Hydrocortisone comes in both oral and injectable forms, and injections of the medicine can be life-saving in case of emergency for children with adrenal disorders.
Hydrocortisone itself is a special class of steroid known as a glucocorticoid. Although it has many uses, for children with adrenal disorders, it is most commonly prescribed if your provider is concerned that your child does not make enough of a naturally produced hormone called cortisol.
Cortisol plays a vital role in many bodily functions. It helps to maintain normal levels of:
A healthy child makes a small amount of cortisol all day long, and even more anytime they are sick or stressed. Because your child’s body makes extra cortisol when they are sick, a child with adrenal insufficiency has to be given extra doses of hydrocortisone (or synthetic cortisol) anytime they are physically stressed. Most commonly, that extra steroid dose can be given my mouth. But in certain emergency situations, when a child can’t take medication by mouth, it has to be given via injection into the muscle.
Hydrocortisone injections raise the level of the hormone cortisol when the body doesn’t produce enough in emergency situations.
They can play a role in the treatment plan for children with many different endocrine conditions, all of which have in common a decreased ability to produce cortisol from one’s adrenal gland.
Since it is meant to be a one time dose, given in an emergency situation, if it is given safely and with proper technique, the risks of injectable hydrocortisone are minimal. Any injection can be associated with any of the following side effects:
Because the injectable medicine is a big dose of hydrocortisone, it can also cause temporary increases in your blood pressure or blood sugar levels. If you have any concerns about the side effects, talk with your provider.
If your child is on chronic hydrocortisone (or other steroid) therapy, speak to your child's provider about carrying an injectable form of hydrocortisone in case of medical emergencies.
Hydrocortisone injections come as a powder to be mixed with liquid diluent. Your health care provider will give you step-by-step instructions on how to mix and administer the injection. You will also receive instructions on when to give the dose. A copy of these sick day protocols should also be shared with your child’s school. Make sure to tell your provider if you need to administer a stress dose.
They are used as a hormone replacement in emergency situations for children with endocrine conditions who don't produce enough of the hormone cortisol.
Your provider will give you step-by-step instructions on how to set up the injection and administer it.
Store the medication in a dark, dry place away from moisture (not in the bathroom or above the kitchen sink).
If your child has a fever, vomits or experiences other illnesses that stress the body, your child may need a “stress” dose. The injectable form should be considered if your child is unable to take this stress dose by mouth. Your provider can help you determine what is right for your child.
Only in case of significant medical emergencies.
The medication starts to work right away when given, but the time until a child starts to feel relief from their symptoms can vary tremendously depending on what symptoms they are experiencing and why. Always seek medical attention after giving your child a hydrocortisone shot.