Product Description.:
CORTEF 5
tablet , white , scored , round round
Clinical Pharmacology: Hydrocortisone (cortisol) is a corticosteroid secreted by the adrenal cortex. In physiologic doses, it is administered to replace deficient endogenous hormones. In larger (pharmacologic) doses, hydrocortisone decreases inflammation and suppresses the immune response. It stimulates erythroid cells of the bone marrow, prolongs survival time of erythrocytes and platelets, and produces neutrophilia and eosinopenia. Hydrocortisone promotes protein catabolism, gluconeogenesis, and redistribution of fat from peripheral to central areas of the body. It reduces intestinal absorption and increases renal excretion of calcium.
In pharmacologic doses, systemically administered glucocorticoids suppress release of corticotropin from the pituitary. The degree and duration of hypothalamic-pituitary-adrenal (HPA) axis suppression produced is highly variable among patients and depends on the dose, frequency and time of administration, and duration of therapy. If suppressive doses are administered for prolonged periods, the adrenal cortex atrophies and patients develop cushingoid features and respond to stress like patients with primary adrenocortical insufficiency. The duration of anti-inflammatory activity approximately equals the duration of HPA-axis suppression. In one study, the duration of HPA-axis suppression after a single oral dose of hydrocortisone 250 mg was 1.25 to 1.5 days.
Hydrocortisone is extensively bound to the plasma proteins, corticosteroid binding globulin (transcortin) and albumin. With physiologic concentrations, it is bound primarily to transcortin and only 5 to 10% of cortisol in plasma is unbound.
Hydrocortisone is metabolized in most tissues, but primarily in the liver to biologically inactive compounds. The half-life of hydrocortisone may be prolonged in patients with hypothyroidism. Inactive metabolites are excreted by the kidneys, primarily as glucuronides and sulfates, but also as unconjugated products. Negligible amounts are excreted in bile.
Indications And Clinical Uses: Endocrine Disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice synthetic analogs may be used in conjunction with mineralocorticoids where applicable in infancy, mineralocorticoid supplementation is of particular importance) congenital adrenal hyperplasia nonsuppurative thyroiditis hypercalcemia associated with cancer.
Nonendocrine Disorders: Rheumatic Disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: psoriatic arthritis, rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low dose maintenance therapy), ankylosing spondylitis, acute and subacute bursitis, acute non-specific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, epicondylitis.
Collagen Diseases: During an exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus, acute rheumatic carditis, systemic dermatomyositis (polymyositis).
Dermatologic Diseases: pemphigus, bullous dermatitis herpeti-formis, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, mycosis fungoides, severe psoriasis and severe seborrheic dermatitis.
Allergic States: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness and drug hypersensitivity reactions.
Ophthalmic Diseases: Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: allergic conjunctivitis, keratitis, allergic corneal marginal ulcers, herpes zoster ophthalmicus, iritis and iridocyclitis, chorioretinitis, anterior segment inflammation, diffuse posterior uveitis and choroiditis, optic neuritis, sympathetic ophthalmia.
Respiratory Diseases: Symptomatic sarcoidosis, L?ffler's syndrome not manageable by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, aspiration pneumonitis.
Hematologic Disorders: Idiopathic thrombocytopenic purpura in adults, secondary thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia, erythroblastopenia (RBC anemia), congenital (erythroid) hypoplastic anemia.
Neoplastic Diseases: For palliative management of: leukemias and lymphomas in adults, acute leukemia of childhood.
Edematous States: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.
Gastrointestinal Diseases: To tide the patient over a critic
