Alkindi Sprinkle, Cortef

Written by Jen Seabright, PharmD
Medically reviewed by Victor Nguyen, PharmD, MBA
Updated on June 30, 2023

The Food and Drug Administration (FDA) has approved hydrocortisone to treat various conditions. These include:

• endocrine (hormone) problems
• rheumatic (joint, ligament, tendon, muscle, or bone) disorders
• collagen (connective tissue) conditions
• certain skin, eye, and lung problems
• allergies and asthma
• blood disorders
• cancers and related symptoms
• fluid buildup in the body due to certain disorders
• digestive problems

These approved uses differ based on the form of hydrocortisone your doctor prescribes.

This article describes hydrocortisone’s uses, side effects, and more. You’ll also find some coupon options to help save on the cost of hydrocortisone.

The Food and Drug Administration (FDA) approves prescription drugs such as hydrocortisone for certain conditions. Approved uses for hydrocortisone are described below. These uses differ based on the form of hydrocortisone prescribed.

Use for certain skin conditions

Doctors may prescribe hydrocortisone oral tablet or topical* cream, ointment, or lotion for treating certain skin conditions. It’s used for this purpose in adults and some children. The length of treatment depends on the condition.

Some skin conditions that hydrocortisone is prescribed to treat include:

• pemphigus (severe itchy blisters)
• bullous pemphigoid and dermatitis herpetiformis (itchy blisters and raised lesions)
• severe skin reactions, such as erythema multiforme and Stevens-Johnson syndrome
• exfoliative dermatitis
• mycosis fungoides
• severe psoriasis
• severe seborrheic dermatitis
• atopic dermatitis (commonly called eczema)
• contact dermatitis

With these skin conditions, you may have itchiness, redness or discoloration, rashes, or scaly areas of skin. Hydrocortisone helps to reduce these symptoms.

Doctors may not prescribe hydrocortisone if you’re allergic to it.

* “Topical” means applied to the skin.

Use for conditions related to inflammation

Doctors may prescribe hydrocortisone oral tablet for treating conditions related to inflammation (swelling and damage). It’s used for this purpose in adults and some children. The length of treatment depends on the condition being treated.

The various conditions related to inflammation that hydrocortisone can treat include:

• endocrine (hormone-related) problems, such as congenital adrenal hyperplasia
• rheumatoid arthritis and other types of arthritis, including gout
• bursitis
• swelling of the joints and tendons
• systemic lupus erythematosus and other collagen (connective tissue) diseases
• polymyositis
• thyroid conditions
• heart conditions
• allergic rhinitis and asthma
• certain eye conditions, such as optic neuritis
• sarcoidosis and other lung problems
• ulcerative colitis and other digestive conditions
• blood disorders, such as hemolytic anemia
• fluid buildup in the body due to certain disorders
• high blood calcium level due to cancer

Doctors may not prescribe hydrocortisone oral tablet if you’re allergic to it or if you have a serious fungal infection.

Below you’ll find answers to a few commonly asked questions about hydrocortisone.

Is hydrocortisone used on the face?

It’s not typically recommended to use hydrocortisone topical* cream, ointment, or lotion on your face. But for certain conditions, your doctor may prescribe hydrocortisone to be applied to your face. Always follow your doctor’s directions for applying hydrocortisone.

* “Topical” means applied to the skin.

Can hydrocortisone be used for acne, sunburn, or vaginal itching?

Acne, sunburn, and vaginal itching are not approved uses for hydrocortisone. However, sometimes your doctor will prescribe a drug for conditions other than those it’s approved to treat. This is called off-label use.

Be sure to use hydrocortisone only as prescribed by your doctor. If you have questions about taking or using hydrocortisone for a certain condition, talk with your doctor.

Is it safe to use hydrocortisone with neomycin and polymyxin B sulfate?

Yes. There’s no known interaction between hydrocortisone and neomycin or polymyxin B sulfate. If you have concerns about using these medications together, talk with your doctor or pharmacist.

Does hydrocortisone have an over-the-counter form available?

Yes, hydrocortisone cream is available over the counter (OTC) in 0.5% and 1% strength. The prescription strength of hydrocortisone cream is 2.5%. Your doctor or pharmacist can provide more information about the OTC cream.

How does hydrocortisone work? And how long does it take to start working?

