medication that are enough to suppress the immune system. Killed or inactivated vaccines may not be as effective for people who are taking this medication.

Vision problems: Long-term use of hydrocortisone can cause glaucoma and cataracts. If you notice changes in your vision, such as faded colours, halos around lights, or blurred vision, contact your doctor as soon as possible. Glaucoma can cause permanent vision loss and should be treated as early as possible.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking hydrocortisone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Long-term treatment with hydrocortisone may suppress growth and development in children. Your child's growth should be monitored while they are taking this medication.

There may be an interaction between hydrocortisone (tablets) and any of the following:

• abrocitinib
• acetylcholinesterase inhibitors (e.g., donepezil, galantamine, rivastigmine)
• acetylsalicylic acid
• aldesleukin
• amphotericin B
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• apalutamide
• aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• baricitinib
• birth control pills
• bismuth subsalicylate
• bosentan
• bromocriptine
• calcitriol
• calcium carbonate
• cholestyramine
• cladribine
• clarithromycin
• cobicistat
• colesevelam
• colestipol
• other corticosteroids (e.g., dexamethasone, prednisolone, prednisone)
• danazol
• deferasirox
• denosumab
• desmopressin
• diabetes medications (e.g., acarbose, canagliflozin, dulaglutide, gliclazide, insulin, metformin, sitagliptin)
• diltiazem
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
• efavirenz
• enzalutamide
• estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol; including estrogen-containing birth control pills)
• etravirine
• grapefruit juice
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• isoniazid
• leflunomide
• lumacaftor and ivacaftor
• mifepristone
• mitotane
• modafinil
• monoclonal antibodies (e.g., atezolizumab, durvalumab, pembrolizumab)
• natalizumab
• nirmatrelvir
• neuromuscular blockers (e.g., atracurium, rocuronium)
• nivolumab
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, ketorolac, naproxen)
• ocrelizumab
• ofatumumab
• phenobarbital
• pimecrolimus
• protein kinase inhibitors (e.g., ceritinib, dabrafenib, tucatinib)
• quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin)
• rifabutin
• rifampin
• seizure medications (e.g., carbamazepine, phenytoin, primidone)
• sodium bicarbonate
• somatrogon
• somatropin
• St. John's wort
• sphingosine 1-phosphate (S1P) receptor inhibitors (e.g., fingolimod, ponesimod, siponimod)
• tacrolimus
• tofacitinib
• upadacitinib
• vaccines (e.g., yellow fever, BCG, measles, mumps, rubella)
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.