Hydrocortisone

What is hydrocortisone?

Hydrocortisone is a corticosteroid medicine used to reduce inflammation. It mimics the effects of natural steroids produced by your body and helps calm irritation, redness, and swelling[1].  

What is hydrocortisone used to treat?

Hydrocortisone is commonly used to treat[1]: 

• Inflammatory skin conditions such as eczema and dermatitis 

• Allergic reactions affecting the skin 

• Rashes and insect bites 

• Mild psoriasis 

• Nappy rash in children 

• Other conditions where inflammation needs to be controlled 

How does hydrocortisone work?

Hydrocortisone works by suppressing the immune response that causes inflammation. This reduces swelling, redness, and itching, helping the skin to heal[1].  

Who can take hydrocortisone?

Hydrocortisone creams and ointments can generally be used by most adults and children over one year of age when given on prescription. However, it may not be suitable for people who[1]: 

• Have infections on the skin, such as fungal, bacterial, or viral infections (unless advised by a doctor) 

• Have an eye infection 

• Are allergic to hydrocortisone 

• Are pregnant or breastfeeding (consult a doctor before use) 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the usual dose of hydrocortisone

The dosage of hydrocortisone depends on the condition and the form of medication prescribed. Here are typical guidelines[1]: 

• Tablets: Commonly 20mg per day, divided as 10mg in the morning, 5mg at midday, and 5mg in the afternoon 

• Creams/ointments: Usually applied once or twice daily for no more than 7 days unless advised otherwise 

• Injections: Administered by a healthcare professional for joint or severe inflammation 

• Suppositories and buccal tablets: Used as directed based on the site of symptoms 

How to take hydrocortisone

Proper use depends on the form of hydrocortisone prescribed[1]: 

• Tablets: Swallow with water; avoid taking with antacids which may reduce absorption 

• Creams/Ointments: Apply a thin layer to the affected area – do not use more than recommended 

• Buccal tablets: Stick to the inside of the mouth and allow to dissolve completely 

• Suppositories: Insert into the rectum as directed 

Can you stop taking hydrocortisone?

Yes, hydrocortisone treatment can usually be stopped once symptoms improve. However, it is important not to stop abruptly if you have been using it for a long time or on large areas. Follow your doctor’s advice in these cases[1].  

What do you do if you take too much hydrocortisone?

Taking too much hydrocortisone can result in systemic side effects. Watch for symptoms like[1]: 

• Headache 

• Insomnia 

• Mood changes, such as anxiety or irritability 

• High blood pressure 

• Weight gain 

If you suspect an overdose, seek medical attention immediately. 

What do you do if you forget a dose of hydrocortisone?

If you miss an application, use it as soon as you remember. If it’s nearly time for your next dose, skip the missed application and continue as usual. Do not double the dose[1]. 

Medicines to avoid when taking hydrocortisone

Hydrocortisone can interact with several medications. Use caution or avoid combining it with[1]: 

• NSAIDs (e.g., ibuprofen), which may increase risk of stomach irritation 

• Blood thinners (e.g., warfarin), which may affect bleeding risk 

• Vaccines, especially live vaccines (e.g., MMR, yellow fever) 

• Antibiotics or antifungals, such as erythromycin or ketoconazole, which may alter hydrocortisone levels 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of hydrocortisone?

Hydrocortisone is generally safe when used correctly, but it can cause side effects. 

The most common side effects include[1]: 

• Skin thinning (with long-term cream use) 

• Increased appetite and weight gain 

• Mood changes, including anxiety or depression 

• Sleep disturbances 

• High blood pressure 

• Increased risk of infections 

Serious but rare side effects may include[1]: 

• Adrenal suppression 

• Fatigue 

• Weakness 

• Low blood sugar 

• Weight loss 

• Poor concentration 

• confusion 

• Cushing’s syndrome with long-term high-dose use 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include:   

• Difficulty breathing   

• Tightness in throat and chest   

• Swelling of the tongue or throat   

• Feeling faint or dizzy   

• Blue/grey skin or lips   

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about hydrocortisone

Is hydrocortisone safe for long-term use? 
Yes, under medical supervision. Long-term use may require monitoring for side effects like adrenal suppression[1]. 

Can I drink alcohol while taking hydrocortisone? 
Yes, but drink in moderation – especially if you're also using NSAIDs, which can irritate the stomach lining[1]. 

Do I need to carry a steroid card? 
Yes, if you're on long-term oral hydrocortisone. It alerts emergency providers to your steroid use[1]. 

Can I use hydrocortisone cream on my face? 
Only if specifically prescribed. The facial skin is delicate and more prone to thinning[1]. 

For the official NHS guide for hydrocortisone, visit their website.