Hydrocortisone (suspension, drops, ointment): instruction manual and cost
Existing forms of the drug
The drug is available in the form of:
- suspension 1 ampoule of 2.5% hydrocortisone acetate. Release ampoules 1 or 2 ml is Used for intramuscular injections, and injected the drug into the joint. Average cost 250 rubles per package;
- powder vials – used for the preparation of injection solution. Contains hydrocortisone sodium gemisuktinat. It is used to put into the muscle or intravenously. The dosage of 100 mg and 500 mg. Cost about 170 rubles;
- «Cortef» tablets – available in 5, 10, and 20 mg, the price of 450 rubles;
- ointment for application to the skin (in tubes) – made in the dose of 5, 20, 30 g, average price of 100 RUB.;
- ointment ophthalmic Hydrocortisone in tube (3, 5 or 10 grams). The value of 50 rubles.;
- eye ointment Hydrocortisone POS (contains concentrated formula), the price of 30-50 rubles;
- «Lokoid Chair» — is an emulsion consisting of hydrocortisone 17-butyrate 0.1%, the average price of 350 rubles;
- cream 10 mg in tube (hydrocortisone acetate 1%);
- eye drops;
- drops for ears.
The effect of the drug
The main effect of the drug on the body — anti-inflammatory and anti-allergic. Hydrocortisone affects the metabolism in the body. Due to this, insulin is produced more actively, and in the blood increases the content of glucose. The drug acts on the exchange of fluids and salts, it detains sodium and water and excretes the calcium.
Hydrocortisone is an immunosuppressant, that is, has the ability to suppress the immune system. This property is due to its use in diseases caused by autoimmune disorders. The drug does not allow to grow lymphatic, and connective tissue. It also strengthens the small blood vessels.
The effect of drugs depending on the species
Powered by one active substance, the drugs act in different ways. Drugs Hydrocortisone can have the following composition:
- hydrocortisone acetate;
- hydrocortisone succinate or hemisuccinate.
These two compounds represent compounds of the same substance. The difference between them lies in the fact that succinate and hemisuccinate dissolved in water, and the acetate is not soluble. The drugs for injection containing succinates shorter.
Succinate hydrocortisone helps with inflammation. And the drug has a hormonal effect, it is used in diseases of the endocrine organs, acute insufficiency of the adrenal glands.
Hydrocortisone acetate is a tool for the treatment of inflammatory processes and allergies. It is an antihistamine substance. It is used topically and in the form of injections inside the muscle or joint.
Entering into joint therapeutic effect of the drug occurs within 5-24 hours and can last for several days (in some cases, the action does not stop for several weeks). The ointment of acetate of Hydrocortisone is used for inflammation of the eyes, it is especially effective if the inflammation is due to allergies.
The movement of drug in the body
If Hydrocortisone is administered intramuscularly, it its absorption in the body happens slowly, it can take up to 2 days. For intravenous injection, the drug has a therapeutic effect within 15 minutes.
If you want to maintain a constant level of medication in the patient’s blood, the drug is administered 4-6 times a day. After the ingestion of the substance enters into the circulatory system. Then Hydrocortisone comes into contact with proteins. Then the drug is recycled in the liver and excreted through the kidneys. Full withdrawal medication takes 3 to 5 days.
The local application in the form of ointments, Hydrocortisone is absorbed into the top layer of skin. A small portion of the drug can be absorbed into the bloodstream and have an overall effect on the organism as hormonal drug.
Absorption is enhanced if the ointment is often and long used on large areas of skin. The dressing on the area of skin ointment is also intensifies the absorption. Easily Hydrocortisone enters the bloodstream in children, so children hormonal ointments applied with caution for small areas of the skin briefly. Absorbed into the bloodstream Hydrocortisone, then metabolized by the liver and exits the body with urine and bile.
Eye ointment is absorbed into the skin layers, but poorly penetrates into the eyeball.
In what diseases is used the drug?
The drug has a varied effect on the body. Therefore, the indications for the use of this medication a lot. Different forms of release of Hydrocortisone used in the treatment of various diseases.
The drug can be used in case of lack of the body’s own nadpochechnikovaya hormones, for example, in the following diseases:
- acute adrenal insufficiency;
- Addison’s disease;
- liver failure;
- hepatic coma.
Hydrocortisone used in the treatment of inflammatory processes:
- different types of arthritis;
The drug is used for treatment of systemic collagen diseases and other rheumatic diseases, as an immunosuppressive agent:
- Crohn’s disease;
- ulcerative colitis;
- systemic lupus erythematosus;
- rheumatoid arthritis;
- rheumatic carditis.
