Hydrocortisone 2.5% / Sulfur 1% in Aqueous cream
Prescription only
Requires a prescription from a doctor or prescriber
Cream
2.5%
Topical
Steroid hormone, in the glucocorticoid class of hormones; when used as a medication
Active ingredients:
Sulfur + Hydrocortisone
No active safety alerts
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Safety monitoring data
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
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1 branded products available
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Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
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Supply & safety information
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Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. Shortage and safety information sourced from MHRA drug safety updates (gov.uk, Crown Copyright under OGL v3.0).
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
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SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Searching UK clinical trials...
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 10 · Randomised trials: 22 · 1955–2025
Showing the 50 most relevant studies, sorted by most relevant.
Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial. (opens in a new tab)
D. Angus, L. Derde, Farah Al-Beidh, et al.
JAMA, 2020
Randomised trial
Cited by 765Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial. (opens in a new tab)
P. Dequin, Nicholas Heming, F. Meziani, et al.
JAMA, 2020
Randomised trial
Cited by 422Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial. (opens in a new tab)
T. Fujii, N. Luethi, P. Young, et al.
JAMA, 2020
Randomised trial
Cited by 407Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial. (opens in a new tab)
J. Sevransky, R. Rothman, D. Hager, et al.
JAMA, 2021
Randomised trial
Cited by 229Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial. (opens in a new tab)
O. Baud, L. Maury, F. Lebail, et al.
Lancet, 2016
Randomised trial
Cited by 307Hydrocortisone treatment in early sepsis-associated acute respiratory distress syndrome: results of a randomized controlled trial (opens in a new tab)
S. Tongyoo, C. Permpikul, W. Mongkolpun, et al.
Critical Care, 2016
Randomised trial
Cited by 196Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis: The HYPRESS Randomized Clinical Trial. (opens in a new tab)
D. Keh, Evelyn Trips, G. Marx, et al.
JAMA, 2016
Randomised trial
Cited by 185Effect of once-daily, modified-release hydrocortisone versus standard glucocorticoid therapy on metabolism and innate immunity in patients with adrenal insufficiency (DREAM): a single-blind, randomised controlled trial. (opens in a new tab)
A. Isidori, M. Venneri, C. Graziadio, et al.
The lancet. Diabetes & endocrinology, 2017
Randomised trial
Cited by 175Effect of Prophylaxis for Early Adrenal Insufficiency Using Low-Dose Hydrocortisone in Very Preterm Infants: An Individual Patient Data Meta-Analysis. (opens in a new tab)
M. Shaffer, O. Baud, T. Lacaze‐Masmonteil, et al.
The Journal of pediatrics, 2019
Meta-analysis
Cited by 98Patient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock. (opens in a new tab)
R. Pirracchio, D. Annane, Andre Waschka, et al.
NEJM evidence, 2023
Meta-analysis
Cited by 47Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
2.15h
Mechanism
The short-term effects of corticosteroids are decreased vasodilation and permeab…
Food interactions
1 warning
Human targets
2 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
0.2-0.3 mg/k
The pharmacokinetics of hydrocortisone can vary by 10 times from patient to patient.
[A188354]…
[A188354]…
Half-life
2.15h
Total hydrocortisone via the oral route has a half life of 2.15h…
Protein binding
90.1%
Corticosteroids are generally bound to corticosteroid binding globulin[A187439] and serum albumin[A187436] in plasma.…
Volume of distribution
39.82L
Total hydrocortisone has a volume of distribution of 39.82L, while the free fraction has a volume of distribution of 474.38L.
[A188354]
[A188354]
Metabolism
Hydrocortisone is metabolised to 6-beta hydrocortisol via CYP3A, 5-beta tetrahydrocortisol via 3-oxo-5-beta-steroid 4-dehydrogenase, 5-alpha…
Elimination
Corticosteroids are eliminated predominantly in the urine.
[A187436]
However, data regarding the exact proportion is not readily available.
[A188387]…
[A187436]
However, data regarding the exact proportion is not readily available.
