Hydrocortisone Tablets

What are hydrocortisone tablets?

Hydrocortisone tablets are a type of corticosteroid (a synthetic version of the hormone cortisol) used to replace or supplement natural cortisol in the body. Cortisol is essential for regulating metabolism, immune response, and stress. They are standard, slow-release, and soluble tablets only available on prescription, and may come under the brand names Plenadren or Efmody[1]. 

If you’ve been diagnosed with adrenal insufficiency, you will need to carry a red steroid emergency card (for adults) or an adrenal insufficiency card (for children). This is so that medical staff will know about your condition if you need emergency treatment[1]. 

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

What are hydrocortisone tablets used to treat?

Hydrocortisone tablets are primarily used for the following conditions[1]: 

• Adrenal insufficiency (e.g. Addison’s disease) 

• Congenital adrenal hyperplasia 

• Secondary adrenal failure (due to pituitary gland issues) 

• Occasionally for inflammatory or autoimmune conditions, though other steroids are more commonly used for these 

How do hydrocortisone tablets work?

Hydrocortisone mimics the natural hormone cortisol, helping to maintain blood pressure, regulate metabolism, control inflammation, and support the body’s response to stress[1]. 

Who can take hydrocortisone tablets?

Hydrocortisone tablets can be taken by adults and children with diagnosed cortisol deficiency or under medical supervision for adrenal disorders. Speak to your doctor first if you[1]: 

• Are allergic to hydrocortisone or its ingredients 

• Have untreated fungal infections 

• Have recently been vaccinated with live vaccines 

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

• Have ever had liver problems 

• Have ever had mental health problems 

• Have any unhealed wounds 

• Have heart failure or recently had a heart attack 

• Have high blood pressure, diabetes, glaucoma, epilepsy, an underactive thyroid, or osteoporosis 

• Have ever had a stomach ulcer 

• Are pregnant, trying to get pregnant, or breastfeeding 

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 typical dosage of hydrocortisone tablets?

Hydrocortisone tablets come as[1]: 

• standard tablets 

• slow-release tablets 

• slow-release capsules 

• soluble tablets that you dissolve in water 

They come in a range of strengths from 2.5mg to 20mg and your doctor will decide on the dose most suitable for your medical condition and history. After a few weeks, they may decide to increase your dose if needed, particularly if you are unwell with other health problems[1]. 

How do you take hydrocortisone tablets?

Hydrocortisone tablets should be taken as follows[1]: 

• Standard tablets: Take 2-3 times daily with food or a snack 

• Slow-release tablets: Once daily, in the morning, on an empty stomach 

• Soluble tablets: Dissolve in water and drink immediately 

Avoid drinking grapefruit juice, which can interfere with the medicine[1].

Can you stop taking hydrocortisone tablets?

Do not stop hydrocortisone tablets suddenly. Stopping abruptly can cause adrenal crisis, a life-threatening condition. Always taper off under medical supervision[1]. 

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

Taking too much can cause problems[1]: 

• Short-term overdose: Depending on how much extra you have taken, usually not dangerous but may cause side effects 

• Long-term overuse: Can lead to Cushing’s syndrome, osteoporosis, diabetes, or eye problems 

Seek emergency medical help if overdose is suspected [4]. 

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

If you forget your dose, take it as soon as you remember. If it’s close to the next dose, skip the missed one. Do not double up to make up for a missed dose[1]. 

How do you store hydrocortisone tablets?

Store hydrocortisone tablets as follows[1]: 

• At room temperature (below 25°C) 

• In original packaging 

• Protected from moisture and light 

• Out of reach of children 

What medicines can’t you take with hydrocortisone tablets?

Hydrocortisone may interact with[1]: 

• Live vaccines (e.g. MMR, yellow fever) 

• NSAIDs (e.g. ibuprofen) 

• Antifungals (e.g. ketoconazole) 

• Antibiotics (e.g. rifampicin) 

• Antiepileptics (e.g. phenytoin) 

• Diabetes medications (may need dose adjustment) 

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 tablets?

Side effects can occur, but hydrocortisone is not a strong steroid. It’s 4 times weaker than prednisolone, for instance and so you are unlikely to experience side effects. Side effects may include[1]: 

• Dizziness, weakness, or tiredness 

• Headaches 

• Muscle ache 

• Indigestion or nausaea 

• Diarrhoea 

• Swollen ankles 

• Mood changes or mental health changes 

Serious side effects are rare and occur in less than 1 in 1,000 people. They may include[1]: 

• Signs of an infection 

• High blood sugar (hyperglycaemia) 

• Adrenal gland problems 

• Low potassium levels 

• Heart palpitations 

• Pancreas problems 

• Breathlessness 

• Swelling of your limbs 

• Eyesight changes 

• Bruising or bleeding that is not normal, including blood in stool 

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 tablets

Do I need to take them for life? 
Yes, if you have adrenal insufficiency, but not for every condition[1]. 

Can I drink alcohol while taking them? 
In moderation, yes – but check with your doctor[1]. 

Can I take them with food? 
Yes, and it’s recommended to reduce stomach upset[1]. 

Do I need to carry a steroid card? 
Yes, especially if on long-term treatment[1]. 

Can I travel with them? 
Yes but carry extra doses and your steroid card[1]. 

Do they cause weight gain? 
Possibly, especially with long-term use[1]. 

Can I exercise while on them? 
Yes, and it’s encouraged to help manage side effects like weight gain and bone loss[1]. 

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