Hydrocortisone is used in shock therapy:
- collapse from failure of adrenal function;
- the shock and trauma of the heart attack.
In allergic diseases, the drug is used as an antihistamine:
- bronchial asthma and Ostrobothnia condition;
- hay fever;
- Allergy serum infusion.
Hydrocortisone injected into the joint under the following conditions:
- inflammation of the synovial membrane of the joint (synovitis);
- bags inflammation of the joint (bursitis);
- carpal tunnel syndrome;
- arthritis, osteoarthritis;
- inflammation of the connective tissue around a tendon (tenosynovitis);
Indications to application of local ointment Hydrocortisone
The ointment used in the following skin diseases:
- itching of the skin;
- all types of dermatitis;
- atopic dermatitis;
- itching and Allergy after bite insect.
What diseases are treated with eye ointment and drops?
Eye ointment and eye drops Hydrocortisone used in the treatment of:
- eye inflammation;
- conjunctivitis, blepharitis and blepharoconjunctivitis (including allergic origin);
- skin lesions of the eyelids;
- burns to the eyes;
- after eye operations;
- inflammation of the cornea (keratitis);
- inflammation of the iris (iritis);
- inflammation of the iris and ciliary body (iridocyclitis);
- inflammation of the choroid (uveitis, horioidita).
Under what conditions Hydrocortisone is contraindicated?
Hydrocortisone is a potent hormonal drug. For different forms of production of Hydrocortisone, has its own contraindications.
Contraindications to the injections
For intramuscular and intravenous Hydrocortisone contraindications are as follows:
- adenoma pituitary region;
- severe hypertension;
- HIV infection;
- mental disorders;
- stomach ulcer or duodenum;
- diabetes mellitus;
- chronic and acute kidney failure;
- epileptic seizures;
- peptic ulcer;
- tuberculosis in the open form;
- fungal infection;
- children under one year;
- after the vaccination.
Contraindications to the use of skin ointments
There are several situations where the application of skin ointment is contraindicated:
- infectious skin diseases (including viral and fungal infections);
- tuberculosis of the skin;
- wounds and scratches on skin;
- skin tumors;
- syphilitic rashes on the skin;
- children up to two years;
- after a vaccination.
Contraindications to the use of eye shapes
Contraindications to the use of ointments and drops for eyes can be of the following diseases:
- viral inflammatory diseases of the eye;
- purulent inflammation of the eye;
- fungal diseases of the eye;
- the course of vaccination;
- damage to the cornea.
Can I apply Hydrocortisone for pregnant women and nursing mothers?
Hydrocortisone can penetrate the barrier of the placenta. Medicine does not have precise data on the impact of Hydrocortisone on the development of a fetus. But there is a possibility that there may be anomalies of development.
Therefore, Hydrocortisone during pregnancy use cautiously. The doctors:
- how much therapy is needed for most women;
- how risky intervention for the child’s future.
If women higher benefit than risk to the fetus, the drug is prescribed, but for a short time and in very small doses.
If a woman during pregnancy taking Hydrocortisone, then the child should be observed, as there is a risk of congenital insufficiency of the adrenal cortex.
Side effects of the drug
Instructions for use of Hydrocortisone suggests that during the drug the possible side effects. Such effects can occur in any method of use of the drug as when administered through injection and for external use. This phenomenon is associated with hormonal activity of the drug and its ability to influence metabolism in the body.
Side effects of intramuscular and intravenous injections
Of the heart and blood vessels can be observed:
- cardiac arrhythmia;
- stagnant processes in the heart.
From the side of musculoskeletal system:
- weak muscles from taking steroid hormones (steroid myopathy);
- brittle bones, frequent fractures;
- necrotic changes in the heads of the bones (especially humerus and ulna);
- muscle cramps.
Signs of the metabolism:
- violations of water-salt metabolism (delay sodium and water, loss of calcium);
- disorders of acid-base balance due to loss of potassium (hypokalemic alkalosis).
Symptoms of the glands of internal secretion:
- signs of the syndrome Itsenko-Kushinga (obesity, Crescent-shaped red face, hirsutism);
- menstrual cycle;
- the rise in blood sugar, decrease of the therapeutic effect of hypoglycemic drugs;
- in children — delayed growth.
From the nervous system:
- mental disorders;
- intracranial hypertension.
- inflammation of the pancreas (pancreatitis);
- ulcerative lesions of the gastrointestinal tract.
Other side effects:
- large and small hemorrhages under the skin;
To reduce such symptoms during treatment, you need to eat right. During treatment the patient need to consume more calcium from food, and foods with sodium is better to exclude. It is necessary to control the level of glucose and blood pressure.
