Hydrocortisone Solution

What is this medication?

HYDROCORTISONE (hye droe KOR ti sone) treats low levels of cortisol in the body (adrenal insufficiency). It works by replacing cortisol normally made by the body. Cortisol is a hormone that plays an important role in how the body responds to stress, illness, and injury. It belongs to a group of medications called steroids.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Khindivi

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Diabetes or high blood sugar levels (prediabetes)
• Feel unwell, or your body is under stress because of trauma or surgery
• Having surgery
• Infection
• Nausea, vomiting, or diarrhea
• Recent or upcoming vaccine
• Stomach or intestine problems
• An unusual or allergic reaction to hydrocortisone, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

Take this medication by mouth with water. Take it as directed on the prescription label at the same time every day. Use a specially marked oral syringe to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. You can take this medication with or without food. If it upsets your stomach, take it with food. Keep taking it unless your care team tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 5 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Talk to your care team about what to do if you vomit after taking your dose.

What may interact with this medication?

Do not take this medication with any of the following:

• Desmopressin
• Iopamidol
• Live virus vaccines
• Metyrapone

This medication may also interact with the following:

• Cyclosporine
• Estrogen hormones
• Grapefruit juice
• NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
• Some antibiotics, such as clarithromycin, erythromycin, rifampin, rifabutin
• Some antivirals for HIV or hepatitis
• Some medications for diabetes, such as glipizide or glyburide
• Some medications for fungal infections, such as ketoconazole, itraconazole, posaconazole
• Some medication for seizures, such as carbamazepine, phenobarbital, phenytoin, primidone
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

Do not suddenly stop taking this medication. You may develop a severe reaction. Your care team will tell you how much medication to take. If your care team wants you to stop the medication, the dose may be slowly lowered over time to avoid any side effects.

If you are going to need surgery or a procedure, tell your care team that you are taking this medication.

This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication. Tell your care team if you take medications for diabetes. They may need to help you adjust your dose.

This medication may slow your child's growth if it is taken for a long time at high doses. Your child's care team will monitor their growth.

Using this medication for a long time may weaken your bones. The risk of bone fractures may be increased. Talk to your care team about your bone health.

Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Change in vision
• Cushing syndrome—increased fat around the midsection, upper back, neck, or face, pink or purple stretch marks on the skin, thinning, fragile skin that easily bruises, unexpected hair growth
• High acid level—trouble breathing, unusual weakness or fatigue, confusion, headache, fast or irregular heartbeat, nausea, vomiting
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• Increase in blood pressure
• Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
• Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
• Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
• Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
• Swelling of the ankles, hands, or feet

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Acne
• General discomfort and fatigue
• Increase in appetite
• Headache
• Nausea
• Trouble sleeping
• Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store in a refrigerator or at room temperature between 20 and 25 degrees C (68 to 77 degrees F). Protect from light. Avoid exposure to heat.Get rid of any unused medication 120 days after opening the bottle or after the expiration date, whichever is first.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put in the trash, empty the medication out of the container. Mix it with cat litter, dirt, coffee grounds, or another unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.