[A188387]…
Clearance
12.85L/h
Total hydrocortisone by the oral route has a mean clearance of 12.85L/h,…
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Status:
Approved
Investigational
Vet approved
Small molecule
About this compound
Hydrocortisone, or cortisol, is a glucocorticoid secreted by the adrenal cortex.[A188387] Hydrocortisone is used to treat immune, inflammatory, and neoplastic conditions.[L10529][L10532][L10535][L10538][L7772][L7321] It was discovered in the 1930s by Edward Kendall and named Compound F, or 17-hydroxycorticosterone.[A188420]
Hydrocortisone was granted FDA approval on 5 August 1952.[L10574]
Hydrocortisone was granted FDA approval on 5 August 1952.[L10574]
Properties:
View FDA drug labelsolid
Avg. mass: 362.46 Da
DrugBank indication
Otic solutions are indicated for infections of the external auditory canal caused by susceptible organisms and with inflammation.
[L10529][L10532]
Hydrocortisone tablets are indicated for certain endocrine, rheumatic, collagen, allergic, ophthalmic, respiratory, hematologic, neoplastic, edematous, gastrointestinal, and other conditions.
[L10535]
A hydrocortisone enema is indicated for ulcerative colitis,[L10538] a topical ointment with antibiotics is indicated for corticosteroid responsive dermatoses with infections,[L7772] and a topical cream with [acyclovir] is indicated to treat cold sores.
[L7321]
Oral granules of hydrocortisone are used as a replacement therapy for Adrenocortical Insufficiency (AI) in children under 17 years of age.
[L16533]
[L10529][L10532]
Hydrocortisone tablets are indicated for certain endocrine, rheumatic, collagen, allergic, ophthalmic, respiratory, hematologic, neoplastic, edematous, gastrointestinal, and other conditions.
[L10535]
A hydrocortisone enema is indicated for ulcerative colitis,[L10538] a topical ointment with antibiotics is indicated for corticosteroid responsive dermatoses with infections,[L7772] and a topical cream with [acyclovir] is indicated to treat cold sores.
[L7321]
Oral granules of hydrocortisone are used as a replacement therapy for Adrenocortical Insufficiency (AI) in children under 17 years of age.
[L16533]
Also known as(166)
(11β)-11,17,21-trihydroxypregn-4-ene-3,20-dione
11beta-hydrocortisone
11beta,17alpha,21-Trihydroxy-4-pregnene-3,20-dione
11β-hydrocortisone
17-Hydroxycorticosterone
4-pregnen-11β,17α,21-triol-3,20-dione
Cortisol
Hidrocortisona
Molecular properties(19)
Drug interactions(1240)
Known interactions with other medications. Always consult a healthcare professional.
Natalizumab
Unknown severity
The risk or severity of immunosuppression can be increased when Hydrocortisone is combined with Natalizumab.
Pimecrolimus
Unknown severity
The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Hydrocortisone.
Roflumilast
Moderate
Roflumilast may increase the immunosuppressive activities of Hydrocortisone.
Sipuleucel-T
Moderate
The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Hydrocortisone.
Aripiprazole
Moderate
The metabolism of Aripiprazole can be increased when combined with Hydrocortisone.
Aripiprazole lauroxil
Moderate
The metabolism of Aripiprazole lauroxil can be increased when combined with Hydrocortisone.
The risk or severity of hyperglycemia can be increased when Hydrocortisone is combined with Ceritinib.
The therapeutic efficacy of Corticorelin ovine triflutate can be decreased when used in combination with Hydrocortisone.
Deferasirox
Unknown severity
The risk or severity of gastrointestinal ulceration and gastrointestinal irritation can be increased when Hydrocortisone is combined with Deferasirox.
Hyaluronidase (ovine)
Moderate
The therapeutic efficacy of Hyaluronidase (ovine) can be decreased when used in combination with Hydrocortisone.
The therapeutic efficacy of Hyaluronidase (human recombinant) can be decreased when used in combination with Hydrocortisone.
Hyaluronidase
Moderate
The therapeutic efficacy of Hyaluronidase can be decreased when used in combination with Hydrocortisone.
Amphotericin B
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Amphotericin B.
Isoetharine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Isoetharine.
Norepinephrine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Norepinephrine.
Phenylpropanolamine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Phenylpropanolamine.
Epinephrine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Epinephrine.
Orciprenaline
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Orciprenaline.
Dobutamine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Dobutamine.
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Ritodrine.
Bitolterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Bitolterol.
Salmeterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Salmeterol.
Formoterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Formoterol.
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Albuterol.
Isoprenaline
Moderate
The therapeutic efficacy of Isoprenaline can be decreased when used in combination with Hydrocortisone.
Arbutamine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Arbutamine.
Arformoterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Arformoterol.
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Fenoterol.
Pirbuterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Pirbuterol.
Ephedra sinica root
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Ephedra sinica root.
Procaterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Procaterol.
Clenbuterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Clenbuterol.
Celiprolol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Celiprolol.
Indacaterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Indacaterol.
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Droxidopa.
Hexoprenaline
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Hexoprenaline.
Olodaterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Olodaterol.
Doxofylline
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Doxofylline.
Racepinephrine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Racepinephrine.
Etafedrine
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Etafedrine.
PF-00610355
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with PF-00610355.
Abediterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Abediterol.
Batefenterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Batefenterol.
Levosalbutamol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Levosalbutamol.
Vilanterol
Unknown severity
The risk or severity of hypokalemia can be increased when Hydrocortisone is combined with Vilanterol.
The serum concentration of Hydrocortisone can be decreased when it is combined with Mitotane.
Dicoumarol
Moderate
Hydrocortisone may increase the anticoagulant activities of Dicoumarol.
Phenindione
Moderate
Hydrocortisone may increase the anticoagulant activities of Phenindione.
Phenprocoumon
Moderate
Hydrocortisone may increase the anticoagulant activities of Phenprocoumon.
4-hydroxycoumarin
Moderate
Hydrocortisone may increase the anticoagulant activities of 4-hydroxycoumarin.
Showing 50 of 1240 interactions
Food & lifestyle interactions
Avoid Alcohol
Avoid alcohol.
Toxicity & overdose
Data regarding acute overdoses of glucocorticoids are rare.
[L10529][L10532][L10535][L10538][L7772][L7321]
Chronic high doses of glucocorticoids can lead to the development of cataract, glaucoma, hypertension, water retention, hyperlipidemia, peptic ulcer, pancreatitis, myopathy, osteoporosis, mood changes, psychosis, dermal atrophy, allergy, acne, hypertrichosis, immune suppression, decreased resistance to infection, moon face, hyperglycemia, hypocalcemia, hypophosphatemia, metabolic acidosis, growth suppression, and secondary adrenal insufficiency.
[A188405]
Overdose may be treated by adjusting the dose or stopping the corticosteroid as well as initiating symptomatic and supportive treatment.
[A188405]
[L10529][L10532][L10535][L10538][L7772][L7321]
Chronic high doses of glucocorticoids can lead to the development of cataract, glaucoma, hypertension, water retention, hyperlipidemia, peptic ulcer, pancreatitis, myopathy, osteoporosis, mood changes, psychosis, dermal atrophy, allergy, acne, hypertrichosis, immune suppression, decreased resistance to infection, moon face, hyperglycemia, hypocalcemia, hypophosphatemia, metabolic acidosis, growth suppression, and secondary adrenal insufficiency.
[A188405]
Overdose may be treated by adjusting the dose or stopping the corticosteroid as well as initiating symptomatic and supportive treatment.
[A188405]
How it works
Mechanism of action
The short-term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation.[A187463] Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days.[A187463]
Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives; they inhibit NF-Kappa B and other inflammatory transcription factors; they promote anti-inflammatory genes like interleukin-10.[A187463]
Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive.[A187463] High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.[A187463]
Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives; they inhibit NF-Kappa B and other inflammatory transcription factors; they promote anti-inflammatory genes like interleukin-10.[A187463]
Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive.[A187463] High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.[A187463]
Pharmacodynamics
Hydrocortisone binds to the glucocorticoid receptor leading to downstream effects such as inhibition of phospholipase A2, NF-kappa B, other inflammatory transcription factors, and the promotion of anti-inflammatory genes.[A187463] Hydrocortisone has a wide therapeutic index[A188405] and a moderate duration of action.[A188354][A188381] Patients should stop taking the medication if irritation or sensitization occurs.[L10529][L10532][L10535][L10538][L7772][L7321]
Pharmacokinetics
How the body processes this drug — absorption, distribution, metabolism, and elimination
Absorption
The pharmacokinetics of hydrocortisone can vary by 10 times from patient to patient.
[A188354]
Following the oral administration of hydrocortisone at a dose of 0.2-0.3 mg/kg/day, the mean Cmax and AUC of plasma free cortisol were 32.69 nmol/L and 90.63 h x nmol/L, respectively.
[A188354]
The mean Cmax and AUC of plasma total cortisol were 514.47 nmol/L and 1743.93 h x nmol/L, respectively.
