Hydroka^®

Hydroka® is a corticosteroid medicine. It is used as an anti-inflammatory treatment in situations where oral administration is not possible, or where intravenous or intramuscular injection is preferred because of the required dose or route of administration.

• Treatment and prevention of adrenal insufficiency and adrenal crisis, including primary or secondary adrenal cortex insufficiency
• Anti-inflammatory effects or immune-system suppression
• Hospitalized patients with COVID-19
• Hypophysitis
• Prevention of allergic reactions caused by iodinated contrast media
• Control of severe or disabling allergic conditions
• Septic shock with inadequate response to fluid resuscitation and vasopressor therapy
• Thyroid storm
• Supportive treatment during the critical phase of acute ulcerative colitis and Crohn’s disease
• Systemic lupus erythematosus
• Severe erythema multiforme, including Stevens–Johnson syndrome
• Acute asthma attack and anaphylactic reactions
• Pneumonia caused by aspiration of gastric contents
• Palliative management of leukemias and lymphomas in adults, and acute leukemia in children
• Management of severe acute and chronic allergic or inflammatory processes involving the eye
• Rheumatoid arthritis, including juvenile rheumatoid arthritis, osteoarthritis synovitis, and use during exacerbations or as maintenance therapy in acute rheumatic carditis

Lyophilized powder containing 100 mg Hydrocortisone for preparation of injectable solution.

Hydroka® is compatible with the following solutions:

• 0.9% sodium chloride
• 5% dextrose

For intravenous infusion, first dissolve the powder by adding sterile water for injection into the vial. Then dilute the prepared solution with one of the compatible solutions listed above.

The final solution should show no discoloration and should be free of foreign particles or precipitate.

Hydroka® may be administered by intramuscular injection, intravenous injection, or intravenous infusion.

Use of Hydroka® requires careful and regular medical supervision at the start of treatment, during treatment, and when discontinuing the medicine.

The required dose varies depending on the disease and the patient’s response, and should be determined by a specialist physician.

After long-term use, gradual discontinuation is recommended.

When given intravenously, Hydroka® is administered over 1 to 10 minutes.

Each vial is for single use only; discard any remaining medicine.

• Hepatitis B screening before starting treatment
• Blood pressure, weight, electrolyte levels, blood glucose, bone density, and creatine kinase
• Growth and development in children
• Suppression of the hypothalamic–pituitary–adrenal axis
• Signs of behavioral or mood changes
• Regular eye examinations and monitoring of intraocular pressure during treatments lasting longer than 6 weeks
• Signs of Cushing’s syndrome
• Evaluation for amebiasis in patients who have spent time in tropical climates or have unexplained diarrhea
• Monitoring for reactivation of tuberculosis in patients with latent tuberculosis or a positive tuberculin test

• Hypersensitivity to Hydrocortisone or any excipient in the medicine
• Concurrent administration with live or live-attenuated vaccines
• Viral infections such as measles, chickenpox, or shingles
• Intramuscular injection in idiopathic thrombocytopenic purpura
• Intrathecal injection
• Systemic fungal infections
• Premature infants
• Ocular herpes
• Head injury

• During treatment, it may be advisable to increase intake of potassium, vitamin A, vitamin B6, vitamin C, vitamin D, folate, calcium, zinc, and phosphorus.
• Contact your physician if psychiatric symptoms appear or worsen, such as depression, euphoria, insomnia, irritability, or mood swings.
• This medicine may worsen myasthenia gravis.
• In patients suspected of having pheochromocytoma, there is a risk of pheochromocytoma crisis.
• Hydroka® should be used with caution in patients with heart, liver, or kidney failure, high blood pressure, gastrointestinal problems, or a history of myocardial infarction or seizure.
• Dose adjustment may be needed in thyroid disorders.
• Dose reduction after long-term use should be done under medical supervision.
• This medicine suppresses the immune system and may increase the risk of infections.
• Avoid exposure to measles or chickenpox. If exposure occurs, contact your physician immediately.
• Hypersensitivity reactions may occur.
• Use with caution in patients with systemic sclerosis, osteoporosis, cataracts, or glaucoma.
• In older adults, Hydroka® should preferably be used at the lowest dose and for the shortest possible duration.

• Consult your physician or pharmacist before using Hydroka® during pregnancy or breastfeeding.
• The decision to use Hydroka® during pregnancy depends on the underlying condition. If use during pregnancy is chosen, both the patient and fetus should be monitored by a physician.
• Hydrocortisone is excreted in breast milk. The decision to breastfeed during treatment should consider the infant’s exposure risk, the benefits of breastfeeding for the infant, and the benefits of treatment for the mother.

Like all medicines, Hydroka® may cause unwanted side effects, although not everyone experiences them. Possible side effects include:

• Stomach discomfort or vomiting
• Sleep problems
• Restlessness
• Excessive sweating
• Increased appetite
• Weight gain
• Pain during intramuscular injection

Consult your physician or pharmacist about using Hydroka® together with other medicines or supplements.

Each package contains 5 vials.

• Keep the medicine out of the sight and reach of children.
• Store below 30°C, protected from light and moisture.
• The medicine may be used until the end of the month stated in the expiry date on the package. Do not use or store expired medicine.
• Keep the medicine in its original packaging until use.

1. Hydrocortisone systemic: Drug information, UpToDate 2025
2. Medicines.org.uk product information for Hydrocortisone sodium succinate.