Suspension, tablets, IV ampoules, ointment, ophthalmic ointment Hydrocortisone: instructions for use, price and reviews

Release form

Lyophilized powder in bottles for the preparation of a solution for intravenous and intramuscular injections of 100 mg and 500 mg, a solvent (alcohol) in ampoules is included.

Suspension in ampoules for intramuscular and intra-articular injections 2.5% 1 ml, 2 ml.

Ointment 1% for external use, 5, 15, 20 and 30 g in a tube.

Eye ointment 0.5% 3.5.10 g in tube.

Eye ointment Hydrocortisone POS 1%, and 2.5% in a tube.

Cream 1% in a tube of 10 ml.

Tablets containing 5, 10 or 20 mg hydrocortisone are available under the name Cortef . An emulsion of 0.1% containing hydrocortisone 17-butyrate has the trade name Locoid Crelo .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Wikipedia defines hydrocortisone as a highly active adrenal hormone. It is similar to cortisone, but more active. It has a pronounced effect on the metabolism of carbohydrates, proteins and fats. In the liver, it enhances glycogen deposition and glucose synthesis, which activates the release of insulin. Increases blood glucose levels, retains sodium and water, and enhances the removal of calcium from the body.

Has anti-inflammatory , anti-allergic , anti-shock effects . Has immunosuppressive activity . Inhibits the development of lymphoid and connective tissue, reduces capillary permeability. In medical practice, natural hydrocortisone or its synthetic esters (acetate and sodium hemisuccinate) are used. Succinates and hemisuccinates dissolve in water and have a rapid but short-term effect when administered by injection. Acetates are suspensions insoluble in water.

Hydrocortisone acetate exhibits predominantly anti-inflammatory activity. Inhibits phospholipase A2, which leads to suppression of prostaglandin synthesis. Inhibits the migration of leukocytes, macrophages and mast cells to the site of inflammation, suppresses proteolytic activity, and retards the growth of fibroblasts. Inhibits the release of histamine. Reduces hypersensitivity reactions, exudative processes at the site of inflammation and hyperemia, has a slowly developing but long-lasting effect. It is used for injection into soft tissues and inside the joint. The effect of intra-articular injection is observed after 6-20 hours and lasts for several days and weeks. Local application of the ointment suppresses inflammatory and allergic reactions of the anterior segment of the eye. In terms of anti-inflammatory activity, it is weaker than prednisolone .

Hydrocortisone hemisuccinate has metabolic and anti-inflammatory effects. It is the drug of choice for acute adrenal insufficiency and other emergency conditions, and adrenogenital syndrome .

Pharmacokinetics

When administered intravenously, the effect is observed after 15 minutes. Binds to proteins by 40-90%. Metabolized in the liver. Excreted by the kidneys, T1/2 - 80-120 minutes. To maintain high concentrations in the blood, it is administered every 4–6 hours. When administered intramuscularly, it is absorbed slowly (up to 48 hours). Penetrates well through mucous membranes. 70% is metabolized in the placenta.

Hydrocortisone ointment penetrates the epidermis and accumulates there. It is slightly absorbed into the systemic circulation, producing a systemic effect. Absorption of the active substance increases when used over large areas, frequent use, when applied to the skin of the face and folds, under occlusive dressings. In children, absorption is more pronounced, and therefore is used in a limited area, not for long. With frequent use, the accumulation of the active substance in the skin increases. Biotransformed in the epidermis, absorbed into the systemic circulation, 90% binds to proteins, is metabolized in the liver, and excreted by the kidneys and bile.

Hydrocortisone ointment for eyes does not penetrate well through the cornea, but penetrates into the epidermis and mucosal epithelium. Penetration depends on the condition of the cornea and increases with inflammation or damage to the ocular mucosa.

Advantages of phonophoresis

Based on most clinical pictures, it is noted that physiotherapy has a positive effect on the dynamics of treatment, thus, the patient’s rehabilitation and recovery are many times faster. This happens for a number of reasons:

ultrasound promotes accelerated and deep penetration of medicinal substances into the skin and tissues, targeting the affected area;
there is no need to endure painful procedures and expose the body to stress;
affordable session cost and ease of use.

You need to know that phonophoresis will not give instant results. It will take several sessions to notice the effect of use. The medicine must accumulate in the skin within 5–7 days and reach the required therapeutic value. However, being developed quite a long time ago and being an old-generation drug, hydrocortisone has a number of serious contraindications.

Indications for use

Systemic use for replacement therapy and treatment of inflammatory processes:

adrenal insufficiency;
arterial hypotension;
cardiogenic and traumatic shock ;
thyrotoxic crisis;
hepatic coma;
collapse in Addison's disease ;
status asthmaticus;
serum sickness;
hay fever;
swelling of the larynx;
nephrotic syndrome;
acute liver failure;
exacerbation of ulcerative colitis and Crohn's disease ;
psoriatic and rheumatoid arthritis ;
acute gouty arthritis ;
juvenile arthritis;
systemic lupus erythematosus;
dermatomyositis;
spondylitis;
glenohumeral periarthritis;
rheumatic carditis.

Intra-articular and periarticular administration:

reactive synovitis;
acute bursitis ;
rheumatoid arthritis;
epicondylitis;
acute tenosynovitis ;
post-traumatic osteoarthritis ;
carpal tunnel syndrome.

Local application of ointment:

Contraindications

Hydrocortisone IV and IM is contraindicated for:

increased sensitivity;
severe course of hypertension;
Itsenko-Cushing's disease;
jade;
epilepsy;
peptic ulcer;
acute psychosis;
osteoporosis;
peptic ulcer;
active forms of tuberculosis ;
diabetes mellitus;
renal failure;
AIDS;
systemic mycoses;
post-vaccination period;
up to 1 year of age.

