Source: Health Products Regulatory Authority (IE) Revision Year: 2016 Publisher: Pinewood Laboratories Ltd., Ballymacarbry, Clonmel, Co Tipperary, Ireland
Hydrocortisone is the major glucocorticoid secreted by the adrenal cortex. It is released in to the circulation under the influence of adrenocorticotrophic hormone (ACTH). The half-life is normally 60-90 minutes. One percent of secreted cortisol is excreted unchanged in urine, 20% converted to cortisone in the liver and the remainder inactivated by conversion to tetrahydrocortisol by 3-hydroxy steroid dehydrogenase also in the liver.
Topically applied steroids are absorbed to a significant extent only if applied to broken skin, to very large areas, or under occlusive dressings.
Corticosteroids are rapidly distributed to all body tissues. They cross the placenta and may be excreted in small amounts in breast milk.
Hydrocortisone is metabolised mainly in the liver, but also the kidney, to various degraded and hydrogenated forms such as tetrahydrocortisone.
Hydrocortisone is excreted in the urine, mostly conjugated as glucuronides. Only very small amounts of unchanged hydrocortisone are excreted.
Adverse effects of Hydrocortisone are due to its effects on electrolyte balance, metabolism and particularly adrenal suppression. Topical use of Hydrocortisone has only rarely been associated with systemic side effects.
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