Hydrocortisone (Cortef®)
What is hydrocortisone?
Hydrocortisone is a prescription medicine that replaces a hormone called cortisol.
Cortisol is important for:
- Energy
- Blood sugar control
- Blood pressure
- Helping the body respond to stress and illness
Hydrocortisone is commonly used in children with:
- Adrenal insufficiency
- Congenital adrenal hyperplasia (CAH)
- Addison disease
- Pituitary disorders
What do the adrenal glands do?
The adrenal glands are small glands located on top of the kidneys. They make hormones that help control:
- Stress response
- Blood pressure
- Energy levels
- Salt and water balance
Some children do not make enough cortisol and need hydrocortisone every day to stay healthy.
How is hydrocortisone taken?
Hydrocortisone is:
- Taken by mouth as a tablet or liquid
- Usually given 2 to 3 times each day
- Taken exactly as prescribed
It is important not to miss doses.
Do not stop hydrocortisone suddenly unless your healthcare provider tells you to.
What is stress dosing?
During illness, surgery, injury, or severe stress, the body normally makes extra cortisol.
Children taking hydrocortisone may need extra doses called “stress doses” during:
- Fever
- Vomiting
- Surgery
- Serious injury
- Severe illness
Your endocrinology team will give you a stress-dose plan.
Some children may also need an emergency hydrocortisone injection if they cannot keep medicine down by mouth.
What are common side effects?
Many children do well on hydrocortisone when taken at the correct dose. Possible side effects may include:
- Increased appetite
- Weight gain
- Mood changes
- Trouble sleeping
- Upset stomach
Long-term high doses may affect growth or bone strength.
When should I call the doctor?
Call your child’s healthcare provider if your child has:
- Vomiting or diarrhea
- Severe weakness
- Dizziness or fainting
- Trouble waking up
- Severe stomach pain
- Signs of dehydration
- Fever that does not improve
- Missed doses during illness
Seek emergency care right away if your child:
- Cannot keep medicine down
- Has severe weakness
- Becomes confused
- Has trouble breathing
- Has a seizure
These may be signs of an adrenal crisis, which is a medical emergency.
Important safety information
Your child may need:
- Regular clinic visits
- Blood tests
- Growth monitoring
- Dose changes as they grow
Always tell healthcare providers that your child takes hydrocortisone.
Many families carry:
- Emergency injection medicine
- A medical alert bracelet or necklace
- A copy of the stress-dose plan
Tips for families
- Give the medicine at the same times each day
- Never stop the medicine suddenly
- Learn when to give stress doses
- Keep emergency medicine available
- Bring medications when traveling
Your endocrinology team will teach you how to safely manage your child’s adrenal condition.
Questions?
If you have questions about hydrocortisone, contact your pediatric endocrinology team at Endo For Kids.