This form of release is contraindicated during pregnancy.

Local use of ointment is contraindicated in:

bacterial skin diseases;
viral and fungal skin lesions;
manifestations of syphilis ;
skin tuberculosis;
ulcers and skin wounds;
skin tumors;
rosacea;
perioral dermatitis;
acne vulgaris;
post-vaccination period;
under 2 years of age.

It is prescribed with caution for diabetes mellitus and systemic tuberculosis . Use with caution on the skin of the face due to the possibility of side effects ( telangiectasia , atrophy , perioral dermatitis ), even after short-term use. To prevent infectious skin lesions, hydrocortisone ointment is recommended to be prescribed in combination with antibacterial and antifungal agents.

Eye ointment is not prescribed for:

viral eye diseases;
violation of the integrity of the cornea;
tuberculosis, purulent and fungal eye infections;
during vaccination;
trachoma.

During pregnancy, local use is possible as prescribed by a doctor, if the expected effect exceeds the risk of possible complications for the fetus. The duration of use in pregnant women should not exceed 7–10 days.

Contraindications to the use of phonophoresis with hydrocortisone

it is forbidden to carry out during pregnancy, because ultrasound and hormonal drugs have a negative effect on the formation of the fetus and the woman’s well-being in general;
Oncological diseases at different stages, even during remission, are grounds for refusal to take a course of physiotherapy. This is based on excessive stimulation of cancer cells;
cardiovascular diseases, including supraventricular tachycardia and atrial fibrillation are a contraindication to the use of phonophoresis;
inflammation of the skin and mucous membranes at the sites of exposure to the device can provoke an exacerbation of diseases;

But the main contraindication in some cases remains hydrocortisone itself, which is a hormonal drug, with all the ensuing consequences and complications for patients. It is not recommended for children under two years of age, as well as for patients who have:

individual hypersensitivity to the components of the drug;
recent vaccination;
damage to the skin in the affected area;
bacterial and viral eye diseases;
dermatitis of various forms;
acne and blackheads.

Carefully:

pregnancy and lactation;
tuberculosis;
diabetes;
arterial hypertension;
diverticulitis and osteoporosis;
postoperative period in the acute phase;
fungal diseases;
acute endocarditis and nephritis;
renal failure;
tendency to form blood clots;
herpetic fever;
AIDS and HIV infection;
myasthenia gravis.

In addition, the following adverse reactions to phonophoresis with hydrocortisone may be observed, even when performing the procedure at home:

Endocrine system - hyperglycemia, increasing the required dose of insulin, renal failure, obesity due to excess hormones, growth retardation.
Musculoskeletal system - osteoporosis, vertebral fractures, aseptic necrosis, arthropathy, steroid myopathy, arthralgia.
Gastrointestinal tract - intestinal perforation, bleeding in the stomach, ulcers, dyspepsia, pancreatitis.
Skin - wound healing worsens, allergic reactions appear and skin color changes.
Central nervous system and visual organs - mental disorders, intracranial pressure, glaucoma and cataracts.

Side effects

Hydrocortisone in ampoules with intramuscular and intra-articular administration can cause:

sodium and fluid retention;
loss of potassium;
congestive heart failure;
heart rhythm disturbance;
hypokalemic alkalosis;
steroid myopathy;
necrosis of the heads of the humerus and femurs;
osteoporosis and pathological fractures;
ulcerative lesions of the gastrointestinal tract;
pancreatitis;
petechiae and ecchymoses ;
increased intracranial pressure;
mental disorders;
convulsions;
immunosuppression;
menstrual irregularities;
growth suppression in children;
Itsenko-Cushing syndrome.

To reduce adverse reactions, a diet rich in potassium and limited in sodium is prescribed. Control blood pressure, blood sugar and clotting.

External use of Hydrocortisone ointment can cause:

irritation at the site of application of the drug;
hyperemia;
burning;
itching and dryness;
striae;
skin depigmentation;
swelling;
atrophic changes;
hypertrichosis;
acne-like rash;
secondary infectious lesions;
telangiectasia.

With long-term use over large areas, systemic undesirable effects may occur, as a manifestation of the resorptive effect of the drug (suppression of the adrenal cortex, hyperglycemia , Cushing's syndrome , glycosuria ). To prevent infectious skin lesions, combination with antibacterial agents is necessary.

Hydrocortisone POS eye ointment, which has a higher content of active substance, causes:

burning;
redness of the sclera;
dermatoconjunctivitis;
eczema eyelids;
secondary steroid glaucoma (with long-term use);
exophthalmos;
cataract;
perforation of the cornea (if its integrity is violated);
addition of a secondary infection.

In this regard, the ointment can be used for up to 2 weeks.

Hydrocortisone-Richter

From the nervous system:

insomnia, irritability, anxiety, agitation, euphoria, epileptiform convulsions; mental disorders; delirium; disorientation; hallucinations; exacerbation of manic-depressive psychosis while taking the drug; depression; paranoia; increased intracranial pressure with swelling of the optic nerve nipple, dizziness; pseudotumor of the cerebellum; headache.

From the side of metabolism:

weight gain, negative nitrogen balance, increased sweating.

From the side of the organ of vision:

corneal ulceration; posterior capsular cataract (more likely in children); increased intraocular pressure with possible damage to the optic nerve; secondary bacterial, fungal, viral eye infections; trophic changes in the cornea; exophthalmos, glaucoma.

