Hydrocortisone Injections

What are hydrocortisone injections?

Hydrocortisone injections are a type of corticosteroid medicine used to reduce inflammation and mimic the effects of cortisol, a hormone naturally produced by the adrenal glands. These injections are prescription-only and will be administered by a healthcare professional. They may be administered into a muscle, or vein depending on the condition being treated[1]. 

You can also find advice here on hydrocortisone, hydrocortisone buccal tablets, hydrocortisone for piles, hydrocortisone for skin, hydrocortisone rectal foam, and hydrocortisone tablets. 

What are hydrocortisone injections used to treat?

Hydrocortisone injections are prescribed to manage various medical conditions. These include[1]:

• Inflammatory joint conditions such as arthritis and bursitis 

• Endocrine disorder such as adrenal insufficiency, including Addison’s disease 

• Severe allergic reactions 

• Autoimmune diseases 

• Skin disorders, including Stevens-Johnson syndrome 

• Severe asthma or COPD flare-ups 

• Gastro-intestinal diseases including ulcerative colitis 

• Medical emergencies including shock caused by adrenal crisis 

How do hydrocortisone injections work?

Hydrocortisone provides therapeutic effects through several mechanisms[1]:

• Suppressing immune responses to reduce inflammation 

• Replacing naturally occurring glucocorticoids in individuals with adrenal insufficiency 

• Reducing swelling, redness, and discomfort in affected tissues

Who can take hydrocortisone injections?

Hydrocortisone injections are suitable for most adults and children. However, you should speak to a doctor or pharmacist if you[1]: 

• Have severe infections unless concurrently treated 

• Have ever had depression or manic depression (bipolar disorder) 

• Have recently been in contact with someone with chickenpox, shingles, or measles 

• Have recently received a vaccination or are due to have one 

• Have any unhealed wounds, high blood pressure, glaucoma, osteoporosis, or diabetes 

• Are allergic to hydrocortisone or its ingredients listed as part of the medicine 

Please note this list is not exhaustive, always 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 typical dosage of hydrocortisone injections?

Dosing is tailored to the individual, their condition, and where the dose will be administered. Your doctor or pharmacist will determine the most appropriate dose and frequency. They usually help with pain and swelling for around two months, but the number of injections is decided by the doctor based on your full medical information[1]. 

How do you take hydrocortisone injections?

Administration methods include[1]: 

• Intramuscular injection (IM): Into a muscle 

• Intravenous injection (IV): Into a vein 

In emergencies such as adrenal crisis, trained individuals may administer injections at home[1].

Can you stop taking hydrocortisone injections?

It is important not to stop hydrocortisone injections suddenly, particularly if used long-term. Sudden cessation can lead to adrenal insufficiency. A doctor or pharmacist will guide you on how to taper the dose safely[1]. 

What do you do if you take too much hydrocortisone injections?

An overdose can cause symptoms such as[1]: 

• High blood pressure 

• Swelling 

• Elevated blood sugar 

• Mood changes 

Seek immediate medical attention if an overdose is suspected.

What do you do if you forget to take hydrocortisone injections?

If you miss a dose[1]:

• If you miss a regular injection, contact your healthcare provider to reschedule. 

• Missing a dose in an emergency such as adrenal crisis canbe serious. Carry an emergency injection kit if advised. 

How do you store hydrocortisone injections?

Store in a cool, dry place below 25°C. Keep in the original packaging. Do not use after the expiry date. Keep out of reach of children[1]. 

What medicines can’t you take with hydrocortisone injections?

Hydrocortisone may interact with the following[1]: 

• NSAIDs such as ibuprofen and aspirin 

• Diuretics 

• Vaccines, particularly live vaccines 

• Anticoagulants like warfarin 

• Antifungals such as ketoconazole 

• Antibiotics like rifampicin and clarithromycin 

Please note this is not a complete list, 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 injections?

Hydrocortisone injections can cause side effects. Common side effects include[1]: 

• Increased pain 

• Swelling at site of injection 

• Bruising 

Serious side effects that may require medical attention include[1]: 

• Underactive adrenal glands – ask your doctor for a steroid emergency card for adults or an adrenal insufficiency card for a child 

• Signs and symptoms of infection such as fever or sore throat 

• Vision disturbances 

• Stomach pain 

• Severe mood changes 

• Chest pain 

• Breathlessness 

• Throbbing or swelling in your arms or legs 

• Headaches with vomiting and fatigue 

• Signs of or complications of diabetes 

• Swelling in the face or limbs as a sign of Cushing’s syndrome 

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[1]:  

• 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 injections

How quickly do they work? 
Relief may begin within a few hours, especially with joint injections[1]. 

Are they painful? 
Mild discomfort may occur at the injection site[1]. 

How often can I have them? 
Your prescriber will make a decision depending on your condition[1]. 

Can I drink alcohol while on them? 
Yes, in moderation, but consult your doctor[1]. 

Can I travel with them? 
Yes. Bring a doctor's letter and store them in your hand luggage[1]. 

Are there alternatives? 
Yes, these include oral steroids and other anti-inflammatory treatments[1]. 

For the official NHS guide to hydrocortisone injections, visit their website.

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