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Summary
General Info

PubChem

PubChem Compound 11279933

Name:	Hydrocortisone
PubChem Compound ID:	11279933
Description:	The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.
Molecular formula:	C₂₁H₃₀O₅
Molecular weight:	362.46 g/mol

DrugBank

Identification

Name:	Hydrocortisone
Name (isomeric):	DB00741
Drug Type:	small molecule
Description:	The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.
Synonyms:	Hydrocortisone Valerate; Hydrocortisonum [INN-Latin]; Hydrocortisone free alcohol; Hydrocortisone Sodium Phosphate; Hydrocortisone Acetate; Hydroxycortisone; Dihydrocostisone; Anti-inflammatory hormone; Hydrocortisone Butyrate; Hydrocortisone alcohol. show more » Hydrocortisone Valerate; Hydrocortisonum [INN-Latin]; Hydrocortisone free alcohol; Hydrocortisone Sodium Phosphate; Hydrocortisone Acetate; Hydroxycortisone; Dihydrocostisone; Anti-inflammatory hormone; Hydrocortisone Butyrate; Hydrocortisone alcohol; 17alpha-Hydroxycorticosterone; 11beta-Hydroxycortisone; Hidrocortisona [INN-Spanish]; Idrocortisone [DCIT]; Hydrocorticosterone; Hydrocortisone Base show less «
Brand:	Cortifan, Tarcortin, Evacort, Hycortol, Zenoxone, Alacort, Timocort, Cortesal, Permicort, Acticort, Efcortelan, Lubricort, Cremicort-H, Stie-cort, Sigmacort, Orabase HCA, Komed HC, EF corlin, Corticreme, Tetrahydro E, Epicort, Locoid Lipocream, Scalpicin Capilar, Compound F, Hytisone, Cortisol alcohol, Maintasone, Cort-Quin, Racet, Hytone, Hydracort, Proctofoam, Hi-cor, Hydrasson, Nutracort, Hydro-colisona, Eldercort, Remederm HC, Hydroskin, Cortef Acetate, Preparation H Hydrocortisone Cream, Dricort, Dermacort, Dioderm, Hydrocortone, Foille Insetti, Proctocort, Schericur, Clear aid, Drotic, Pediotic Suspension, Kendall's compound F, Locoid, Dermaspray, Cortisol, Vioform-Hydrocortisone, Incortin-hydrogen, Fiocortril, Uniderm, Incortin-H, Cortaid, Colocort, Hydro-adreson, Beta-hc, Nogenic HC, Scheroson F, Cortolotion, Heb Cort, Hysone, Cortifoam, Cutisol, Cobadex, Dermil, Flexicort, Texacort, Algicirtis, Cortef, Thyrotropic-releasing factor, Cortisporin Otico, Cortisolonum, Meusicort, Cetacort, Heb-Cort, Vytone, Prepcort, Cortoxide, Ficortril, Cremesone, Efcorbin, H-Cort, Hemsol-HC, Cortiment, Aeroseb-HC, Gyno-Cortisone, Delacort, THE, Optef, Kyypakkaus, Lactisona, Dermocortal, Cortonema, Epiderm H, Glycort, Synacort, Genacort, Micort-hc, Efcortelin, Eldecort, Otosone-F, Aeroseb HC, Mildison, Rectoid, Cort-Dome, Reichstein's Substance M, Hytone lotion, Medicort, Aquanil HC, Anflam, Balneol-hc, Cortanal, Penecort, Alphaderm, CaldeCORT Spray, Otobiotic, Milliderm, Barseb HC, Dome-cort, Otalgine, Esiderm H, Polcort H, Hydrocort, Cleiton, Hydrocortistab, Transderma H, Ala-Scalp, Aquacort, Anusol HC, Cortisporin, Signef, Protocort, Dermolate, Hycortole, Urocortisone, Lacticare-HC, Westcort, Traumaide, Hydrocortal, Otocort, Domolene-HC, Cortispray, Nystaform-HC, Tetrahydrocompound E, Pandel, Systral Hydrocort, Hycort, Sanatison, Hydrocortisyl, Derm-Aid, Hidalone, Neosporin-H Ear, VoSol HC, Hidro-Colisona, Amberin, Prevex HC, Cortenema, Basan-Corti, Texacort lotion 25, Lacticare HC, Ala-cort, Stiefcorcil, Cortril
Brand name mixture:	Neo-Cortef Eye Ear Ont(Hydrocortisone Acetate + Neomycin Sulfate), Neo-Cortef Eye Ear Dps(Hydrocortisone Acetate + Neomycin Sulfate), Proctosone Sup(Dibucaine Hydrochloride + Esculin + Hydrocortisone Acetate + Neomycin Sulfate), Actinac Pwr(Allantoin + Butoxyethyl Nicotinate + Chloramphenicol + Hydrocortisone Acetate + Sulfur), Proctosedyl Sup(D... show more » Neo-Cortef Eye Ear Ont(Hydrocortisone Acetate + Neomycin Sulfate), Neo-Cortef Eye Ear Dps(Hydrocortisone Acetate + Neomycin Sulfate), Proctosone Sup(Dibucaine Hydrochloride + Esculin + Hydrocortisone Acetate + Neomycin Sulfate), Actinac Pwr(Allantoin + Butoxyethyl Nicotinate + Chloramphenicol + Hydrocortisone Acetate + Sulfur), Proctosedyl Sup(Dibucaine Hydrochloride + Esculin + Framycetin Sulfate + Hydrocortisone), Otizol Hc Liq(Hydrocortisone (Hydrocortisone Acetate) + Lidocaine (Lidocaine Hydrochloride) + Neomycin (Neomycin Sulfate)), Proctosedyl Ointment(Dibucaine Hydrochloride + Esculin + Framycetin Sulfate + Hydrocortisone), Vioform Hydrocortisone Mild(Clioquinol + Hydrocortisone), Vioform + Hydrocortisone(Clioquinol + Hydrocortisone), Actinac Pws(Allantoin + Butoxyethyl Nicotinate + Chloramphenicol + Hydrocortisone Acetate + Sulfur), Cortisporin(Bacitracin Zinc + Hydrocortisone + Neomycin Sulfate + Polymyxin B Sulfate), Neo-Cortef Eye Ear Drops Sterile Suspension(Hydrocortisone Acetate + Neomycin Sulfate), Ti-U-Lac Hc Lotion(Hydrocortisone + Urea), Sopamycetin/Hc Ont(Chloramphenicol + Hydrocortisone Acetate), Vosol Hc(Acetic Acid + Benzethonium Chloride + Hydrocortisone + Propylene Glycol Diacetate), Calmurid Hc Crm(Hydrocortisone + Urea), Proctosedyl Suppositories(Dibucaine Hydrochloride + Esculin + Framycetin Sulfate + Hydrocortisone), Ophthocort Ont(Chloramphenicol + Hydrocortisone Acetate + Polymyxin B (Polymyxin B Sulfate)), Eye and Wound Powder(Chlorhexidine Hydrochloride + Hydrocortisone Acetate + Penicillin G Procaine + Sulfathiazole), Vioform Hydrocortisone Cream(Clioquinol + Hydrocortisone), Sopamycetin/Hc Ointment(Chloramphenicol + Hydrocortisone Acetate), Forte Topical Suspension(Hydrocortisone Acetate + Hydrocortisone Sodium Succinate + Neomycin (Neomycin Sulfate) + Penicillin G Procaine + Polymyxin B Sulfate), Proctosone Ont(Dibucaine Hydrochloride + Esculin + Hydrocortisone Acetate + Neomycin Sulfate), Sopamycetin/Hc Susp(Chloramphenicol + Hydrocortisone Acetate) show less «
Category:	Anti-inflammatory Agents
CAS number:	50-23-7

