Cortef (Oral)

Generic name: hydrocortisone [ hye-droe-KOR-ti-sone ]
Brand names: Alkindi Sprinkle, Cortef
Drug class: Glucocorticoids

Medically reviewed by Drugs.com. Last updated on Oct 23, 2024.

Uses for Cortef

Hydrocortisone provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, eye or vision problems, lupus, skin conditions, and ulcerative colitis. Hydrocortisone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.

This medicine is available only with your doctor's prescription.

Before using Cortef

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of hydrocortisone oral granules in the pediatric population. Safety and efficacy have been established.

No information is available on the relationship of age to the effects of hydrocortisone tablets in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of hydrocortisone in geriatric patients.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Desmopressin
Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abametapir
Aceclofenac
Acemetacin
Aldesleukin
Amtolmetin Guacil
Aspirin
Atazanavir
Balofloxacin
Bemiparin
Besifloxacin
Bromfenac
Bufexamac
Bupropion
Celecoxib
Choline Salicylate
Ciprofloxacin
Clonixin
Cobicistat
Conivaptan
Darunavir
Dexibuprofen
Dexketoprofen
Diclofenac
Diflunisal
Dipyrone
Droxicam
Enoxacin
Etodolac
Etofenamate
Etoricoxib
Fedratinib
Felbinac
Fenoprofen
Fepradinol
Feprazone
Fexinidazole
Fleroxacin
Floctafenine
Flufenamic Acid
Flumequine
Flurbiprofen
Fosnetupitant
Gatifloxacin
Gemifloxacin
Ibuprofen
Indomethacin
Itraconazole
Ketoprofen
Ketorolac
Lenacapavir
Levofloxacin
Lomefloxacin
Lornoxicam
Loxoprofen
Lumiracoxib
Lutetium Lu 177 Dotatate
Macimorelin
Mavacamten
Meclofenamate
Mefenamic Acid
Meloxicam
Morniflumate
Moxifloxacin
Nabumetone
Nadifloxacin
Nadroparin
Naproxen
Nepafenac
Netupitant
Niflumic Acid
Nimesulide
Nimesulide Beta Cyclodextrin
Norfloxacin
Ofloxacin
Omaveloxolone
Oxaprozin
Oxyphenbutazone
Parecoxib
Pazufloxacin
Pefloxacin
Phenobarbital
Phenylbutazone
Piketoprofen
Piroxicam
Pranoprofen
Primidone
Proglumetacin
Propyphenazone
Proquazone
Prulifloxacin
Rofecoxib
Rufloxacin
Salicylic Acid
Salsalate
Sargramostim
Sodium Salicylate
Somatrogon-ghla
Sparfloxacin
Sulindac
Tenoxicam
Tiaprofenic Acid
Tolfenamic Acid
Tolmetin
Tosufloxacin
Valdecoxib

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alcuronium
Atracurium
Auranofin
Colestipol
Gallamine
Hexafluorenium
Licorice
Metocurine
Rifapentine
Saiboku-To

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper use of Cortef

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects.

If you use this medicine for a long time, do not suddenly stop using it without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely.

This medicine comes with a Medication Guide. Read and follow these instructions carefully.

The oral granules are contained within capsules. Do not swallow the capsule. Do not chew or crush the granules. Do not let the capsules get wet because some of the granules may stick to the capsule. Do not give the granules through a nasogastric or gastric tube because it may block the tube.

If you are switching from other oral hydrocortisone medicine to Alkindi® Sprinkle, your doctor may give you a starting dose of this medicine that is different from the previous oral hydrocortisone medicine that you have been taking.

Part of the oral granules may pass into your child's stool (bowel movement). This is normal and nothing to worry about.