[A188354]
Following the dose of 0.4-0.6 mg/kg/day, the mean Cmax and AUC of plasma free cortisol were 70.81 nmol/L and 199.11 h x nmol/L.
[A188354]
The mean Cmax and AUC of plasma total cortisol were 754.94 nmol/L and 2533.02 h x nmol/L, respectively.
[A188354]
Topical hydrocortisone cream is 4-19% bioavailable [A188375] with a Tmax of 24h.
[A188372]
Hydrocortisone retention enemas have a bioavailability of 0.810 for slow absorbers and 0.502 for rapid absorbers.
[A188378]
Slow absorbers take up hydrocortisone at a rate of 0.361±0.255/h while fast absorbers take up hydrocortisone at a rate of 1.05±0.255/h.
[A188378]
A 20mg IV dose of hydrocortisone has an AUC of 1163±277ng\*h/mL.
[A188381]
[A188354]
Following the oral administration of hydrocortisone at a dose of 0.2-0.3 mg/kg/day, the mean Cmax and AUC of plasma free cortisol were 32.69 nmol/L and 90.63 h x nmol/L, respectively.
[A188354]
The mean Cmax and AUC of plasma total cortisol were 514.47 nmol/L and 1743.93 h x nmol/L, respectively.
[A188354]
Following the dose of 0.4-0.6 mg/kg/day, the mean Cmax and AUC of plasma free cortisol were 70.81 nmol/L and 199.11 h x nmol/L.
[A188354]
The mean Cmax and AUC of plasma total cortisol were 754.94 nmol/L and 2533.02 h x nmol/L, respectively.
[A188354]
Topical hydrocortisone cream is 4-19% bioavailable [A188375] with a Tmax of 24h.
[A188372]
Hydrocortisone retention enemas have a bioavailability of 0.810 for slow absorbers and 0.502 for rapid absorbers.
[A188378]
Slow absorbers take up hydrocortisone at a rate of 0.361±0.255/h while fast absorbers take up hydrocortisone at a rate of 1.05±0.255/h.
[A188378]
A 20mg IV dose of hydrocortisone has an AUC of 1163±277ng\*h/mL.
[A188381]
Half-life
Total hydrocortisone via the oral route has a half life of 2.15h while the free fraction has a half life of 1.39h.
[A188354]
A 20mg IV dose of hydrocortisone has a terminal half life of 1.9±0.4h.
[A188381]
[A188354]
A 20mg IV dose of hydrocortisone has a terminal half life of 1.9±0.4h.
[A188381]
Protein binding
Corticosteroids are generally bound to corticosteroid binding globulin[A187439] and serum albumin[A187436] in plasma. Hydrocortisone is 90.1% bound to proteins in plasma, with 56.2% bound to albumin.
[A184223]
[A184223]
Volume of distribution
Total hydrocortisone has a volume of distribution of 39.82L, while the free fraction has a volume of distribution of 474.38L.
[A188354]
[A188354]
Metabolism
Hydrocortisone is metabolised to 6-beta hydrocortisol via CYP3A, 5-beta tetrahydrocortisol via 3-oxo-5-beta-steroid 4-dehydrogenase, 5-alpha tetrahydrocortisol via 3-oxo-5-alpha-steroid 4-dehydrogenase 2, cortisone via Corticosteroid 11-beta-dehydrogenase isozyme 1 and Corticosteroid 11-beta-dehydrogenase isozyme 2, and glucuronide products.
[A188321][A188318]
Cortisone is further metabolized to tetrahydrocortisone and dihydrocortisol.
[A188321][A188318]
[A188321][A188318]
Cortisone is further metabolized to tetrahydrocortisone and dihydrocortisol.
[A188321][A188318]
Route of elimination
Corticosteroids are eliminated predominantly in the urine.
[A187436]
However, data regarding the exact proportion is not readily available.
[A188387]
[A187436]
However, data regarding the exact proportion is not readily available.
[A188387]
Clearance
Total hydrocortisone by the oral route has a mean clearance of 12.85L/h, while the free fraction has a mean clearance of 235.78L/h.
[A188354]
A 20mg IV dose of hydrocortisone has a clearance of 18.2±4.2L/h.
[A188381]
[A188354]
A 20mg IV dose of hydrocortisone has a clearance of 18.2±4.2L/h.