Pharmacology

Indication:	For the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Also used to treat endocrine (hormonal) disorders (adrenal insufficiency, Addisons disease). It is also used to treat many immune and allergic disorders, such as arthritis, lupus, severe psoriasis, severe asthma, ulcerative colitis, and Crohn's disease.
Pharmacology:	Hydrocortisone is the most important human glucocorticoid. It is essential for life and regulates or supports a variety of important cardiovascular, metabolic, immunologic and homeostatic functions. Topical hydrocortisone is used for its anti-inflammatory or immunosuppressive properties to treat inflammation due to corticosteroid-responsive dermato... show more » Hydrocortisone is the most important human glucocorticoid. It is essential for life and regulates or supports a variety of important cardiovascular, metabolic, immunologic and homeostatic functions. Topical hydrocortisone is used for its anti-inflammatory or immunosuppressive properties to treat inflammation due to corticosteroid-responsive dermatoses. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger a variety of important cardiovascular, metabolic, immunologic and homeostatic effects. Glucocorticoids are distinguished from mineralocorticoids and sex steroids by having different receptors, target cells, and effects. Technically, the term corticosteroid refers to both glucocorticoids and mineralocorticoids, but is often used as a synonym for glucocorticoid. Glucocorticoids suppress cell-mediated immunity. They act by inhibiting genes that code for the cytokines IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8 and TNF-alpha, the most important of which is the IL-2. Reduced cytokine production limits T cell proliferation. Glucocorticoids also suppress humoral immunity, causing B cells to express lower amounts of IL-2 and IL-2 receptors. This diminishes both B cell clonal expansion and antibody synthesis. The diminished amounts of IL-2 also leads to fewer T lymphocyte cells being activated. show less «
Mechanism of Action:	Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors... show more » Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In other words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding. show less «
Absorption:	Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption.
Protein binding:	95%
Biotransformation:	Primarily hepatic via CYP3A4
Route of elimination:	Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile.
Half Life:	6-8 hours
Toxicity:	Side effects include inhibition of bone formation, suppression of calcium absorption and delayed wound healing
Affected organisms:	Humans and other mammals

Interactions

Food interaction:

Take with food to reduce irritation. Calcium, phosphorous, potassium, Vitamin A, C, D and zinc needs increased with long term use.