Side effects when applied to the skin ointment Hydrocortisone
When using the ointment on the skin can occur following phenomena:
- irritation, burning, redness and itching of the skin in the area of application of the ointment;
- increased body hair (hypertrichosis);
- the skin can change color;
- prepodobna rash;
- atrophic cutaneous manifestations;
- the extension of the cutaneous vessels;
- the formation of stretch marks (striae) on the skin.
If the ointment is applied to extensive areas of skin for a long time, possible side effects related to hormonal action of the drug:
- obesity, red Crescent-shaped face, stretch marks (striae);
- suppression of adrenocortical function;
- the rise in blood sugar and urine.
Side effects in the treatment of eye ointment and drops
Treatment with eye ointment and drops is usually carried out for a period of not more than two weeks to avoid the following manifestations:
- redness of the eyes, burning sensation;
- glaucoma, cataracts;
- eczematous inflammation of the eyelids;
- bulging eyes (exophthalmos);
- perforation of the cornea (if there is trauma to the eye).
How to use Hydrocortisone?
Instructions for use powder Hydrocortisone suggests that the tool introduced into the body in the form of a solution for intravenous or intramuscular injections.
Intravenous prescribed for acute diseases. First introduced 100 mg dose and then increase gradually adjusted to 500 mg. Intravenous infusion do every 4-6 hours to keep the body a constant dose of the drug. This method is administered the drug the first day. In the following days the dose is adjusted to 1000-1500 mg. This dose is administered until, until you get improvement.
Long-term injections are not administered due to the possible delay of sodium. If you need a long therapy, the patient is transferred to another drug.
For children using inhalation with a solution of powder of Hydrocortisone. Children’s dose of not more than 25 mg per day. When inhaled, the drug will not provide local and General effects on the body.
The vial was shaken and injected intramuscularly from 50 to 1500 mg of the drug per day (adults). Instructions for use of Hydrocortisone suggests that for children the dosage of the drug should be calculated on the basis of their body weight. Per 1 kg of weight of the child, apply 1-2 mg of Hydrocortisone in the day turns 6-9 mg per 1 kg of body weight.
In severe cases, adults the drug is administered every 4 hours for 150 mg.
Intra-articular injections do children over 14 and adults 5-50 mg, young children — Usually 5-25 mg. for pain relief requires 3-5 injections.
For imposing inside of the joint is used as a suspension of Hydrocortisone with the anesthetic Lidocaine, which gives even more analgesic effect. This version of the drug called Hydrocortisone Richter. For adults the dosage is 5-50 mg daily. In children the dose depends on age:
- from 3 months to 1 year — 25 mg;
- to 6 years — 25-50 mg;
- 6 to 14 years — 50 mg.
Treatment with intraarticular injection can be repeated at most 3 times a year. Repeat courses of treatment is possible after 3 weeks. More frequent treatment is not recommended because the drug is bad for cartilage. When inflammation of the tendon injections can only be done in the area of the vagina of the tendon. Directly into the tendon the drug is not administered.
How to apply ointment for the skin?
The ointment is applied to skin in a thin layer. Sometimes areas of skin treated with ointment, bandage. The dressing should be changed every 1-2 days. The treatment lasts 1-3 weeks. However, if after 7 days of applying the ointment, no positive changes in the patient’s condition, ointment overturned. Ointment Hydrocortisone should be applied with caution, especially on the face, and to ensure that the composition does not fall into the eyes.
If the ointment is applied for a long time, it is necessary diet. The diet should include protein foods, and limit sodium.
In children the ointment is used only for a short time, in small areas of the body and under the constant supervision of a physician. In children the ointment penetrates easily into the blood, which leads to growth retardation and adrenal insufficiency. In the treatment of children do not apply bandage with ointment.
The use of eye ointments and drops
You can pull the lid and lay in the patient’s eyes small amount of ointment from a tube (1-2 cm). The procedure is performed 3 times a day. You should then close your eyes.
During treatment ointment can not wear lenses. You need to regularly measure the pressure inside the eye. If both treatments are used eye drops, apply the ointment only after 15-20 minutes.
A suspension of Hydrocortisone can be applied in the form of drops. Instilled into each eye, 2 drops 4 times a day.
Storage, sale, shelf life
Ampules and vials stored at temperatures above 20 degrees. Ointment stored in a cool place (5-15 degrees). Form for injection store about 5 years and ointment (cutaneous and ocular) is 3 years. You should not use an expired form of hydrocortisone, the drops of which have a cloudy precipitate.
Ointment Hydrocortisone is a drug not requiring a prescription. Hydrocortisone for injection is prescribed by doctor and dispensed by prescription.
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