[A188381]
Drug targets(2)
Proteins and enzymes this drug interacts with in the body
Glucocorticoid receptor
NR3C1
agonist
Specific functioncore promoter sequence-specific DNA binding
Cellular location
Cytoplasm
General function & pharmacology
Receptor for glucocorticoids (GC) .
PMID:27120390 PMID:37478846
Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modulator of other transcription factors .
PMID:28139699
Affects inflammatory responses, cellular proliferation and differentiation in target tissues. Involved in chromatin remodeling .
PMID:9590696
Plays a role in rapid mRNA degradation by binding to the 5' UTR of target mRNAs and interacting with PNRC2 in a ligand-dependent manner which recruits the RNA helicase UPF1 and the mRNA-decapping enzyme DCP1A, leading to RNA decay .
PMID:25775514
Could act as a coactivator for STAT5-dependent transcription upon growth hormone (GH) stimulation and could reveal an essential role of hepatic GR in the control of body growth (By similarity)
PMID:27120390 PMID:37478846
Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modulator of other transcription factors .
PMID:28139699
Affects inflammatory responses, cellular proliferation and differentiation in target tissues. Involved in chromatin remodeling .
PMID:9590696
Plays a role in rapid mRNA degradation by binding to the 5' UTR of target mRNAs and interacting with PNRC2 in a ligand-dependent manner which recruits the RNA helicase UPF1 and the mRNA-decapping enzyme DCP1A, leading to RNA decay .
PMID:25775514
Could act as a coactivator for STAT5-dependent transcription upon growth hormone (GH) stimulation and could reveal an essential role of hepatic GR in the control of body growth (By similarity)
Annexin A1
ANXA1
agonist
Specific functioncadherin binding involved in cell-cell adhesion
Cellular location
Nucleus
General function & pharmacology
Plays important roles in the innate immune response as effector of glucocorticoid-mediated responses and regulator of the inflammatory process. Has anti-inflammatory activity .
PMID:8425544
Plays a role in glucocorticoid-mediated down-regulation of the early phase of the inflammatory response (By similarity). Contributes to the adaptive immune response by enhancing signaling cascades that are triggered by T-cell activation, regulates differentiation and proliferation of activated T-cells .
PMID:17008549
Promotes the differentiation of T-cells into Th1 cells and negatively regulates differentiation into Th2 cells .
PMID:17008549
Has no effect on unstimulated T cells .
PMID:17008549
Negatively regulates hormone exocytosis via activation of the formyl peptide receptors and reorganization of the actin cytoskeleton .
PMID:19625660
Has high affinity for Ca(2+) and can bind up to eight Ca(2+) ions (By similarity).
Displays Ca(2+)-dependent binding to phospholipid membranes .
PMID:2532504 PMID:8557678
Plays a role in the formation of phagocytic cups and phagosomes. Plays a role in phagocytosis by mediating the Ca(2+)-dependent interaction between phagosomes and the actin cytoskeleton (By similarity)
PMID:8425544
Plays a role in glucocorticoid-mediated down-regulation of the early phase of the inflammatory response (By similarity). Contributes to the adaptive immune response by enhancing signaling cascades that are triggered by T-cell activation, regulates differentiation and proliferation of activated T-cells .
PMID:17008549
Promotes the differentiation of T-cells into Th1 cells and negatively regulates differentiation into Th2 cells .
PMID:17008549
Has no effect on unstimulated T cells .
PMID:17008549
Negatively regulates hormone exocytosis via activation of the formyl peptide receptors and reorganization of the actin cytoskeleton .
PMID:19625660
Has high affinity for Ca(2+) and can bind up to eight Ca(2+) ions (By similarity).
Displays Ca(2+)-dependent binding to phospholipid membranes .
