Like all medicines, hydrocortisone tablets can cause side effects although not everyone gets them.
Hydrocortisone is not a strong steroid so you're unlikely to get side effects. It's 4 times weaker than another common steroid called prednisolone.
Common side effects
These common side effects of hydrocortisone happen in more than 1 in 100 people. There are things you can do to help cope with them:
Feeling dizzy, weak or tired
If hydrocortisone makes you feel dizzy, weak or tired, stop what you're doing and sit or lie down, or have a rest, until you feel better.
Do not drive, cycle, or use tools or machinery if you're feeling tired.
Do not drink alcohol as it will make you feel worse.
Headaches
Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.
Talk to your doctor if the headaches are severe or last longer than a week.
Muscle ache
If you get unusual muscle ache that's not from exercise or other physical activity, talk to your doctor. You may need a blood test to find the cause.
Indigestion or feeling sick (nausea)
Try taking your tablets with food. It may also help to avoid rich or spicy food.
Tell your doctor if it does not get better or you get severe indigestion or stomach pain. They may be able to prescribe an extra medicine to protect your stomach.
Diarrhoea
Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
If you take the combined contraceptive pill or the progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Swollen ankles
Get plenty of rest and raise your legs when you're sitting down. Try not to stand for a long time.
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people.
You're more likely to get serious side effects if you take high doses of hydrocortisone over many months.
Speak to a doctor if you get a puffy, rounded face and weight gain in your upper back or belly. This happens gradually and can be a sign of Cushing's syndrome.
Call a doctor or call 111 straight away if you:
- have a high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm) or a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- are sleepy or confused, feeling very thirsty or hungry, peeing more often than usual, flushing, breathing quickly or have breath that smells like fruit – these can be signs of high blood sugar (hyperglycaemia)
- have a very upset stomach or vomiting, very bad dizziness or fainting, muscle weakness, mood changes, loss of appetite and weight loss or are feeling very tired – these can be signs of adrenal gland problems
- have muscle pain, weakness or cramps, or your heartbeats suddenly become more noticeable (heart palpitations) – these can be signs of low potassium levels
- have severe stomach pain, severe back pain, a severe upset stomach or vomiting – these can be signs of pancreas problems
- get breathless
- have swelling in your arms or legs
- have changes in your eyesight
- have any bruising or bleeding that is not normal
- have red or black poo
Immediate action required: Call 999 or go to A&E if:
- you have black or dark brown vomit or you're vomiting blood
Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.
Bring all the medicines you take with you.
Mood changes
You may notice mood changes and mental health problems while taking hydrocortisone.
Talk to your doctor or call 111 if:
- you're feeling high, or have moods that go up and down
- you're feeling depressed
- you're feeling anxious
- you have problems sleeping
- you have difficulty in thinking, or are feeling confused and forgetting things
- you're feeling, seeing or hearing things that do not exist (hallucinations)
- you notice changes in the way you usually behave
The higher the dose, the more intense the mood changes can be.
Immediate action required: Call 999 or go to A&E if:
- you have thoughts about harming yourself or ending your life
Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.
Bring all the medicines you take with you.
Serious allergic reaction
It happens rarely, but it's possible to have a serious allergic reaction (anaphylaxis) to hydrocortisone tablets.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Long-term side effects
You may take hydrocortisone tablets for a long time, even for the rest of your life. Over time, hydrocortisone can have several harmful effects on your body. It can lead to:
- weak or fragile bones (osteoporosis)
- poorly controlled diabetes
- eyesight problems
- slower growth in children and teenagers
If you have to take hydrocortisone tablets for a long time, it's a good idea to take the following steps to stay as healthy as possible.
Exercise regularly and make sure you get enough calcium in your diet to help strengthen your bones. Milk, cheese and leafy greens contain lots of calcium. To check your bones, your doctor may arrange for you to have an occasional bone scan.
If you have diabetes, you may need to check your blood sugar (glucose) more often. Your doctor can advise you about this.
To reduce the chances of eyesight problems, visit an optometrist every 12 months to check for high pressure in your eye (glaucoma) and cataracts.
Long-term side effects in children and teenagers
Hydrocortisone can cause slower growth in children and teenagers if they take it for a long time.
Your child's doctor will monitor their height and weight carefully for as long as they're having treatment with hydrocortisone. This will help them spot any slowing down of your child's growth and change their treatment if needed.
Even if your child's growth slows down, it does not seem to have much effect on their overall adult height.
Talk to your doctor if you're worried about your child taking hydrocortisone tablets.
Other side effects
These are not all the side effects of hydrocortisone tablets. For a full list see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.