From the musculoskeletal system:

slower growth and ossification processes in children (premature closure of epiphyseal growth zones); osteoporosis; very rarely - pathological bone fractures; aseptic necrosis of the head of the humerus and femur; muscle tendon rupture; steroid myopathy; decreased muscle mass; arthralgia.

Effects due to the mineralocorticoid activity of the drug:

fluid and sodium retention with the formation of peripheral edema; hypernatremia; hypokalemia, arrhythmia, myalgia, muscle spasm, increased weakness, fatigue.

From the immune system:

opportunistic infections, exacerbation of latent tuberculosis, hypersensitivity reactions; local and generalized: skin rash, itching; anaphylactic shock; delayed wound healing; tendency to develop pyoderma and candidiasis, exacerbation of infections, especially with vaccination and simultaneous treatment with immunosuppressive drugs.

From the skin and mucous membranes:

petechiae; ecchymoses; hyper- or hypopigmentation; steroid acne; striae; folliculitis, hirsutism, telangiectasia.

Local reactions:

tissue swelling and pain at the injection site, which spontaneously disappear after a few hours, increased pain in the joint when the drug is injected into the joint, burning, numbness, paresthesia at the injection site, atrophy of the skin and subcutaneous tissue at the injection site (if accidentally administered into the deltoid muscle ), rarely - necrosis of surrounding tissues, scar formation at the injection site.

Instructions for use of Hydrocortisone (Method and dosage)

Hydrocortisone ointment, instructions for use

Apply a thin layer to the affected areas of the skin 2-3 times a day. The duration of treatment is 6-14 days, and if the course is persistent, it is extended to 20 days. For hypertrophic manifestations, they are used under occlusive dressings, which are changed after 24-48 hours. If after a week of treatment there is no improvement, the use of the drug is stopped and further treatment is agreed with the doctor. Avoid contact with eyes. Use with extreme caution on facial skin, as telangiectasia and atrophy may occur. For long-term treatment, a sodium-restricted diet is prescribed and sufficient protein is administered.

In children, suppression of the adrenal cortex develops more quickly, and the production of growth hormone is also reduced. Therefore, it is prescribed to children only under medical supervision. When used in children 1 year of age, limit the duration of treatment and do not use occlusive dressings. In cases where it is necessary to apply ointment to the face area under a bandage, the duration of treatment is limited to two weeks.

Unlike ointment, 1% cream (Nycomed) can be used for sunburn, photodermatitis and diaper rash in children. Can be used on the face.

Hydrocortisone eye ointment, instructions for use

Eye ointment is placed in the conjunctival sac behind the lower eyelid, and a 1-2 cm strip of ointment is applied 3 times a day. After the procedure, carefully close your eyes. The duration of treatment is up to two weeks and can be extended only as prescribed by a doctor.

Do not allow the tube to come into contact with the surface of the conjunctiva of the eye. Do not use contact lenses during treatment. When using drops simultaneously, the ointment is applied 15 minutes after instillation. When using the ointment for more than 2 weeks, intraocular pressure should be monitored.

Hydrocortisone suspension, instructions for use

Before use, shake the contents to obtain a homogeneous suspension. Hydrocortisone in ampoules is injected deep into the gluteal muscle 50-300 mg, maximum 1000-1500 mg per day. For life-threatening conditions, 150 mg is administered every 4 hours for the first two days, then after 8 hours. Children are prescribed 1-2 mg per kg of weight every 4 hours, the daily dose is up to 6-9 mg per kg of weight.

Adults and children over 14 years of age are given 5-50 mg into the joint cavity, and younger children 5-25 mg once a week. The course of treatment is 3-5 injections. The action begins within 6-20 hours and lasts several days or weeks.

Hydrocortisone Richter suspension containing hydrocortisone and lidocaine is injected only periarticularly or into the joint cavity. Adults 5-50 mg. A single dose for children aged 3 months to 1 year with periarticular administration is 25 mg, up to 6 years - 25-50 mg, 6-14 years - 50 mg.

Repeated administration is carried out after 3 weeks. It is injected into the same joint no more than 3 times a year, since it has an adverse effect on hyaline cartilage. For tendonitis, the injection is made into the tendon sheath (it cannot be injected into the tendon).

Instructions for the drug in ampoules (bottles)

Lyophilized hydrocortisone hemisuccinate powder is dissolved in the supplied diluent and administered intravenously or intramuscularly. In acute conditions, intravenous hydrocortisone is prescribed. At the beginning, a dose of 100 mg is administered over 30 seconds, then within 10 minutes it is increased to 500 mg (according to the severity of the condition). The injections are repeated every 2-6 hours. High doses are prescribed until the condition stabilizes (usually 48-72 hours). The daily dose is 1000-1500 mg. Typically, 2/3 of the dose is administered in the morning, and 1/2 in the afternoon. If long-term corticosteroid therapy is necessary, switch to another drug that does not cause sodium retention. The dose for children is at least 25 mg per day.

Hydrocortisone sodium hemisuccinate powder, which is highly soluble in water, can be used for inhalation using a nebulizer. Technically this is feasible, but the action will not be local, but systemic. This must be taken into account, especially when inhalations with hydrocortisone are performed for children; the daily dose in this case should not exceed 25 mg of the drug. Do inhalation in the morning and evening, no more than 5 days.

Physiotherapeutic local treatment with hydrocortisone gives good results, increases efficiency and is often used in the complex treatment of many diseases.

