Hydrocortisone tablets

About hydrocortisone tablets

Hydrocortisone tablets are a type of medicine known as a steroid (or corticosteroid). Corticosteroids are not the same as anabolic steroids.

Hydrocortisone tablets work as a hormone replacement for a natural hormone called cortisol.

You may take hydrocortisone tablets if your body does not make enough cortisol – for example if you have Addison's disease or if you've had your adrenal glands taken out.

They can also be prescribed for hypopituitarism, a rare condition affecting the pituitary gland.

Hydrocortisone tablets come as standard tablets, slow-release tablets and soluble tablets. These are only available on prescription.

Other types of hydrocortisone

There are different types of hydrocortisone, including skin treatments and injections.

Find out more about other ways you can use hydrocortisone to treat different health problems.

Key facts

Who can and cannot take hydrocortisone tablets

Hydrocortisone tablets can be taken by adults and children.

Hydrocortisone tablets are not suitable for some people. Tell your doctor before starting the medicine if you:

How and when to take hydrocortisone tablets

Dosage

Hydrocortisone tablets come as standard or slow-release tablets. They are also available as a soluble tablet that you dissolve in water before use.

Your pharmacist or doctor will tell you which type of hydrocortisone tablets you're taking and how to take them. Always follow the instructions that come with your medicine.

Hydrocortisone comes as 5mg, 10mg and 20mg tablets.

If you take hydrocortisone tablets for hormone replacement the usual dose is 20mg to 30mg a day, split into 2 doses. The first dose in the morning may be larger than the second dose in the evening.

If you have an infection, or if you need to have dental treatment or an operation, you'll probably need to take a higher dose for a while.

How to take standard tablets

Standard tablets start to release the medicine into your body as soon as you swallow them.

You’ll usually take them 2 or 3 times a day. Take the tablets with or just after a snack or meal. This is so they do not upset your stomach.

How to take slow-release tablets

Some hydrocortisone tablets are slow release (also known as modified release). These tablets release the medicine into your body gradually throughout the day.

You’ll usually take slow-release tablets once a day.

Take them in the morning, around half an hour before breakfast. Swallow them whole. Do not break or crush the tablets, as they will not work properly.

Do not eat grapefruit or drink grapefruit juice while you're being treated with hydrocortisone tablets. Grapefruit can change the way hydrocortisone works and increases the risk of side effects.

How to take soluble tablets

Some hydrocortisone tablets need to be dissolved in at least 50ml of water immediately before swallowing. Make sure you swallow all of the liquid, otherwise you may not get all of the dose. The hydrocortisone starts to be absorbed as soon as the liquid is swallowed.

You’ll usually take soluble tablets 3 times a day. Take the tablets with or just after a snack or meal. This is so they do not upset your stomach.

What if I forget to take a tablet?

Try to remember to take your tablets every day. Regularly missing doses can make you feel unwell.

If you forget to take a dose, take it as soon as you remember. If you do not remember until the next dose is due, skip the missed dose.

Never take 2 doses to make up for a forgotten one.

If you often forget to take your tablets, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicine.

Will the dose I take go up or down?

Your doctor may increase or decrease your dose of hydrocortisone during the first weeks or first month of your treatment until your health problem is stable.

You may need a bigger dose for a while if you are unwell with other health problems such as an infection, or if you need to have an operation.

You may need a short, very high dose of hydrocortisone if you have Addison's disease and your cortisol levels drop suddenly. This is a medical emergency called an adrenal crisis.

If you have been diagnosed with adrenal insufficiency you will need to carry a steroid emergency card with you. If you need emergency treatment, this will tell medical staff about your condition and how to treat you.

What if I take too much?

Taking too many hydrocortisone tablets as a one-off is unlikely to harm you. If you're worried, talk to your doctor or pharmacist.

If you take too much hydrocortisone for more than a few days, it could harm your health. Talk to your doctor as soon as possible.

Side effects

Common side effects

Like all medicines, hydrocortisone tablets can cause side effects although not everyone gets them.

Hydrocortisone is not a strong steroid so you're unlikely to get side effects. It's 4 times weaker than another widely used steroid called prednisolone.

These common side effects happen in more than 1 in 100 people.

Keep taking the medicine, but tell your doctor if the side effects bother you or don't go away:

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

You're more likely to get serious side effects if you take high doses of hydrocortisone over many months.

Contact your doctor straight away if you:

Side effects can happen at different times. An upset stomach or mood changes can happen straight away. Other side effects, such as getting a rounder face, happen after weeks or months.

Children and teenagers

If your child or teenager takes hydrocortisone tablets for more than a year or so, it can slow down their normal growth.

Your child's doctor will monitor their height and weight carefully for as long as they're having treatment with hydrocortisone. This will help them spot any slowing down of your child's growth and change their treatment if needed.

Even if your child's growth slows down, it does not seem to have much effect on their overall adult height.

Talk to your doctor if you're worried about your child taking hydrocortisone tablets.

Serious allergic reaction

It's extremely rare to have an allergic reaction (anaphylaxis) to hydrocortisone tablets but if this happens to you, contact a doctor straight away.

These are not all the side effects of hydrocortisone tablets. For a full list see the leaflet inside your medicine packet.

How to cope with side effects of hydrocortisone

Protecting yourself from long-term effects

What to do about:

You may take hydrocortisone tablets for a long time, even for the rest of your life. Over many years hydrocortisone can have several harmful effects on your body. It can lead to:

If you have to take hydrocortisone tablets for a long time, it's worth taking these steps to stay as healthy as possible:

Pregnancy and breastfeeding

Hydrocortisone tablets and pregnancy

Hydrocortisone tablets can be taken in pregnancy.

Your doctor will only prescribe them if the benefits of the medicine outweigh the risks.

If you're taking hydrocortisone tablets for Addison's disease, it's important to carry on taking the medicine throughout pregnancy. Sometimes, your dose may need to increase and it's usual to receive high doses of hydrocortisone by injection during childbirth.

Hydrocortisone tablets and breastfeeding

You can take hydrocortisone tablets while you're breastfeeding. Hydrocortisone does get into breast milk, but in amounts that are usually too small to harm your baby.

If you’re taking a total dose of more than 160mg of hydrocortisone each day for a long time, your baby may need extra monitoring.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible

Important

For safety, tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

For more information about how hydrocortisone can affect you and your baby during pregnancy, read this leaflet on steroids on the Best Use of Medicines in Pregnancy (BUMPs) website.

Cautions with other medicines

There are many medicines that can affect the way hydrocortisone tablets work.

It's important to ask your doctor or pharmacist if a medicine is safe to take with hydrocortisone tablets before you start taking them. This includes prescription medicines and ones that you buy such as paracetamol and ibuprofen.

Common questions about hydrocortisone tablets

How do hydrocortisone tablets work? How long will I take hydrocortisone tablets for? What happens if I stop taking hydrocortisone tablets? Why do I need to be careful of infections? Can I have vaccinations? Do I need to carry a steroid card? Will it affect my fertility? Will it affect my contraception? Can I drink alcohol with it? Is there any food or drink I need to avoid? Are there other steroid tablets available?