Drug interaction:

Neostigmine	The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, neostigmine.
Butethal	The barbiturate, butethal, may decrease the effect of the corticosteroid, hydrocortisone.
Colestipol	Cholestyramine decreases the effect of hydrocortisone
Acetylsalicylic acid	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, acetylsalicylic acid.
Acenocoumarol	The corticosteroid, hydrocortisone, alters the anticoagulant effect, acenocoumarol.

Neostigmine	The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, neostigmine.
Butethal	The barbiturate, butethal, may decrease the effect of the corticosteroid, hydrocortisone.
Colestipol	Cholestyramine decreases the effect of hydrocortisone
Acetylsalicylic acid	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, acetylsalicylic acid.
Acenocoumarol	The corticosteroid, hydrocortisone, alters the anticoagulant effect, acenocoumarol.
Edrophonium	The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, edrophonium.
Salicylate-sodium	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, salicylate-sodium.
Mephenytoin	The enzyme inducer, mephenytoin, may decrease the effect of the corticosteroid, hydrocortisone.
Anisindione	The corticosteroid, hydrocortisone, alters the anticoagulant effect of anisindione.
Amobarbital	The barbiturate, amobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Heptabarbital	The barbiturate, heptabarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Vecuronium	Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Hydrocortisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.
Methylphenobarbital	The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Pentobarbital	The barbiturate, pentobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Secobarbital	The barbiturate, secobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Fosphenytoin	The enzyme inducer, fosphenytoin, may decrease the effect of the corticosteroid, hydrocortisone.
Pyridostigmine	The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine.
Butabarbital	The barbiturate, butabarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Ambenonium	The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, ambenonium.
Hexobarbital	The barbiturate, hexobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Methohexital	The barbiturate, methohexital, may decrease the effect of the corticosteroid, hydrocortisone.
Aprobarbital	The barbiturate, aprobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Trastuzumab	Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.
Cholestyramine	Cholestyramine may decrease the effect of hydrocortisone.
Dihydroquinidine barbiturate	The barbiturate, dihydroquinidine barbiturate, may decrease the effect of the corticosteroid, hydrocortisone.
Salsalate	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, salsalate.
Rifampin	The enzyme inducer, rifampin, may decrease the effect of the corticosteroid, hydrocortisone.
Dicumarol	The corticosteroid, hydrocortisone, alters the anticoagulant effect of dicumarol.
Ethotoin	The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, hydrocortisone.
Primidone	The barbiturate, primidone, may decrease the effect of the corticosteroid, hydrocortisone.
Magnesium salicylate	The corticosteroid, hydrocortisone, may decrease the effect of magnesium salicylate.
Phenytoin	The enzyme inducer, phenytoin, may decrease the effect of the corticosteroid, hydrocortisone.
Quinidine barbiturate	The barbiturate, quinidine barbiturate, may decrease the effect of the corticosteroid, hydrocortisone.
Talbutal	The barbiturate, talbutal, may decrease the effect of the corticosteroid, hydrocortisone.
Trisalicylate-choline	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, trisalicylate-choline.
Butalbital	The barbiturate, butalbital, may decrease the effect of the corticosteroid, hydrocortisone.
Midodrine	Increased arterial pressure
Warfarin	The corticosteroid, hydrocortisone, alters the anticoagulant effect of warfarin.
Tacrine	Tacrine and Hydrocortisone may independently exacerbate muscle weakness in myasthenia gravis patients. Monitor for additive muscle weakness effects.
Phenobarbital	The barbiturate, phenobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Bismuth Subsalicylate	The corticosteroid, hydrocortisone, may decrease the effect of the salicylate, bismuth subsalicylate.

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Targets

Glucocorticoid receptor

Enzymes

Cytochrome P450 11B1, mitochondrial

Cytochrome P450 11B2, mitochondrial

Cytochrome P450 2C8

Transporters

Multidrug resistance protein 1

ATP-binding cassette sub-family G member 2

Solute carrier organic anion transporter family member 1A2

Carriers

Sex hormone-binding globulin