Hydrocortisone Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Adrenocortical Insufficiency

Acute Adrenal Gland Failure:
100 mg IV bolus, then 300 mg/day in divided doses every 8 hours or as a continuous infusion for 48 hours. When patient stable, change to oral, 50 mg every 8 hours for 6 doses, then taper to 30 - 50 mg/day.

Usual Adult Dose for Anti-inflammatory

Oral, Intramuscular or Intravenous: 15 to 240 mg/day.

Usual Adult Dose for Shock

200 mg per day by continuous intravenous infusion

Comment:
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic Shock 2012:
-Do not use intravenous hydrocortisone if adequate fluid resuscitation and vasopressor therapy restore hemodynamic stability
-Use hydrocortisone alone
-Do not administer for sepsis in the absence of shock
-Do not use ACTH stimulation test to identify adults with septic shock requiring hydrocortisone
-Use continuous infusion rather than repetitive bolus injections
-Taper hydrocortisone treatment when vasopressors no longer required

Usual Adult Dose for Asthma - Acute

Intravenous: 100 to 500 mg every 6 hours.

Usual Adult Dose for Ulcerative Colitis

100 mg rectal suspension (retention enema) nightly for 21 days or until clinical remission occurs. Difficult cases may require 2 or 3 months of treatment. Clinical symptoms should subside within 3 to 5 days; discontinue use if no improvement within 2 to 3 weeks; some patients may require 2 to 3 months of therapy; if therapy lasts more than 21 days, discontinue slowly by decreasing use to every other night for 2 to 3 weeks.

Usual Adult Dose for Ulcerative Proctitis

One applicatorful (10% rectal foam with applicator) rectally once or twice daily for two to three weeks, then every second day thereafter.

Usual Pediatric Dose for Adrenocortical Insufficiency

Acute Adrenal Gland Failure:

Infants and young children: 1 to 2 mg/kg/dose intravenous bolus, then 25 to 100 mg/day in divided doses every 6 to 8 hours.

Older children: 100 mg intravenous bolus, then 300 mg/day in divided doses every 8 hours or as a continuous infusion for 48 hours; once patient is stable change to 50 mg orally every 8 hours for 6 doses, then taper to 30 to 50 mg per day in divided doses.

Usual Pediatric Dose for Anti-inflammatory

Infants and children:

Oral: 2.5 to 10 mg/kg/day divided every 6 to 8 hours.
Intramuscular or intravenous: 1 to 5 mg/kg/day divided every 12 to 24 hours.

Adolescents:

Oral, intramuscular or intravenous: 15 to 240 mg every 12 hours.

Usual Pediatric Dose for Shock

Children:

Initial: 50 mg/m2/day by continuous intravenous infusion

Infusions up to 50 mg/kg/day may be required for shock reversal

Adolescents:

200 mg per day by continuous intravenous infusion

Comment:
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic Shock 2012:
-Do not use intravenous hydrocortisone if adequate fluid resuscitation and vasopressor therapy restore hemodynamic stability
-Use hydrocortisone alone
-Do not administer for sepsis in the absence of shock
-Do not use ACTH stimulation test to identify adults with septic shock requiring hydrocortisone
-Use continuous infusion rather than repetitive bolus injections
-Taper hydrocortisone treatment when vasopressors no longer required

Usual Pediatric Dose for Asthma - Acute

Children:

Intravenous: optional loading dose: 4 to 8 mg/kg; maximum: 250 mg; then maintenance: 2 mg/kg/dose every 6 hours.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Dosage adjustment should be based on severity of condition treated and response of patient.

Precautions

Avoid abrupt withdrawal after long-term therapy.

Dialysis

Supplemental dose is not required.

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