Ultrasound with Hydrocortisone

Ultrasound has a pronounced analgesic, antispasmodic and anti-inflammatory effect, stimulates blood circulation, improves trophism. As a result, the consequences of hemorrhages, infiltrates, traumatic edema and exudates resolve faster. During ultrasound therapy, ointment or gel based medications are additionally used. Their use allows you to achieve therapeutic concentration in the problem area. A moving technique is used: the area is lubricated with 1% ointment and, pressing the vibrator head tightly, move it in a circle or in the longitudinal direction. Before starting the procedures, it is necessary to take into account contraindications for ultrasound with Hydrocortisone:

systemic skin diseases;
pustular lesions at the site of the procedure;
skin cancer;
psychoneuroses;
pregnancy (second half);
arterial hypertension stage III;
severe atherosclerosis ;
heart rhythm disturbances;
arterial hypotension;
frequent attacks of angina pectoris ;
thyrotoxicosis;
osteoporosis;
complicated peptic ulcer ;
complicated myopia ;
severe diabetes mellitus

Phonophoresis with Hydrocortisone

From a technical point of view, the procedure differs little from ultrasound exposure. With phonophoresis, using high-frequency ultrasonic vibrations with an intensity of 800 to 3000 kHz, the medicinal substance is also injected into the damaged area. In this case, a suspension of hydrocortisone 5 ml, petroleum jelly and lanolin 25 g each

It is used for arthrosis, prostatitis , neuritis of the facial nerve , neurodermatitis , adnexitis , vulvar itching, sinusitis . A noticeable effect is observed after 5-6 procedures, and a lasting effect is observed after completing the full course.

Contraindications to phonophoresis with hydrocortisone include:

hypertension ;
heart failure;
heart rhythm disturbance;
thyrotoxicosis;
peptic ulcer;
severe diabetes mellitus
vibration disease;
osteoporosis;
bronchiectasis;
complicated myopia ;
syringomyelia.

It is worth considering general contraindications for physical procedures: cancer , bleeding, pregnancy.

Electrophoresis

This is a method of influencing the body with direct current and medicinal substances administered with its help. The active electrode of the device affects the problem area, and the indifferent electrode is in the patient’s hand. During the procedure, the drug is used in ampoules.

Indications for hydrocortisone electrophoresis include:

rheumatic diseases;
injuries;
arthrosis;
bursitis and tendovaginitis ;
dermatological diseases and their consequences in the form of scars (the external condition of the skin improves, scars are almost completely eliminated).

Hydrocortisone suspension for intra-articular and peri-articular injection 25mg+5mg/ml 5ml

Registration Certificate Holder

GEDEON RICHTER (Hungary)

Dosage form

Medicine - Hydrocortisone-Richter (Hydrocortisone-Richter)

Description

Suspension for intra-articular and periarticular administration

white or almost white in color, with a characteristic odor.

1 ml
1 fl.
hydrocortisone acetate 25 mg 125 mg lidocaine hydrochloride 5 mg 25 mg

Excipients

: propyl parahydroxybenzoate, methyl parahydroxybenzoate, sodium chloride, sodium phosphate, sodium dihydrogen phosphate, povidone, polysorbate 80, N,N-dimethylacetamide, water d/i.

5 ml - colorless glass bottles (1) - cardboard packs.

Indications

osteoarthritis involving multiple joints;
monoarthrosis (knee, elbow, hip joints);
arthritis of rheumatic or other etiology (except for tuberculous and gonorrheal arthritis);
glenohumeral periarthritis;
bursitis;
epicondylitis;
tenosynovitis;
for preoperative preparation for interventions on ankylosed joints;
as a local therapy in addition to systemic glucocorticosteroid therapy.

Contraindications for use

hypersensitivity to hydrocortisone and/or lidocaine, or any of the excipients;
intra-articular infection;
Itsenko-Cushing syndrome;
tendency to thrombosis;
systemic infection (sepsis) without specific antibacterial treatment;
as a treatment for Achilles tendon diseases;
I trimester of pregnancy.

Carefully:

peptic ulcer of the stomach and duodenum, herpes simplex, incl. ocular herpes (risk of corneal perforation), arterial hypertension, diabetes mellitus (or a family history of this disease); osteoporosis (increased risk of osteoporosis in postmenopause); chronic psychotic reactions; history of tuberculosis; glaucoma; steroid myopathy; epilepsy; chicken pox; chronic heart failure; old age (over 65 years), II-III trimesters of pregnancy, breastfeeding period.

pharmachologic effect

Hydrocortisone

- glucocorticoid agent (GCS). Has anti-inflammatory, anti-edematous effect. Inhibits the release of cytokines (interleukins and interferon) from lymphocytes and macrophages, inhibits the release of inflammatory mediators by eosinophils, disrupts the metabolism of arachidonic acid and the synthesis of prostaglandins. Reduces inflammatory cell infiltration, reduces the migration of leukocytes, incl. lymphocytes to the area of inflammation. When administered intra-articularly, the therapeutic effect occurs within 6-24 hours and lasts several days or weeks.

Lidocaine

- a local anesthetic with a membrane-stabilizing effect and a rapid analgesic effect.

Drug interactions

In patients with Addison's disease, hydrocortisone should not be injected into the joint area at the same time as taking barbiturates, since this combination can provoke acute adrenal insufficiency.

Caution should be exercised when using GCS simultaneously with the following drugs:

barbiturates, phenylbutazone, phenytoin, rifampicin, carbamazepine, primidone, aminoglutethimide (these drugs may reduce the effects of GCS);
inhibitors of the CYP3A isoenzyme, incl. some drugs for the treatment of HIV infection, for example, ritonavir, cobicistat (they increase the risk of developing systemic HP);
oral hypoglycemic drugs (an increase in the dose of oral hypoglycemic drugs may be required due to the hyperglycemic effect of GCS);
anticoagulants (with simultaneous use of GCS, the effectiveness of anticoagulants may increase or decrease);
salicylates (when GCS is discontinued, the concentration of salicylates in the blood serum may significantly increase and the risk of toxicity may increase. Since both salicylates and GCS have an ulcerogenic effect, the simultaneous use of these drugs may increase the risk of gastrointestinal bleeding and ulceration);
amphotericin, diuretics, theophylline, digoxin, cardiac glycosides (increased risk of hypokalemia);
oral contraceptives (increased concentration of corticosteroids in the blood serum);
antihypertensive drugs (GCS reduce the effectiveness of antihypertensive drugs);
mifepristone (reduced effectiveness of corticosteroids).

