hydrocortisone sodium succinate at a glance
Medicine class
Systemic glucocorticoid corticosteroid.
Administration
Given intravenously or intramuscularly by a trained professional after reconstitution; intravenous infusion is also possible.
Why this form is used
The water-soluble sodium succinate ester allows rapid administration in a small volume.
What is hydrocortisone sodium succinate used for?
Selected products are licensed when a rapid and intense corticosteroid effect is required, including:
Primary or secondary adrenocortical insufficiency and certain forms of shock where adrenal insufficiency is present or suspected; these indications are specified for the selected Solu-Cortef product.
Severe allergic states, including anaphylactic reactions, as an adjunct to established emergency treatment.
Severe bronchial asthma.
Systemic lupus erythematosus.
Severe erythema multiforme, including Stevens–Johnson syndrome.
Ulcerative colitis and Crohn’s disease.
Inflammatory consequences of aspiration of gastric contents.
How does hydrocortisone sodium succinate work?
Hydrocortisone acts like cortisol. It binds glucocorticoid receptors, changes gene activity, reduces inflammatory signalling and modifies immune responses. It also affects glucose, protein, salt and water metabolism. The water-soluble sodium succinate form supports rapid parenteral administration.
hydrocortisone sodium succinate preparations and strengths
Injection
Route: Parenteral
Strengths: 100 mg
How to take hydrocortisone sodium succinate
A healthcare professional must prepare and administer this powder, except where a person or carer has been specifically trained to use an adrenal-crisis emergency kit. The reconstituted solution should be checked for particles or discolouration and is for single use.
It may be given into a vein, by intravenous infusion or into a muscle.
It is not intended for intrathecal or epidural administration.
Tell the treating team about infections, recent exposure to chickenpox, shingles or measles, planned vaccinations, pregnancy, breastfeeding and all other medicines.
hydrocortisone sodium succinate side effects
Common or expected effects
- Nausea, indigestion or abdominal discomfort.
- Mood changes, irritability, anxiety, sleep disturbance or confusion.
- Increased blood glucose, appetite or weight.
- Fluid and sodium retention, raised blood pressure or reduced potassium.
- Increased susceptibility to infection or masking of its usual symptoms.
- With greater or prolonged exposure: skin thinning, bruising, muscle weakness, osteoporosis, adrenal suppression, cataract or glaucoma.
Get urgent medical advice
- Anaphylaxis, including airway swelling, bronchospasm or collapse.
- Severe, unusual or rapidly worsening infection.
- Gastrointestinal bleeding, ulcer perforation or pancreatitis.
- Severe psychiatric symptoms, including mania, psychosis, major depression or suicidal thoughts.
- New visual disturbance, severe eye pain or suspected retinal complications.
- Marked weakness associated with low potassium, significant fluid retention, heart failure or thrombosis.
- Acute adrenal insufficiency after inappropriate abrupt withdrawal following prolonged systemic exposure.
hydrocortisone sodium succinate in pregnancy
Systemic hydrocortisone can be used during pregnancy when a clinician considers it necessary. Repeated or prolonged exposure requires an individual benefit–risk review and appropriate follow-up. Do not stop essential corticosteroid treatment without medical advice.
hydrocortisone sodium succinate while breastfeeding
Hydrocortisone is a preferred systemic corticosteroid during breastfeeding. Short-term treatment is generally compatible; prolonged or substantial exposure may require assessment of infant feeding, growth and possible adrenal effects, particularly if the baby is premature or unwell.
hydrocortisone sodium succinate interactions
Check all prescribed and non-prescription medicines and supplements. Important examples include:
CYP3A4 inhibitors, including itraconazole, ketoconazole, clarithromycin, ritonavir and cobicistat
Can increase hydrocortisone exposure and systemic corticosteroid adverse effects.
CYP3A4 inducers, including rifampicin, carbamazepine, phenobarbital and phenytoin
Can increase hydrocortisone metabolism and reduce its effect.
Common questions about hydrocortisone sodium succinate
Answers are fully visible for fast scanning and source review.
Can hydrocortisone sodium succinate treat adrenal crisis?
Injectable hydrocortisone is time-critical treatment for suspected adrenal crisis. People with prescribed emergency kits should follow their individual training and seek immediate medical help.
Can it be used for anaphylaxis?
It is licensed for anaphylactic reactions as adjunctive treatment and does not replace immediate established anaphylaxis management.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.