HYDROCORTISONE ACETATE

It is a natural glucocorticoid hormone of the adrenal cortex possessing anti-inflammatory, anti-allergic, anti-exudative and anti-fibroblastic properties. Hydrocortisone acetate in aqueous suspension form ensures slow absorption and a prolonged duration of action at the site of injection with negligible systemic effects

Indications

Rheumatology (a.) Intra-articular injection : rheumatoid arthritis, osteoarthritis, gouty arthritis, joint sequelae of fractures and dislocations. (b.) Peri-articular/soft tissue injection: scapulo-humeral periarthritis, periarthritis of hip, bursitis, tendinitis, synovitis, tenosynovitis, talalgias meta- tarsalgias, epico-ndylitis, Duuytren’s contracture, Peyronie’s disease, cystic tumours of aponeurosis or tendon (ganglia). Neurology Intra-thecal/epidural injection: lumbago, sciatica, cervico-brachial neuralgia & other painful radiculop-athies; selected cases of inflammatory disorders such as tuberculous meningitis & multple sclerosis. Dermatology intra-lesional injection: keloids, hypertrophic scars, other localised hypertrophic, infiltrated, inflammatory lesions of lichen panus, psoriatic plaques, granuloma annulare and lichen simplex chronicus; discoid lupus erythematosus, necrobiosis lipoidica diabe- ticorum, alopecia areata. Ophthalmolgy (a) Sub-conjunctival injection: scleritis, episcleritis, iridocyclitis, iritis and other inflammatory disorders of the eye. (b) Retro-bulbar injection: optic neuritis, retro-bulbar neuritis. Oto-rhino-laryngology: (a) Sub-mucous injection allergic rhinitis, nasal polyposis. (b) Intra-sins injection: allergic sinusitis. (c) Transtympanic injection: cicatrising lesions of the middle ear. Gynaecology:Intra-lesional injection: tubal stenosis. Other conditions (a) Intra-cavitary injection: pleurisy,pericarditis, peritonitis. (b) Retention enema: proctitis, proctocolitis.

Dosage

Intra-articular: 0.5-2 ml. Peri-articular:0.5-2 ml. Epidural/intra-thecal: 1-2 ml. Intra-lesional in dermatology: 0.25-2 ml. Subconjunctival: 0.25-1 ml. Retro-bulbar: 0.25-1 ml. Sub-mucous: 0.5-1 ml. Intra-sinus: 3 ml. Transtympanic: 0.5-1 ml. Intralesional in gynaecology: 3 ml. Intra-cavitary: 1-3 ml. Retention enema: 3 ml. in 20 to 120 ml. normal saline. To be repeated at an interval of some days to several weeks depending on the response.

Contra-Indications

Local or systemic infection. In ophthalmology ; herps zoster, herpetic or fungal keratitis, previous history of cataract. Neborn babies or premature infants.Not to be given i.v. or i.m.

Special Precautions

Injection have to be made under strict aseptic conditions. In dermatology avoid use in anterior portion of scalp for fear of micro-embolisation. Possibility of infection due to local bacterial proliferation especially in intra-articular injection.

Drug Interactions

Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone and barbiturates. Rifampicin reduces corticosteroid activity. Peptic ulcer with cocurrent NSAID’S administration. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum concentration of salicylates and antimuscarinic agents.