PMID:2532504 PMID:8557678
Plays a role in the formation of phagocytic cups and phagosomes. Plays a role in phagocytosis by mediating the Ca(2+)-dependent interaction between phagosomes and the actin cytoskeleton (By similarity)
Metabolizing enzymes(15)
Enzymes involved in drug metabolism — important for understanding drug interactions
Enzyme activity key
substrate
inhibitor
inducer
CYP3A4Cytochrome P450 3A4
substrate
inducer
CYP3A5Cytochrome P450 3A5
substrate
CYP3A7Cytochrome P450 3A7
substrate
CYP11B1Cytochrome P450 11B1, mitochondrial
substrate
CYP11B2Cytochrome P450 11B2, mitochondrial
substrate
CYP2C8Cytochrome P450 2C8
inducer
AKR1D1Aldo-keto reductase family 1 member D1
substrate
SRD5A23-oxo-5-alpha-steroid 4-dehydrogenase 2
substrate
HSD11B211-beta-hydroxysteroid dehydrogenase type 2
substrate
HSD11B111-beta-hydroxysteroid dehydrogenase 1
substrate
CYP2A6Cytochrome P450 2A6
inducer
CYP1B1Cytochrome P450 1B1
inducer
CYP2B6Cytochrome P450 2B6
inducer
CYP2C9Cytochrome P450 2C9
inducer
CYP2C19Cytochrome P450 2C19
inducer
Transporters(3)
Proteins that transport this drug across cell membranes
ATP-dependent translocase ABCB1
ABCB1
substrate
inducer
Specific functionABC-type xenobiotic transporter activity
Cellular location
Cell membrane
General function & pharmacology
Translocates drugs and phospholipids across the membrane .
PMID:2897240 PMID:35970996 PMID:8898203 PMID:9038218 PMID:35507548
Catalyzes the flop of phospholipids from the cytoplasmic to the exoplasmic leaflet of the apical membrane. Participates mainly to the flop of phosphatidylcholine, phosphatidylethanolamine, beta-D-glucosylceramides and sphingomyelins .
PMID:8898203
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells PMID:2897240 PMID:35970996 PMID:9038218
PMID:2897240 PMID:35970996 PMID:8898203 PMID:9038218 PMID:35507548
Catalyzes the flop of phospholipids from the cytoplasmic to the exoplasmic leaflet of the apical membrane. Participates mainly to the flop of phosphatidylcholine, phosphatidylethanolamine, beta-D-glucosylceramides and sphingomyelins .
PMID:8898203
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells PMID:2897240 PMID:35970996 PMID:9038218
Solute carrier organic anion transporter family member 1A2
SLCO1A2
inhibitor
Specific functionbile acid transmembrane transporter activity
Cellular location
Cell membrane
General function & pharmacology
Na(+)-independent transporter that mediates the cellular uptake of a broad range of organic anions such as the endogenous bile salts cholate and deoxycholate, either in their unconjugated or conjugated forms (taurocholate and glycocholate), at the plasmam membrane .
PMID:19129463 PMID:7557095
Responsible for intestinal absorption of bile acids (By similarity). Transports dehydroepiandrosterone 3-sulfate (DHEAS), a major circulating steroid secreted by the adrenal cortex, as well as estrone 3-sulfate and 17beta-estradiol 17-O-(beta-D-glucuronate) .
PMID:11159893 PMID:12568656 PMID:19129463 PMID:23918469 PMID:25560245 PMID:9539145
Mediates apical uptake of all-trans-retinol (atROL) across human retinal pigment epithelium, which is essential to maintaining the integrity of the visual cycle and thus vision .
PMID:25560245
Involved in the uptake of clinically used drugs .
PMID:17301733 PMID:20686826 PMID:27777271
Capable of thyroid hormone transport (both T3 or 3,3',5'-triiodo-L-thyronine, and T4 or L-tyroxine) .
PMID:19129463 PMID:20358049
Also transports prostaglandin E2 .
PMID:19129463
Plays roles in blood-brain and -cerebrospinal fluid barrier transport of organic anions and signal mediators, and in hormone uptake by neural cells (By similarity). May also play a role in the reuptake of neuropeptides such as substance P/TAC1 and vasoactive intestinal peptide/VIP released from retinal neurons .
PMID:25132355
May play an important role in plasma and tissue distribution of the structurally diverse chemotherapeutic drugs methotrexate and paclitaxel .
PMID:23243220
Shows a pH-sensitive substrate specificity which may be ascribed to the protonation state of the binding site and leads to a stimulation of substrate transport in an acidic microenvironment .
PMID:19129463
Hydrogencarbonate/HCO3(-) acts as the probable counteranion that exchanges for organic anions .
PMID:19129463
May contribute to regulate the transport of organic compounds in testis across the blood-testis-barrier (Probable)
PMID:19129463 PMID:7557095
Responsible for intestinal absorption of bile acids (By similarity). Transports dehydroepiandrosterone 3-sulfate (DHEAS), a major circulating steroid secreted by the adrenal cortex, as well as estrone 3-sulfate and 17beta-estradiol 17-O-(beta-D-glucuronate) .