Dosage regimen

For local intra- and periarticular use.

The drug is not intended for systemic use. The drug Hydrocortisone-Richter should be administered intra- and periarticularly, depending on the size of the joint and the severity of the disease.

The injection is performed in compliance with the rules of asepsis and antisepsis. Shake the bottle before use. After opening the bottle, the suspension must be used within 1 hour. The rubber stopper can be punctured no more than 3 times. The rubber stopper must be disinfected before each puncture.

For tendonitis, the injection should be made into the tendon sheath; It is contraindicated to inject the drug directly into the tendon.

The drug Hydrocortisone-Richter should not be used to treat diseases of the Achilles tendon.

Adults:

5-50 mg of the drug Hydrocortisone-Richter, depending on the size of the joint and the severity of the disease.

Special patient groups

Children and adolescents under 18 years of age:

5-30 mg of Hydrocortisone-Richter per day, divided into several doses.
It is recommended to prescribe the drug in the lowest effective therapeutic dose and, if possible, for a short course. Elderly patients (over 65 years of age):
In elderly patients, it is recommended to use the same doses as in younger adult patients. In older patients, undesirable effects may be more pronounced.

In one day, the drug can be injected into no more than 3 joints; Repeated injection is possible if a 3-week interval is observed. Injecting the drug directly into a joint may have an adverse effect on hyaline cartilage, so the drug can be injected into the same joint no more than 3 times a year.

Overdose

Symptoms:

Depending on the amount of GCS and lidocaine entering the systemic circulation, local or systemic manifestations may be observed.

Treatment:

there is no specific antidote. Treatment is symptomatic.

Side effect

There are no data on the incidence of adverse reactions (HP).

Frequency unknown (frequency cannot be determined from available data).

Under certain conditions, in particular with prolonged topical use and/or the use of high doses of hydrocortisone and lidocaine, both substances can enter the systemic circulation in quantities sufficient to develop systemic HP.

Infectious and parasitic diseases:

opportunistic infections, exacerbation of latent tuberculosis.

From the blood and lymphatic system:

leukocytosis.

From the immune system:

hypersensitivity.

From the endocrine system:

with long-term treatment and/or use in high doses, suppression of the function of the adrenal cortex is possible.

From the side of metabolism:

increased appetite, fluid and sodium retention, hypokalemic alkalosis. Increased protein catabolism may cause a negative nitrogen balance. GCS reduce glucose tolerance and increase the need for hypoglycemic drugs.

Mental disorders:

insomnia, mental disorder.

From the nervous system:

increased intracranial pressure with swelling of the optic nerve, convulsions, dizziness, headache.

From the side of the organ of vision:

corneal ulceration, glaucoma, exophthalmos, chorioretinopathy, blurred vision.

From the heart:

the entry of lidocaine injected into the joint area into the systemic circulation (in a significant amount) can cause conduction disturbances and peripheral vasodilation; heart failure.

From the side of blood vessels:

thromboembolism, arterial hypertension.

From the digestive system:

peptic ulcer (in some cases with perforation and bleeding), gastric bleeding, pancreatitis, esophagitis, nausea.

For the skin and subcutaneous tissues:

delayed wound healing, skin atrophy, skin stretch marks, acne, itching, folliculitis, hirsutism, hypopigmentation, skin irritation, dry skin, thin and sensitive skin, telangiectasia.

From the musculoskeletal system:

osteoporosis, steroid myopathy, aseptic osteonecrosis, myalgia, arthralgia.

General disorders and disorders at the injection site:

fever, malaise. As with other local injections, when hydrocortisone is injected into a joint, you may experience pain and swelling at the injection site. As a rule, such reactions disappear spontaneously after a few hours.

Laboratory and instrumental data:

decreased potassium content in the blood, increased intraocular pressure, “occult” bleeding syndrome. A higher incidence of HP has been reported in elderly patients.

GCS should be used with caution in the following cases:

diabetes mellitus (or a family history of this disease); osteoporosis (increased risk of osteoporosis in postmenopause); arterial hypertension; chronic psychotic reactions; history of tuberculosis; glaucoma; steroid myopathy; peptic ulcer of the stomach or duodenum; epilepsy; herpes simplex, incl. ocular herpes (risk of corneal perforation); chicken pox.

Use in pediatrics

When taking GCS, a slowdown in the growth rate of children and adolescents is observed. It is recommended to prescribe the drug in the lowest effective therapeutic dose and, if possible, for a short course. The dose of GCS should be reduced gradually, until the drug is completely discontinued.

Excipients

The drug Hydrocortisone-Richter, a suspension for intra-articular and periarticular administration, contains parahydroxybenzoates. These substances may cause allergic reactions (possibly delayed) and, in rare cases, bronchospasm.

This medicinal product contains 30.48 mg sodium per dose.
This fact must be taken into account when using the drug in patients on a sodium-restricted diet. Effect on the ability to drive vehicles and operate machinery
The drug Hydrocortisone-Richter, a suspension for intra-articular and periarticular administration, does not affect the ability to drive vehicles and operate machinery.

