|
Back to Chest Drug index
Name: Hydrocortisone butyrate
|
|
|
Xolair reduced the rate of hospital emergency visits by 44% in
patients with inadequately controlled asthma.
|
|
|
|
|
|
related discussion |
|
|
|
|
|
|
|
|
|
|
Pregnancy Category C
Drug classes
- Corticosteroid, short acting
- Glucocorticoid
- Mineralocorticoid
- Adrenal cortical hormone (hydrocortisone)
- Hormonal agent
Therapeutic actions
Enters target cells and binds to cytoplasmic receptors; initiates many
complex reactions that are responsible for itsanti-inflammatory,
immunosuppressive (glucocorticoid), and salt-retaining
(mineralocorticoid) actions. Some of these actions are considered
undesirable, depending on the indication for which the drug is being
used.
Indications
- Replacement therapy in adrenal cortical insufficiency
- Hypercalcemia associated with cancer
- Short-term management of various inflammatory and allergic disorders,
such as rheumatoid arthritis, collagen diseases (eg, SLE),
dermatologic
diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders
- Hematologic disorders-thrombocytopenic purpura, erythroblastopenia
- Trichinosis with neurologic or myocardial involvement
- Ulcerative colitis, acute exacerbations of multiple sclerosis, and
palliation in some leukemias and lymphomas
Intra-articular or soft-tissue administration: Arthritis, psoriatic
plaques, and so forth.
- Retention enema: For ulcerative colitis/proctitis
- Dermatologic preparations: To relieve inflammatory and pruritic
manifestations of dermatoses that are steroid responsive
- Anorectal cream, suppositories: To relieve discomfort of hemorrhoids
and
perianal itching or irritation
- Note that synthetic analogues with weaker mineralocorticoid activity
may
be preferable to hydrocortisone, except for replacement therapy. Local
administration to the affected site (eg, by the use of ophthalmic
corticosteroid preparations for eye disorders) may be preferable to
systemic use.
Contraindications/cautions
Systemic administration: infections, especially tuberculosis, fungal
infections, amebiasis, hepatitis B, vaccinia, or varicella, and
antibiotic-resistant infections; kidney disease (predisposes to
edema);
liver disease, cirrhosis, hypothyroidism; ulcerative colitis with
impending perforation; diverticulitis; recent GI surgery; active or
latent peptic ulcer; inflammatory bowel disease (drug may cause
exacerbations or bowel perforation); hypertension, CHF;
thromboembolitic
tendencies, thrombophlebitis, osteoporosis, convulsive disorders,
metastatic carcinoma, diabetes mellitus; lactation.
Retention enemas, intrarectal foam: systemic fungal infections, recent
intestinal surgery, extensive fistulas.
Topical dermatologic administration: fungal, tubercular, herpes
simplex
skin infections; vaccinia, varicella; ear application when eardrum is
perforated; lactation.
Adverse effects Systemic
- CNS: Vertigo, headache, paresthesias, insomnia, convulsions, psychosis
- GI: Peptic or esophageal ulcer, pancreatitis, abdominal distention,
nausea, vomiting, increased appetite and weight gain (long-term
therapy)
- CV: Hypotension, shock, hypertension and CHF secondary to fluid
retention, thromboembolism, thrombophlebitis, fat embolism, cardiac
arrhythmias secondary to electrolyte disturbances
- Hematologic: Na+ and fluid retention, hypokalemia, hypocalcemia,
increased blood sugar, increased serum cholesterol, decreased serum
T3 and T4 levels
- MS: Muscle weakness, steroid myopathy and loss of muscle mass,
osteoporosis, spontaneous fractures (long-term ther-apy)
- EENT: Cataracts, glaucoma (long-term therapy), increased intraocular
pressure
- Dermatologic: Thin, fragile skin; petechiae; ecchymoses; purpura;
striae; subcutaneous fat atrophy
- Hypersensitivity: Anaphylactoid or hypersensitivity reactions
- Endocrine: Amenorrhea, irregular menses, growth retardation, decreased
carbohydrate tolerance and diabetes mellitus, cushingoid state
(long-termtherapy), hypothalamic-pituitary-adrenal (HPA) suppression
systemic with therapy longer than 5 d
- Other: Immunosuppression, aggravation or masking of infections,
impaired
wound healing
Adverse Effects Related to Specific Routes of Administration
- IM repository injections: Atrophy at injection site
- Retention enema: Local pain, burning; rectal bleeding; systemic
absorption and adverse effects (above)
- Intra-articular: Osteonecrosis, tendon rupture, infection
- Intraspinal: Meningitis, adhesive arachnoiditis, conus medullaris
syndrome
- Intralesional therapy, head and neck: Blindness (rare)
- Intrathecal administration: Arachnoiditis
- Topical dermatologic ointments, creams, sprays: Local burning,
irritation, acneiform lesions, striae, skin atrophy. Systemic absorption can lead to HPA suppression (see above), growth
retardation in children, and other systemic adverse effects. Children
may
be at special risk of systemic absorption because of their larger skin
surface area to body weight ratio.
Are you a Doctor, Pharmacist, PA or a Nurse?
Join the Doctors Lounge online medical community
-
Editorial activities: Publish, peer review, edit
online articles.
-
Ask a Doctor Teams: Respond to patient questions and
discuss challenging presentations with other members.
Doctors Lounge Membership Application
|