Always follow the instructions from a pharmacist or doctor, or the leaflet in the medicine packet.
Dosage
Hydrocortisone tablets come as:
- 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. Make sure you understand how to take the dose you've been prescribed.
If you take hydrocortisone tablets for hormone replacement, the usual dose is 20mg to 30mg a day, split into 2 doses. The first dose in the morning may be larger than the second dose in the evening.
Changes to your dose
Your doctor may increase or decrease your dose of hydrocortisone during the first weeks or first month of your treatment until your health problem is stable.
You may need a bigger dose for a while if you're unwell with other health problems such as an infection, or if you need to have an operation or dental treatment.
You may need a short, very high dose of hydrocortisone if you have Addison's disease and your cortisol levels drop suddenly. This is a medical emergency called an adrenal crisis.
Steroid cards
If you've been diagnosed with adrenal insufficiency you'll need to carry a red steroid emergency card with you (for adults) or an adrenal insufficiency card if the treatment is for a child. If you need emergency treatment, this will tell medical staff about your condition and how to treat you.
How to take it
Do not eat grapefruit or drink grapefruit juice while you're being treated with hydrocortisone tablets. Grapefruit can change the way hydrocortisone works and increases the risk of side effects.
How to take standard tablets
Standard tablets start to release the medicine into your body as soon as you swallow them.
You'll usually take them 2 or 3 times a day. Take the tablets with or just after a snack or meal. This is so they do not upset your stomach.
How to take slow-release tablets
Slow-release (also known as modified release) tablets release the medicine into your body gradually throughout the day.
You'll usually take slow-release tablets once a day.
Take them in the morning, about half an hour before breakfast. Swallow them whole. Do not break or crush the tablets, as they will not work properly.
How to take soluble tablets
Dissolve soluble hydrocortisone tablets in at least 50ml of water then swallow the liquid immediately. Make sure you swallow all the liquid, otherwise you may not get all of the dose. The hydrocortisone starts to be absorbed as soon as the liquid is swallowed.
You'll usually take soluble tablets 3 times a day. Take the tablets with or just after a snack or meal. This is so they do not upset your stomach.
How long to take it for
How long you take hydrocortisone depends on why you're taking it.
If you take hydrocortisone tablets because your body cannot make enough cortisol (if you have Addison's disease, for example), you'll usually need to take them for the rest of your life.
If you forget to take it
Try to remember to take your tablets every day. Frequently missing doses can make you feel unwell.
If you forget to take a dose of hydrocortisone, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.
If you take too much
Taking 1 or 2 extra hydrocortisone tablets once is unlikely to harm you. If you're worried, talk to your doctor or pharmacist.
If you take too much hydrocortisone for more than a few days, it could harm your health.
Urgent advice: Contact 111 for advice now if:
- you take more than your prescribed dose of hydrocortisone and you have new symptoms, such as stomach pain or difficulty sleeping
Get help from 111 online or call 111. Call 111 if you need advice for a child under 5 years old
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the hydrocortisone packet or leaflet inside it, any remaining medicine, and any other medicines you take.
Stopping hydrocortisone
Do not stop taking hydrocortisone suddenly. It may cause your symptoms to come back.
You may also get 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. You'll need to reduce your dose gradually.