Storage conditions

The drug should be stored out of the reach of children, at a temperature not exceeding 25°C.

Best before date

Shelf life: 2 years. Do not use after the expiration date.

Use during pregnancy and breastfeeding

Restrictions during pregnancy - With caution. Restrictions when breastfeeding - With caution.

Pregnancy

For pregnant women in the first trimester, the use of the drug is contraindicated due to the lack of sufficient data on the safety of the drug in this group. In the II-III trimesters of pregnancy, the use of hydrocortisone is possible when the expected benefit to the mother outweighs the potential risk to the fetus (the risk of congenital developmental defects (for example, cleft palate) and intrauterine growth retardation is low).

Breastfeeding period

Hydrocortisone and lidocaine pass into breast milk. The use of GCS during breastfeeding can lead to dysfunction of the adrenal glands and impaired growth in infants.

Use for renal impairment

Data on the use of the drug in patients with impaired renal function are not provided.

Use for liver dysfunction

Data on the use of the drug in patients with impaired liver function are not provided.

Use in elderly patients

Restrictions for elderly patients - Use with caution. Use with caution in elderly patients over 65 years of age.

Use in children

Restrictions for children - With caution. Children are recommended to prescribe the drug in the smallest therapeutic doses and, if possible, for the shortest possible period.

Terms of sale

The drug is available with a prescription.

Contacts for inquiries

GEDEON RICHTER JSC (Hungary)

Organization accepting complaints from consumers Moscow representative office of JSC Gedeon Richter 119049 Moscow, 4th Dobryninsky lane, 8 Tel. Email

Overdose

Overdose with long-term use of the drug intramuscularly or intravenously can manifest itself as suppression of the adrenal cortex, nausea and vomiting, hyperglycemia , bleeding, sodium and water retention, increased blood pressure, the development of Cushing's syndrome , and exacerbation of chronic infections.

With topical use of the ointment, acute overdose is unlikely, but with prolonged use, symptoms of chronic overdose with systemic manifestations may appear. Treatment: symptomatic therapy, gradual withdrawal of the drug.

HYDROCORTISONE-RICHTER SUSPENSION FOR INJECTION 125MG/5ML

From the endocrine system:

Decreased glucose tolerance and increased need for a hypoglycemic drug; manifestation of latent diabetes mellitus; steroid diabetes mellitus. With long-term treatment - suppression of adrenal function; Itsenko-Cushing syndrome; growth retardation in children and adolescents.

From the gastrointestinal tract:

Nausea; vomit; pancreatitis; peptic ulcer; esophagitis; bleeding and perforation of the gastrointestinal tract; increased appetite; flatulence; hiccups; in rare cases - increased activity of liver transaminases and alkaline phosphatase.

From the cardiovascular system:

Lidocaine can cause conduction disturbances (in doses exceeding therapeutic doses), peripheral vasodilation; with large doses of hydrocortisone: increased blood pressure; hypokalemia and its characteristic ECG changes; thromboembolism; heart failure.

From the nervous system:

Insomnia, irritability, anxiety, agitation, euphoria, epileptiform convulsions; mental disorders; delirium; disorientation; hallucinations; exacerbation of manic-depressive psychosis while taking the drug; depression; paranoia; increased intracranial pressure with swelling of the optic nerve nipple, dizziness; pseudotumor of the cerebellum; headache.

From the side of metabolism:

Weight gain, negative nitrogen balance, increased sweating.

From the side of the organ of vision:

Corneal ulceration; posterior capsular cataract (more likely in children); increased intraocular pressure with possible damage to the optic nerve; secondary bacterial, fungal, viral eye infections; trophic changes in the cornea; exophthalmos, glaucoma.

From the musculoskeletal system:

Slowing down of growth and ossification processes in children (premature closure of epiphyseal growth zones); osteoporosis; very rarely - pathological bone fractures; aseptic necrosis of the head of the humerus and femur; muscle tendon rupture; steroid myopathy; decreased muscle mass; arthralgia.

Effects due to the mineralocorticoid activity of the drug:

Fluid and sodium retention with the formation of peripheral edema; hypernatremia; hypokalemia, arrhythmia, myalgia, muscle spasm, increased weakness, fatigue.

From the immune system:

Opportunistic infections, exacerbation of latent tuberculosis, hypersensitivity reactions; local and generalized: skin rash, itching; anaphylactic shock; delayed wound healing; tendency to develop pyoderma and candidiasis, exacerbation of infections, especially with vaccination and simultaneous treatment with immunosuppressive drugs.

From the skin and mucous membranes:

Petechiae; ecchymoses; hyper- or hypopigmentation; steroid acne; striae; folliculitis, hirsutism, telangiectasia.

Local reactions:

Tissue swelling and pain at the injection site, which spontaneously disappear after a few hours, increased pain in the joint when the drug is injected into the joint, burning, numbness, paresthesia at the injection site, atrophy of the skin and subcutaneous tissue at the injection site (if accidentally administered into the deltoid muscle ), rarely - necrosis of surrounding tissues, scar formation at the injection site.

Other:

Malaise, withdrawal syndrome (high body temperature, myalgia, arthralgia, adrenal insufficiency); leukocyturia, leukocytosis.

Elderly patients are at higher risk of developing adverse reactions.

With long-term treatment and the use of large doses of hydrocortisone and lidocaine, systemic side effects may develop.

Interaction

The effect of the drug when administered intramuscularly or intravenously is weakened by barbiturates, antihistamines and antiepileptics, and diuretics - they increase hypokalemia. The effect of hypoglycemic agents is reduced with this method of administration.

Use with NSAIDs increases the risk of ulcer formation, and with paracetamol - hepatotoxicity.

