cortisone

Class: Chemotherapy / supportive care

Generic Name: Hydrocortisone (high-droh-KOR-ti-zone), cortisone, hydrocortisone sodium succinate, hydrocortisone sodium phosphate
Trade Name: Ala-Cort®, Hydrocortone phosphate, Solu-Cortef®, Hydrocort Acetate®, Lanacort®, Cortef®

For which conditions is this drug approved? Hydrocortisone is FDA approved for the palliation of lymphomas and leukemias in adults and acute leukemia of childhood, as well as for the relief or treatment of several symptoms that may be caused by cancer. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Hydrocortisone belongs to a group of agents referred to as glucocorticoids. It is believed that hydrocortisone produces its effects through anti-inflammatory processes. Hydrocortisone inhibits the inflammatory process that may be involved in some types of cancer or side effects caused by cancer.

How is hydrocortisone typically given (administered)? Hydrocortisone may be administered in several different ways, often depending upon the type of condition being treated. Hydrocortisone may be administered into a vein (intravenous), into a muscle (intramuscular), as topical ointment applied to skin, as a suppository, as eye ointment or eye drops, or by mouth.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with hydrocortisone.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.  Patients may also have levels of hormones, electrolytes and blood sugar measured.

What are the common side effects of treatment with hydrocortisone?

• Increased appetite
• Irritability
• Insomnia
• Swelling of ankles and feet
• Nausea
• Heartburn
• Muscle weakness
• Impaired wound healing
• Increased blood sugar levels
• Headaches
• Dizziness
• Mood swings
• Cataracts
• Reduction in bone density

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Diabetic patients should monitor their glucose levels carefully while taking hydrocortisone and speak to their doctor about how hydrocortisone may affect their blood glucose levels.

When should patients notify their physician?

• Fever chills
• Flu or cold-like symptoms
• Chest pain, jaw pain, shortness of breath
• Confusion
• Noticeable changes in heart rate or rhythm
• Extreme or persistent fatigue or weakness
• Unexplained bleeding (bruising, black or tarry stools, blood in urine, nosebleeds)
• Abdominal pain
• Extreme or persistent nausea and vomiting
• Dizziness
• Persistent or severe headache
• Convulsions
• Severe hot flashes
• Menstrual irregularities
• Sudden mood swings
• Insomnia
• Bone pain
• Changes in vision
• Swelling, redness or pain in only one extremity
• Rashes or discoloration of skin
• Painful urination
• Increased urination
• Severe thirst
• Swelling of feet or ankles
• Sudden weight gain
• Slow wound healing

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug.  By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2004 CancerConsultants.com.  Last updated 01/04.
Important Limitations of Use
TThe information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.

As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information.  Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.

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