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What Factors Determine Hydrocortisone Dosage?

By M. West
Updated May 17, 2024
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The main factors that determine hydrocortisone dosage are the type and severity of the disease being treated and the size of the patient. The larger the size of the patient, the more drug will be required to produce the desired blood level. As a consequence, adults are prescribed much larger dosages than children. Dosage will differ in method of administration as well as in size. Acute life-threatening disorders will require an intramuscular or intravenous injection, while non-acute maladies may be treated with an oral dosage. For treatment of skin disease, it also be applied topically through hydrocortisone cream or ointment, and for alleviation of colitis, it may be given rectally through a suspension.

One of the conditions this drug is used for is adrenocortical insufficiency, which is failure of the adrenal glands to produce enough steroid hormones. The adult hydrocortisone dosage is 100 mg intravenously, followed by 300 mg per day either in segmented amounts or as a 48-hour infusion. Once the adult patient improves, the dose will switch to oral, 50 mg three times per day, later reducing to 30 to 50 mg once per day. Small children with this condition will be intravenously administered 1 to 2 milligrams/kilograms (mg/kg) initially, then later the dose will be reduced to 25 to 100 mg per day in segmented quantities. Older children will be given a hydrocortisone shot initially, then later prescribed an oral dose of 30 to 50 mg per day in divided amounts.

The adult hydrocortisone dosage for inflammation may be administered intravenously, either intramuscularly or orally. Normally 15 to 240 mg per day is prescribed. Oral dosages recommended for young children with inflammation are 2.5 to 10 mg/kg per day in segmented quantities. Intravenous or intramuscular dosages for this age group are typically 1 to 5 mg/kg per day. The anti-inflammatory dose for older children is the oral, intramuscular or intravenous administration of 15 to 240 mg twice per day.

Another disease this drug is used to treat is shock, which is an emergency condition arising from inadequate blood flow within the body. The typical adult hydrocortisone dosage is 500 mg to 2 grams (g) administered intravenously, four to 12 times per day. Children in shock are given two initial doses of 50 mg/kg intravenously, separated by four hours. The child dose is later reduced to once per day, as needed. Adolescents in shock are prescribed 500 mg to 2 g, four to 12 times per day.

Asthma, which is a disorder involving the breathing airways, can be treated with hydrocortisone. The adult hydrocortisone dosage is usually 100 to 500 mg intravenously, four times a day. Treatment of children with acute asthma may involve a loading dose of 4 to 8 mg/kg intravenously. The child maintenance dose is 2 mg/kg, four times per day.

Ulcerative colitis, an inflammatory condition affecting the large intestine, may be alleviated with this medication. Adult hydrocortisone dosage is normally the administration of 100 mg of a rectal suspension every night for 21 days. Severe instances of the disease may need two to three months of the treatment. If the duration of this therapy is greater than 21 days, it should be discontinued slowly by reducing the hydrocortisone dose to once every 48 hours for a duration of two to three weeks.

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