Hydrocortisone reduces the concentration of salicylates in the blood and the activity of hypoglycemic agents. Cardiac glycosides and diuretics increase hypokalemia. When prescribed with amphotericin B, heart failure occurs.

The simultaneous use of eye ointment and drugs that cause an increase in intraocular pressure contributes to a greater increase in intraocular pressure.

Analogs

Level 4 ATX code matches:
Lokoid Krelo

Lokoid

Lokoid Lipocrem

Tablets Cortef , powder in vials for injection Solu-Cortef , solution for injection Sopolkort N.

Analogs of ointments that contain hydrocortisone: Ascortin , Hyoxysone , Cortade , Laticort , Lokoid Lipokrem .

Reviews of Hydrocortisone

Ointments and creams containing corticosteroids have antiallergic, anti-inflammatory and antipruritic effects. What is Hydrocortisone ointment for and for what skin diseases is it used? This is primarily eczema, neurodermatitis, psoriasis, itchy and allergic dermatoses, skin manifestations of lupus erythematosus. Most often, hormonal therapy is resorted to only if other local treatments are ineffective. Indeed, the use of this ointment gives a rapid anti-inflammatory effect; after a few days, itching and swelling disappear.

Reviews of Hydrocortisone ointment are most often positive, and this applies to people who tried to use hormonal ointment for the first time. Those who have extensive experience in using hormone-based ointments say that prednisolone is significantly superior in anti-inflammatory activity to hydrocortisone, and also retains water to a lesser extent in the body. And ointments containing dexamethasone and betamethasone are even more active. Hydrocortisone and prednisolone belong to the first generation of corticosteroids, which are relatively weakly active substances. Ointments and creams with these substances are used in pediatric practice, in addition, they can be applied to the skin of the face. Judging by the reviews, for any form of eczema, treatment began with the use of this ointment; in case of an unexpressed effect, more potent agents were used - Fluorocort or Polcortolone. Skin atrophy , acne, hypopigmentation, and striae are common local adverse reactions of corticosteroids that occur on the face and groin area, so low-potency corticosteroids should be used in these areas.

What else can the ointment be used for? It is used in physiotherapeutic procedures, for example, in the treatment with ultrasound of diseases of the joints and spine, scar contractures, heel spurs. Under the influence of ultrasound, exudates are absorbed, analgesic, anti-inflammatory and vasodilating effects are manifested. Phonophoresis using a suspension has a similar effect. Almost everyone who underwent treatment left positive reviews about phonophoresis with hydrocortisone. High efficiency, rapid disappearance of pain and recovery were noted. This procedure was prescribed after gynecological diseases, as well as for sinusitis. Some patients noted an exacerbation after the first sessions.

Information has appeared on the Internet about the use of this ointment for wrinkles. What is this based on and is it harmful to use the ointment for this purpose? Topical application of hydrocortisone causes fluid retention and some swelling, which hides wrinkles and makes them visually invisible. But this is a temporary effect; after the “procedures” are stopped, the liquid is lost and the wrinkles appear again. Doctors are categorically against the use of hydrocortisone for cosmetic purposes. First of all, it is a hormonal drug that has a systemic effect on the body (in the form of changes in metabolic processes) and a local effect - skin atrophy, it becomes thinner and the aging process accelerates. In addition, hormonal ointment causes skin addiction and a decrease in effect when applied topically. Considering the contraindications and possible complications, isn’t the price of such imaginary rejuvenation too high? Hydrocortisone ointment and eye ointment should be prescribed only by a doctor according to strict indications; you cannot treat them yourself. Eye ointment was prescribed to patients with keratitis, chemical burns and after surgical interventions. Some patients experienced burning, redness of the sclera and itching of the eyelids during the first days of using it, but after examination by a doctor, treatment was continued. There are no eye drops containing the active ingredient hydrocortisone. If you are interested in hormonal eye drops, then these are: Oftan Dexamethasone, Dexapos, Maxitrol, Maxidex, Dexamethasone, which includes dexamethasone.

Hydrocortisone can be used for inhalation for laryngitis for decongestant purposes. If a suspension is used for inhalation, it must be diluted. How to dilute for inhalation? Take 1 ml of suspension and 2-3 ml of physiological solution, fill the inhaler, breathe for 5 minutes. Inhalation is carried out in the morning and evening. Reviews about inhalations are positive, since swelling and spasm quickly stop, cough decreases, and breathing becomes easier.

Nasal suspension is sometimes prescribed as an instillation for hypertrophic rhinitis, but, as a rule, this is not effective and surgical treatment cannot be avoided. Otolaryngologists often prescribe pharmaceutical drops, which include a solution of dioxidine, adrenaline and a suspension of hydrocortisone or Miramistin, Nazivin and a suspension. There are good results in the treatment of allergic rhinitis and sinusitis.

Hydrocortisone-richter

Adverse reactions primarily occur at the injection site, most often in the form of tissue swelling and pain, and spontaneously disappear after a few hours. In addition, delayed wound healing, skin atrophy, stretch marks, acne-like rash, itching, folliculitis, hirsutism, hypopigmentation, skin irritation, dry, thin and sensitive skin, and telangiectasia are possible.

With long-term treatment and the use of large doses of glucocorticoids and lidocaine, systemic side effects may develop.

From the endocrine system:

decreased glucose tolerance and increased need for a glucose-lowering drug, manifestation of latent diabetes, steroid diabetes mellitus. With long-term treatment - suppression of adrenal function, Itsenko-Cushing syndrome, growth retardation in children and adolescents.

