The following are typical for all systemic corticosteroids. Their inclusion in this list does not necessarily indicate that the specific event has been observed with this particular formulation. Increases in ALT, AST and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation. There is no clinical syndrome of acute overdosage with hydrocortisone.
Hydrocortisone is dialyzable.
Following the initial emergency period, consideration should be given to employing a longer-acting injectable preparation or an oral preparation. When high-dose hydrocortisone therapy must be continued beyond 48 to 72 hours, hypernatremia may occur. Under such circumstances it may be desirable to replace hydrocortisone with a corticosteroid product such as methylprednisolone sodium succinate which causes little or no sodium retention. The initial dose of hydrocortisone is 100 to 500 mg or more depending on the severity of the condition. While the dose may be reduced for infants and children, it is governed more by the severity of the condition and response of the patient than by age or body weight but should not be less than 25 mg daily.