How quickly does oral Cortef start to work?

28 Nov 2009

Cortef should start working in a day.

Pharmacokinetics

Hydrocortisone is well absorbed after oral administration achieving peak blood concentrations after one hour. Plasma protein binding is greater than 90%. Hydrocortisone is primarily bound to plasma globulin. Globulins have a high affinity for hydrocortisone but low binding capacity. Plasma albumin may also bind hydrocortisone. Although albumin has a low affinity for hydrocortisone it does have a high binding capacity.

Only unbound form of hydrocortisone is pharmacologically active. Hydrocortisone is metabolised in the liver by hydrogenation to tetrahydrocortisone and other degraded forms. These are then excreted in the urine as glucuronide conjugates, with a small proportion of unchanged hydrocortisone. The biological half-life of hydrocortisone is about 100 minutes.