1 mg/kg IV every 8 to 12 hours for 1 to 5 days has been studied in premature and term neonates (combined n from 3 studies = 89, gestational age 23 to 40 weeks). An initial loading dose of 2 mg/kg IV was used in 1 retrospective study and another prospective, observational study used a higher maintenance dose of 3 to 6 mg/kg/day IV divided 2 to 4 times daily in a small number of patients (n = 5) with severe capillary leak syndrome and/or previous steroid treatment. In the largest prospective, randomized, placebo controlled study (n = 48, gestational age to weeks), patients receiving hydrocortisone 1 mg/kg IV every 8 hours for 5 days required significantly less vasopressor support (lower doses of dopamine and dobutamine, shorter duration of vasopressor therapy, and fewer patients requiring more than 1 vasopressor) compared to patients receiving placebo. The trend of the average mean arterial blood pressure (MAP) was also significantly higher in patients receiving hydrocortisone compared to patients receiving placebo.
Hydrocortisone is classed as a mild topical corticosteroid. Topical corticosteroids are also referred to as topical steroids . Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis . A topical steroid can be used to relieve the symptoms when patches of eczema or dermatitis flare up. Hydrocortisone is also useful in reducing inflammation due insect bites and stings . A doctor may also prescribe hydrocortisone to treat nappy rash in a baby or infant.
Dosing should be individualized on the basis of disease and patient response
-Initial dose: to 8 mg/kg/day oral or IV in 3 or 4 divided doses (20 to 240 mg/m2/day)
Maintenance dose: After a favorable initial response, dose should be decreased in small amounts to the lowest dose that maintains an adequate clinical response; if a positive response is not achieved after a reasonable period of time, alternative therapy should be sought.
-Lower doses, including doses lower than recommended doses, may suffice in less severe disease; doses in excess of recommended doses may be required in severe disease; in life-threatening situations, doses exceeding multiples of the oral dose may be justified.
-Patients should be closely monitored for signs requiring dose adjustments; if therapy is to be stopped after more than a few days, it should be gradually withdrawn.
Uses: For use as a potent anti-inflammatory agent in managing disorders, diseases, and conditions affecting many organ systems including endocrine, dermatologic, ophthalmic, nervous, gastrointestinal, respiratory, musculoskeletal, and hematologic.