How do hydrocortisone tablets work?
Hydrocortisone is a steroid (or corticosteroid) medicine.
Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands are above your kidneys.
The adrenal glands produce 2 hormones called cortisol and aldosterone.
If your adrenal glands are not making enough cortisol, hydrocortisone tablets work by replacing the hormone and bringing your levels up to normal.
What will happen if I stop taking hydrocortisone tablets?
If you stop taking hydrocortisone tablets suddenly it may cause your symptoms to come back. You may also get dangerous withdrawal symptoms including:
- severe tiredness
- weakness and feeling unwell
- body aches including stomach ache
- feeling dizzy
- joint and muscle pain
If you need to stop taking hydrocortisone, your doctor will reduce your dose gradually to prevent these side effects.
Important
Do not stop taking hydrocortisone tablets without talking to your doctor.
How does hydrocortisone compare with other steroid medicines?
There are other steroid tablets available such as:
- deflazacort
- dexamethasone
- methylprednisolone
- prednisolone
These steroids are much stronger than hydrocortisone tablets. They're not usually used as replacement treatment, for example in Addison's disease, because they're too strong and can cause more side effects.
Do I need to be careful of injections?
Taking hydrocortisone tablets can affect your immune system, so you're more likely to catch flu, COVID-19, the common cold and chest infections. Tell your doctor if you get symptoms of an infection or test positive for COVID-19.
Keep away from people with an infectious disease, especially chickenpox, shingles or measles. If you get any of these illnesses they could make you very ill.
Important
Tell your doctor straight away if you come into contact with someone who has chickenpox, shingles or measles. Your doctor may be able to prescribe a medicine to protect you.
Can I still have vaccinations?
If you need any vaccinations, let the doctor or nurse know that you're taking a steroid.
Some types of vaccines, known as live vaccines, are not suitable while you're taking hydrocortisone. This is because taking hydrocortisone affects your immune system, so you're more at risk of infection caused by a live vaccine.
Live vaccines include the oral typhoid vaccine and the BCG vaccine for tuberculosis.
There are non-live versions of vaccines available for conditions including flu, shingles and polio. These are safe to have while you're taking hydrocortisone.
Do I need a steroid card?
Steroid emergency card (red card)
If you're taking steroid medicines such as hydrocortisone, your adrenal glands may not make as much of the hormones your body needs, such as cortisol (known as the stress hormone). If this happens, it's known as adrenal insufficiency.
This is more likely to happen if you take high doses of tablets for a long time, or you regularly use different kinds of steroids at the same time, such as steroid nasal spray and a steroid inhaler.
Your doctor or pharmacist will check your risk of adrenal insufficiency based on the type and dose of steroids you take, and may recommend that you carry a red steroid emergency card to let people know you are taking steroids. This card is the size of a credit card and can fit in a wallet or purse. A similar card, called the adrenal insufficiency card, is available for children.
Important
If you need any medical or dental treatment, or are having surgery or an invasive procedure, show your red steroid emergency card (for adults) or the adrenal insufficiency card (for children) to your doctor or dentist. This is important so they know you're having steroid treatment and can give you extra steroids as needed.
Blue steroid card
If you're taking hydrocortisone tablets for longer than 3 weeks, have been prescribed a high dose or are prescribed them often, your doctor or pharmacist will give you a blue steroid treatment card.
The card is the size of a credit card and fits in your wallet or purse. It tells you how you can reduce the risks of side effects. It also gives details of your doctor, how much hydrocortisone you take and how long the treatment will last.
If you need any medical or dental treatment, show your blue steroid card to the doctor or dentist.
Will it affect my contraception?
Hydrocortisone tablets do not stop any contraception from working, including the combined pill, progestogen-only pill or emergency contraception.
However, if hydrocortisone makes you have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Find out more:
- What to do if you're sick or have diarrhoea when taking the combined pill
- What to do if you're sick or have diarrhoea when taking the progestogen-only pill
If you start taking the combined pill your dose of hydrocortisone may need adjusting.
Can I drive or ride a bike?
Hydrocortisone can make you feel dizzy or tired.
If this happens to you, do not drive, cycle or use machinery or tools until you feel better.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking hydrocortisone. GOV.UK has more information on the law on drugs and driving.
Can I drink alcohol while taking hydrocortisone tablets?
Yes, you can drink alcohol while taking hydrocortisone tablets.
However, if hydrocortisone tablets make you feel dizzy, it's a good idea not to drink alcohol as it will make you feel worse.
Is there any food or drink I need to avoid?
Do not eat grapefruit or drink grapefruit juice while you're taking hydrocortisone tablets. Grapefruit can change the way hydrocortisone works and increases the risk of side effects.