From the digestive system:

nausea, vomiting, pancreatitis, peptic ulcer, esophagitis, bleeding and perforation of the gastrointestinal tract, increased appetite, flatulence, hiccups, in rare cases - increased activity of liver transaminases and alkaline phosphatase.

From the cardiovascular system:

with significant absorption, lidocaine can cause cardiac conduction disturbances and peripheral vasodilation; with large doses of hydrocortisone: increased blood pressure, hypokalemia and associated ECG changes, thromboembolism, heart failure.

From the nervous system:

insomnia, irritability, anxiety, agitation, euphoria, epileptiform convulsions, mental disorders, delirium, disorientation, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure with papilledema, dizziness, pseudotumor of the cerebellum, headache.

From the side of metabolism:

increased potassium excretion, hypokalemia, weight gain, negative nitrogen balance, increased sweating.

From the side of the organ of vision:

corneal ulceration, posterior capsular cataract (more likely in children), increased intraocular pressure with possible damage to the optic nerve, secondary bacterial fungal and viral eye infections, trophic changes in the cornea, exophthalmos, glaucoma.

From the musculoskeletal system:

slower growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis, very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur, rupture of tendons and muscles, steroid myopathy, decreased muscle mass, arthralgia.

Effects due to the mineralocorticoid activity of the drug:

fluid and sodium retention with the formation of peripheral edema, hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia, muscle spasm, increased weakness, fatigue), hypokalemic alkalosis.

From the immune system:

opportunistic infections, exacerbation of latent tuberculosis, hypersensitivity reactions; local and generalized: skin rash, itching, anaphylatic shock, delayed wound healing, tendency to develop pyoderma and candidiasis, exacerbation of infections, especially with vaccination and simultaneous treatment with immunosuppressive drugs.

Dermatological reactions:

petechiae, ecchymosis, hyper- and hypopigmentation, steroid acne, striae, atrophy of the skin and subcutaneous tissue at the injection site (injection into the deltoid muscle is especially dangerous), folliculitis, hirsutism, hypopigmentation, irritation, telangiectasia.

Other:

poor health, withdrawal syndrome (high body temperature, myalgia, arthralgia, adrenal insufficiency), leukocyturia, leukocytosis.

Local reactions:

increased pain in the joint when injected into the joint, tissue swelling, burning, numbness, paresthesia at the injection site, rarely - necrosis of surrounding tissues, scar formation at the injection site.

Hydrocortisone price, where to buy

All forms of this drug are available in the pharmacy chain at affordable prices, so you can buy them without any problems. The price of Hydrocortisone ointment is 30-37 rubles, the price of eye ointment ranges from 121 to 133 rubles. The price of Hydrocortisone in ampoules (Farmak, Ukraine) is 147-155 rubles. (for 10 ampoules) A suspension of hydrocortisone with lidocaine (Gedeon Richter) costs more - 215-251 rubles for 1 bottle.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

LuxPharma* special offer

Hydrocortisone France tablets 10 mg No. 25
RUB 1,990 order
Hydrocortisone (analogue of Cortef) table. 20 mg No. 20
RUB 1,750 order

ZdravCity

Hydrocortisone ointment for eyes. 0.5% 3gPharmzavod Elfa A.O.
130 rub. order
Hydrocortisone eye ointment 0.5% 3g JSC Tatkhimfarmpreparaty
31 rub. order
Hydrocortisone-Richter Susp. for intravenous and peri-ost. input 25mg+5mg/ml 5ml 1 pc. JSC Gedeon Richter
RUB 227 order
Hydrocortisone-POS eye ointment. 2.5% 2.5gUrsapharm Arzneimittel GmbH
85 rub. order
Hydrocortisone-AKOS ointment for external use 1% 15gOJSC Sintez
63 RUR order

Pharmacy Dialogue

Hydrocortisone ointment (tube 1% 10g)Nizhpharm JSC
33 rub. order
Hydrocortisone ointment (tube 0.5% 3g)Jelfa SA
127 RUR order
Hydrocortisone ointment (tube 0.5% 5g) TCPP
40 rub. order
Hydrocortisone ointment (tube 0.5% 3g) Tatkhimpharmpreparaty JSC
29 RUR order
Hydrocortisone-POS ointment (tube 2.5% 2.5 g (eye)) Ursapharm
86 rub. order

Pharmacy24

Hydrocortisone Acetate 25 mg/ml N10 suspension for injection PAT "Pharmstandard-Biolik", Kharkiv, Ukraine
98 UAH.order
Hydrocortisone acetate 2.5% 2 ml No. 10 PAT "Farmak", Ukraine
159 UAH order
Hydrocortisone 0.5% 3 g eye ointment Elfa A.T. Pharmaceutical Plant, Poland
68 UAH order
Hydrocortisone 1% 10 g ointment VAT "Nizhpharm", Nizhny Novgorod, Russian Federation
40 UAH order
Hydrocortisone-POS 1% 2.5 g eye ointment Ursafarm Arznaimittel GmbH, Nimecchina
92 UAH order

PaniPharmacy

Hydrocortisone ointment Hydrocotisone ointment-pos. 1% 2.5g Germany, Ursapharm
105 UAH order
Hydrocortisone ointment Hydrocortisone eye ointment 0.5% 3g Poland, Jelfa
89 UAH order
Hydrocortisone ampoule Hydrocortisone acetate d/in. 2.5% 2ml No. 10 Ukraine, Pharmstandard-Biolek
114 UAH order
Hydrocortisone ampoule Hydrocortisone acetate d/in. 2.5% 2ml No. 10 Ukraine, Farmak OJSC
174 UAH order
Hydrocortisone ointment Hydrocortisone ointment 1% 10g Russia, Nizhpharm
42 UAH order