Hydrocortisone is a corticosteroid medication. It blocks certain substances in the body to reduce swelling and itchiness. It also causes blood vessels to constrict (get narrower). This can reduce swelling, redness or discoloration, and other symptoms.

Hydrocortisone oral tablet may start working about 30 minutes after you take a dose. The cream, ointment, and lotion may take a few days to start working. You’ll likely notice an improvement in your symptoms about 1–2 weeks after starting treatment.

If you’d like to know more about what to expect with hydrocortisone treatment, talk with your doctor or pharmacist.

Hydrocortisone may cause mild or serious side effects. More common mild side effects of hydrocortisone and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about hydrocortisone’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for hydrocortisone listed in the “Article resources” section.

Mild side effects

More common mild side effects reported with some forms of hydrocortisone are listed below. These side effects may differ based on the form of hydrocortisone you take or use.

This article doesn’t include all possible mild side effects of the drug. To learn more about hydrocortisone’s side effects based on the form, refer to the prescribing information for hydrocortisone listed in the “Article resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Hydrocortisone oral tablet’s mild side effects include:

• swelling in the legs, feet, or ankles
• muscle weakness
• small increases in liver enzymes (a possible sign of liver problems) that are reversible
• flushing (temporary warmth, redness, or deepening of skin color) of the face
• mild allergic reaction*

Hydrocortisone topical† cream’s mild side effects include:

• skin burning and irritation
• new or worsening itchiness
• dry skin
• hair follicle inflammation (swelling and damage)
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for hydrocortisone” section.

† “Topical” means applied to the skin.

Serious side effects

Serious side effects of hydrocortisone are listed below. These side effects may differ based on the form of hydrocortisone you use.

This article doesn’t include all possible serious side effects of the drug. To learn more about hydrocortisone’s side effects based on the form, refer to the prescribing information for hydrocortisone listed in the “Article resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, hydrocortisone’s serious side effects include:

• softening and breakdown of skin
• thinning of the skin
• new or worsening bacterial infection
• other permanent skin changes such as stretch marks
• severe allergic reaction*

For hydrocortisone oral tablet, the following serious side effects may also occur:

• heart failure
• high blood pressure
• osteoporosis (thinning bones)
• rupture (tear) in the Achilles tendon
• glaucoma (increased pressure in the eyes)

* For details about this side effect, see the “Interactions and warnings for hydrocortisone” section.

Below, you’ll find information about hydrocortisone’s possible interactions and warnings.

Interactions of hydrocortisone

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you use hydrocortisone, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for hydrocortisone” section below.

Warnings for hydrocortisone

Some people should not use hydrocortisone, and others should use it cautiously.

Hydrocortisone could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether hydrocortisone is a safe option for you. These warnings may differ based on the form of hydrocortisone you take or use.

Ask your doctor about specific warnings for hydrocortisone, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Hydrocortisone can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to hydrocortisone or any of its ingredients, your doctor will likely not prescribe hydrocortisone. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to hydrocortisone, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of hydrocortisone

You should not use more hydrocortisone than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken or applied too much hydrocortisone, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and hydrocortisone

Information about hydrocortisone and pregnancy and breastfeeding is described below.

Hydrocortisone and pregnancy

Hydrocortisone should not be taken or used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication. Your doctor may suggest birth control options to use during treatment with hydrocortisone.

Hydrocortisone and breastfeeding

It’s not known whether hydrocortisone should be taken or used while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before using this medication.

This article describes hydrocortisone’s uses, side effects, and more. Let your doctor know if you have questions about hydrocortisone or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Am I at higher risk of side effects than others?
• Does my dosage of hydrocortisone oral tablet need to be changed if I’m taking other drugs with it?
• Are there any other medications that I can take for my condition?

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Hydrocortisone — hydrocortisone cream. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/44463d7c-6397-4c57-9d60-f753d91d0465/spl-doc
• Hydrocortisone — hydrocortisone lotion. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/a2c18606-631f-4e89-8936-3d635a41c37d/spl-doc
• Hydrocortisone — hydrocortisone ointment. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/4e4b7175-2046-4bfe-aee3-afafe08300f3/spl-doc
• Hydrocortisone — hydrocortisone tablet. (2020). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/6c676166-2471-478c-b662-f8c9c168977b/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.