Lilinorm (Hydrocortisone)

Hydrocortisone acts as a glucocorticoid to modulate endocrine and inflammatory pathways.

• Adrenal insufficiency: restores physiologic cortisol levels and prevents adrenal crisis.
• Inflammatory disorders: reduces systemic inflammation and immune activity in conditions such as rheumatoid arthritis.
• Severe allergic reactions: mitigates hypersensitivity responses when oral glucocorticoid therapy is indicated.

• Hydrocortisone binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and regulates gene transcription. This interaction up‑regulates anti‑inflammatory proteins and down‑regulates pro‑inflammatory cytokines, leading to decreased leukocyte migration, reduced capillary permeability, and suppression of immune cell activation, thereby providing both glucocorticoid and mineralocorticoid effects.

Hydrocortisone may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Increased appetite: heightened hunger leading to potential weight gain.
• Fluid retention: swelling of extremities due to sodium and water retention.
• Mood changes: irritability, anxiety, or euphoria.
• Elevated blood glucose: hyperglycaemia, especially in diabetic patients.

Serious or Rare Side Effects

• Severe infection: heightened susceptibility to bacterial, viral, or fungal infections.
• Adrenal crisis on abrupt withdrawal: life‑threatening hypotension and shock.
• Osteoporosis: decreased bone mineral density with long‑term use.
• Cataracts: lens opacity developing after prolonged therapy.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for complications.

• Monitor blood glucose: check regularly in diabetic or pre‑diabetic patients.
• Assess blood pressure: watch for hypertension due to fluid retention.
• Screen for infection: avoid use in active, uncontrolled infections.
• Taper dose: discontinue gradually to prevent adrenal insufficiency.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Hydrocortisone can alter the pharmacokinetics or pharmacodynamics of several agents.

Major Interactions (Avoid)

• Ketoconazole: may increase systemic hydrocortisone concentrations, raising toxicity risk.
• Rifampin: can reduce hydrocortisone effectiveness by inducing hepatic metabolism.
• Warfarin: hydrocortisone may potentiate anticoagulant effect, increasing bleeding risk.

Moderate Interactions (Monitor Closely)

• Diuretics: may exacerbate hypokalaemia when combined with glucocorticoids.
• NSAIDs: concurrent use raises the chance of gastrointestinal ulceration or bleeding.
• Live vaccines: glucocorticoid therapy may diminish vaccine efficacy and increase infection risk.