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Drug Type
Corticosteroid.
Trade Name
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| bet | 273/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Drug Type
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Corticosteroid.
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Trade Name
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IV: Solu-Cortef.
Oral: Hysone.
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Presentation
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100 mg vial, 4 mg tablet, 20mg tablet
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Dosage / Interval
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For oral dosing round dose off to the nearest whole milligram (ie round dose off to the nearest half or quarter tablet).
Hypotension
≥ 35 weeks CGA/PMA: 1 mg/kg/dose 6–8 hourly (range 1−2 mg/kg/dose).
< 35 weeks CGA/PMA: 1 mg/kg/dose 6–12 hourly (range 1−2 mg/kg/dose).
Hypoglycaemia: 1–2.5 mg/kg/dose every 6 hours.
Physiologic replacement (hypoadrenalism): 8-20 mg/m2/day in 3-4 divided doses. [2]
Dosing and dose adjustment should be done in consultation with a Paediatric Endocrinologist.
Stress dose: 50 mg/m2/day in 4 divided doses [up to 100 mg/m2/day]. [If length not available use hypoglycaemia dose].
Body Surface Area (BSA) calculation:
Low dose for prevention of bronchopulmonary dysplasia (not routinely recommended) [1-3]:
0.5 mg/kg/dose every 12 hours for 7 days; then
0.5 mg/kg/dose every 24 hours for 3 days.
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Route
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IV, oral.
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Preparation
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IV
Add 2 mL of water for injection to the 100 mg vial (50 mg/mL). Draw up 1 mL (50 mg) of reconstituted solution and add 4 mL sodium chloride 0.9% to make a final volume of 5 mL with a concentration of 10 mg/mL.
Oral
Hydrocortisone is not soluble in water. Underdosing or inaccurate dosing can occur when a whole 4mg tablet is dispersed in water, and a proportion of the final volume administered. Doses of hydrocortisone for oral administration should be rounded off to the nearest whole milligram (ie round dose off to the nearest half or quarter tablet).
Instructions to prepare an oral dose: Using a tablet cutter, cut a 4mg tablet in halves or quarters (depending on the dose required). Crush the portion of tablet required for the dose and disperse it in 1-2mL of sterile water or milk for administration to patient. Discard remaining portion of tablet.
Refer to Appendix 1 for instruction sheet for staff and parents.
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Administration
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IV: Slow IV injection over at least 1 minute.
Oral: With feeds.
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Monitoring
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Measure blood pressure and blood glucose frequently during acute illness.
In infants with primary adrenal insufficiency, monitor glucocorticoid replacement by clinical assessment, including growth velocity, body weight, blood pressure and energy levels.
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