To use the granules:

Your doctor will tell you how to prepare or give the dose to your child. Ask your doctor or pharmacist if you have questions.
Take one capsule from the bottle.
Hold the capsule with the writing at the top. Tap the capsule to make sure the granules fall to the bottom.
Squeeze the bottom of the capsule gently to loosen the top of the capsule from the bottom.
Twist the top of the capsule carefully.
You may give the medicine with or without food onto a spoon or directly into the child's mouth. If you are taking this medicine with food, pour the granules onto a spoonful of cold or room temperature soft food (eg, yogurt, fruit puree).
Do not add the granules to a fluid because it may decrease the full dose and it may leave a bitter taste.
The medicine should be given and swallowed within 5 minutes to avoid bitter taste.
Give a sip of fluids like water, milk, breast-milk, or formula right away to make sure all granules are swallowed.
Call your doctor right away if the granules come back up into your child's mouth (regurgitation) or your child has vomiting after swallowing the granules. Your child may not receive the full dose of this medicine and another dose may be needed.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- Dose depends on medical condition:
  - Adults—At first, 20 to 240 milligrams (mg) per day. Your doctor may adjust your dose as needed.
  - Children—Use and dose must be determined by your doctor.
For oral dosage form (granules):
- For adrenal problems:
  - Children—Dose is based on body surface area and must be determined by your doctor. Your doctor may adjust the dose depending on the age and symptoms. Dose is usually 0.5 to 1 milligram (mg) divided in 3 doses and given 3 times a day. Some patients may have their dose divided in 2 doses and given 2 times a day.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Use the oral granules within 60 days after opening the bottle.

Precautions while using Cortef

If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any unwanted effects that may be caused by this medicine. Blood or urine tests may be needed to check for unwanted effects.

Not giving enough or stopping Alkindi® Sprinkle, or switching from other hydrocortisone medicine may cause serious adrenal gland problems (eg, adrenal crisis). Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, joint pain, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems (eg, Cushing's syndrome). Talk to your doctor right away if you have blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.

If you are using this medicine for a long time, tell your doctor about any extra stress or anxiety in your life, including other health concerns and emotional stress. Your dose of this medicine might need to be changed for a short time while you have extra stress.

This medicine may cause you to get more infections than usual. Avoid people who are sick or have infections and wash your hands often. If you are exposed to chickenpox or measles, tell your doctor right away. If you start to have a fever, chills, sore throat, or any other sign of an infection, call your doctor right away.

Check with your doctor right away if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. These may be symptoms of eye or vision problems (eg, cataracts, glaucoma, central serous chorioretinopathy). Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

While you are being treated with hydrocortisone, do not have any immunizations (vaccines) without your doctor's approval. Hydrocortisone may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while taking this medicine.

This medicine might cause thinning of the bones (osteoporosis) or slow growth in children if used for a long time. Tell your doctor if you have any bone pain or if you have an increased risk for osteoporosis. If your child is using this medicine, tell the doctor if you think your child is not growing properly.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain skin tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of Cortef

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Aggression
anxiety
blurred vision
burning, dry, or itching eyes
decrease in the amount of urine
discharge, excessive tearing
dizziness
dry mouth
ear congestion
fast, slow, pounding, or irregular heartbeat or pulse
fever
headache
irregular heartbeats
irritability
mental depression
mood changes
noisy, rattling breathing
numbness or tingling in the arms or legs
pounding in the ears
redness, pain, swelling of eye, eyelid, or inner lining of the eyelid
restlessness
runny or stuffy nose
shaking
sneezing
sore throat
swelling of the fingers, hands, feet, or lower legs
trouble breathing
trouble sleeping
trouble thinking, speaking, or walking
unusual tiredness or weakness
weight gain

Incidence not known

Backache
bloody, black, or tarry stools
cough or hoarseness
darkening of the skin
decrease in height
decreased vision
diarrhea
eye pain
eye tearing
facial hair growth in females
fainting
fever or chills
flushed, dry skin
fractures
fruit-like breath odor
full or round face, neck, or trunk
heartburn or indigestion (severe and continuous)
increased hunger
increased thirst
increased urination
loss of appetite
loss of sexual desire or ability
lower back or side pain
menstrual irregularities
muscle pain, tenderness, wasting, or weakness
nausea
pain in the back, ribs, arms, or legs
painful or difficult urination
skin rash
stomach pain or cramps
sweating
trouble healing
unexplained weight loss
vision changes
vomiting
vomiting of material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Hives
increased appetite
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
puffiness or swelling of the eyelids or around the eyes, face, or lips

Incidence not known