Renson Special Precautions

In patients receiving hydrocortisone substitution therapy, the dosage of hydrocortisone in stress situations, e.g. trauma, infections, or surgery, must be increased 2-4 fold and, if necessary, the patient must be transferred to parenteral therapy.
Long-term systemic glucocorticoid therapy causes adrenocortical insufficiency which may last for months after the treatment has been stopped. Therefore, in stress situations, e.g. infections, the dosage of Hydrocortisone must be increased.
To avoid the withdrawal syndrome of glucocorticoid therapy, long-term corticosteroid therapy must be withdrawn gradually over a period of several weeks. Dosing on alternate days reduces the risk of adrenocortical insufficiency and the withdrawal syndrome associated with stopping the treatment. Caution should be exercised when administrating pharmaceutical dose of hydrocortisone to patients with acute psychosis, peptic ulcer, diabetes, osteoporosis, glaucoma or hypertension.
Glucocorticoids may reduce the potency of vaccines and increase the risk of neurological complications of vaccination. Live virus vaccines can cause an infection in patients receiving corticosteroids.
Pheochromocytoma crisis, which may be fatal, has been reported after administration of systemic corticosteroids. Corticosteroids should only be administered to patients with suspected or identified pheochromocytoma after an appropriate risk/benefit evaluation.
Effects on Ability to Drive and Use Machine: Hydrocortisone may cause vertigo, visual field loss and muscle wasting and weakness. If affected, patients should not drive or operate machinery.