Hydrocortison zur Cortisolersatztherapie

About hydrocortisone

Hydrocortisone belongs to a group of medicines called corticosteroids. It is sometimes referred to simply as an oral steroid. It is used as a replacement treatment for people whose adrenal glands are not producing as much of the steroid hormones (such as cortisol) as they normally do. This can happen in a condition known as adrenal insufficiency, or Addison-Krankheit. It also happens in people who have had surgery to remove their adrenal glands and who therefore no longer make their own natural steroid hormones. These hormones are vital for your body and if you do not have enough of them, you can become very unwell.

Hydrocortisone is usually prescribed alongside another replacement medicine called Fludrocortison. Fludrocortisone is a substitute medicine for one of the other vital hormones that are no longer being made in people with adrenal insufficiency.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking hydrocortisone it is important that your doctor knows:

• Wenn Sie hohen Blutdruck haben.

• Wenn Sie einen Herzinfarkt erlitten haben oder andere Herzprobleme haben.

• Wenn Sie Probleme mit der Funktion Ihrer Leber haben oder wenn Sie Probleme mit der Funktion Ihrer Nieren haben.

• If you (or a close family member) have either diabetes (diabetes mellitus) or an eye condition called glaucoma.

• If you have any of the following conditions: an underactive thyroid gland, 'thinning' of the bones (osteoporosis), epilepsy, a condition causing muscle weakness (called myasthenia gravis), a stomach ulcer, or an inflammatory bowel disorder.

• Wenn Sie jemals ein psychisches Gesundheitsproblem hatten.

• If you are pregnant or breastfeeding. (Oral steroids like hydrocortisone can be taken while you are expecting or breastfeeding; however, it is important that your doctor knows about the baby.)

• Wenn Sie derzeit eine Infektion haben oder in der Vergangenheit Tuberkulose (TB) hatten.

• Wenn Sie jemals einen unerwünschten Blutgerinnsel in einer Arterie oder Vene hatten.

• Wenn Sie kürzlich eine Impfung erhalten haben oder bald eine erhalten werden.

• If you are taking other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines.

• Wenn Sie jemals eine allergische Reaktion auf ein Medikament hatten oder wenn Sie jemals Muskelschmerzen nach der Einnahme eines Steroidmedikaments entwickelt haben.

• Before starting the treatment, read the manufacturer's printed information leaflet from inside the pack and any additional information you are given by your doctor. These will give you more information about hydrocortisone and will also provide you with a full list of side-effects which you could experience from taking it.

• Your doctor or pharmacist will tell you how many tablets to take and when to take them. This information will also be printed on the label of the packet of tablets to remind you about what was said to you. It is important that you take hydrocortisone exactly as your doctor tells you to. As a guide:

  • If you are taking immediate-release tablets (called simply 'Hydrocortisone tablets'), it is likely that you will be prescribed two or three doses to take each day. It is usual for your morning dose to be larger than the other doses. Take the tablets just after eating a meal, or alternatively with a snack.

  • If you have been prescribed a brand of tablet called Plenadren®, this is a tablet which releases hydrocortisone to your body throughout the day. It is usual to take one dose a day, 30 minutes before your breakfast. Swallow the tablet whole (this means do not break, crush, or chew it), with a drink of water. Do not drink grapefruit juice if you are taking Plenadren® because it will interfere with the way the tablets work.

  • If you (or your child) have been prescribed granules in capsules for opening (Alkindi®) follow the manufacturer's instructions closely. Do not swallow the capsule. Carefully open the capsule and place the granules either directly onto the tongue, onto a spoon or onto some soft food like yoghurt or apple sauce. Make sure the capsule is empty of granules. Have a drink of water or milk after swallowing the granules.

• Try to take your doses at the same time of day each day, as this will help you to remember to take hydrocortisone regularly. If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose). Do not take two doses together to make up for a forgotten dose.

• Continue to take hydrocortisone tablets regularly each day - it is vital for your well-being. Hydrocortisone replacement treatment is almost always lifelong.

• You will be given a 'Steroid Treatment Card' which says that you are on steroids and contains some important advice for you. It is important that you read this card and carry it with you at all times. It also contains details about your dose, how long you have been taking hydrocortisone and who prescribed it for you. Please make sure that this information is kept up to date. If you are due to have an operation or dental treatment, or if you are having any treatment for an injury, please tell the person carrying out the treatment that you are taking hydrocortisone and show them your treatment card.

• Versuchen Sie, Ihre regelmäßigen Termine bei Ihrem Arzt einzuhalten. Damit kann Ihr Arzt Ihren Fortschritt überwachen. Ihr Arzt wird möchten, dass Sie von Zeit zu Zeit Tests durchführen lassen, um sicherzustellen, dass Sie frei von einigen unerwünschten Nebenwirkungen der Behandlung bleiben.

• It is important that if you become ill you make an appointment to see your doctor straightaway. Also, if you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have them), you should contact your doctor for advice as soon as possible.

• Make sure you get your next supply of tablets well in advance so that you never run out. People with Addison's disease are entitled to free prescriptions.

• Some vaccines are not suitable for you while you are being treated with hydrocortisone. If you need any immunisations, make sure you mention that you are taking hydrocortisone.

• If you buy any medicines 'over the counter', please check with a pharmacist that they are suitable for you to take alongside hydrocortisone.

Along with its useful effects, hydrocortisone can cause unwanted side-effects which your doctor will discuss with you. The benefits of taking hydrocortisone usually outweigh the side-effects; however, they can sometimes be troublesome. Although not everyone experiences side-effects, and some will improve as your body adjusts to the new medicine, speak with your doctor or pharmacist if you become concerned about any of the following:

• Bewahren Sie alle Medikamente außerhalb der Reichweite und Sicht von Kindern auf.

• An einem kühlen, trockenen Ort aufbewahren, fern von direkter Hitze und Licht.