PMID:11159893 PMID:12568656 PMID:19129463 PMID:23918469 PMID:25560245 PMID:9539145
Mediates apical uptake of all-trans-retinol (atROL) across human retinal pigment epithelium, which is essential to maintaining the integrity of the visual cycle and thus vision .
PMID:25560245
Involved in the uptake of clinically used drugs .
PMID:17301733 PMID:20686826 PMID:27777271
Capable of thyroid hormone transport (both T3 or 3,3',5'-triiodo-L-thyronine, and T4 or L-tyroxine) .
PMID:19129463 PMID:20358049
Also transports prostaglandin E2 .
PMID:19129463
Plays roles in blood-brain and -cerebrospinal fluid barrier transport of organic anions and signal mediators, and in hormone uptake by neural cells (By similarity). May also play a role in the reuptake of neuropeptides such as substance P/TAC1 and vasoactive intestinal peptide/VIP released from retinal neurons .
PMID:25132355
May play an important role in plasma and tissue distribution of the structurally diverse chemotherapeutic drugs methotrexate and paclitaxel .
PMID:23243220
Shows a pH-sensitive substrate specificity which may be ascribed to the protonation state of the binding site and leads to a stimulation of substrate transport in an acidic microenvironment .
PMID:19129463
Hydrogencarbonate/HCO3(-) acts as the probable counteranion that exchanges for organic anions .
PMID:19129463
May contribute to regulate the transport of organic compounds in testis across the blood-testis-barrier (Probable)
Organic anion transporter 3
SLC22A8
substrate
Specific functionorganic anion transmembrane transporter activity
Cellular location
Basolateral cell membrane
General function & pharmacology
Functions as an organic anion/dicarboxylate exchanger that couples organic anion uptake indirectly to the sodium gradient .
PMID:14586168 PMID:15644426 PMID:15846473 PMID:16455804 PMID:31553721
Transports organic anions such as estrone 3-sulfate (E1S) and urate in exchange for dicarboxylates such as glutarate or ketoglutarate (2-oxoglutarate) .
PMID:14586168 PMID:15846473 PMID:15864504 PMID:22108572 PMID:23832370
Plays an important role in the excretion of endogenous and exogenous organic anions, especially from the kidney and the brain .
PMID:11306713 PMID:14586168 PMID:15846473
E1S transport is pH- and chloride-dependent and may also involve E1S/cGMP exchange .
PMID:26377792
Responsible for the transport of prostaglandin E2 (PGE2) and prostaglandin F2(alpha) (PGF2(alpha)) in the basolateral side of the renal tubule .
PMID:11907186
Involved in the transport of neuroactive tryptophan metabolites kynurenate and xanthurenate .
PMID:22108572 PMID:23832370
Functions as a biopterin transporters involved in the uptake and the secretion of coenzymes tetrahydrobiopterin (BH4), dihydrobiopterin (BH2) and sepiapterin to urine, thereby determining baseline levels of blood biopterins .
PMID:28534121
May be involved in the basolateral transport of steviol, a metabolite of the popular sugar substitute stevioside .
PMID:15644426
May participate in the detoxification/ renal excretion of drugs and xenobiotics, such as the histamine H(2)-receptor antagonists fexofenadine and cimetidine, the antibiotic benzylpenicillin (PCG), the anionic herbicide 2,4-dichloro-phenoxyacetate (2,4-D), the diagnostic agent p-aminohippurate (PAH), the antiviral acyclovir (ACV), and the mycotoxin ochratoxin (OTA), by transporting these exogenous organic anions across the cell membrane in exchange for dicarboxylates such as 2-oxoglutarate .
PMID:11669456 PMID:15846473 PMID:16455804
Contributes to the renal uptake of potent uremic toxins (indoxyl sulfate (IS), indole acetate (IA), hippurate/N-benzoylglycine (HA) and 3-carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF)), pravastatin, PCG, E1S and dehydroepiandrosterone sulfate (DHEAS), and is partly involved in the renal uptake of temocaprilat (an angiotensin-converting enzyme (ACE) inhibitor) .
PMID:14675047
May contribute to the release of cortisol in the adrenals .
PMID:15864504
Involved in one of the detoxification systems on the choroid plexus (CP), removes substrates such as E1S or taurocholate (TC), PCG, 2,4-D and PAH, from the cerebrospinal fluid (CSF) to the blood for eventual excretion in urine and bile (By similarity). Also contributes to the uptake of several other organic compounds such as the prostanoids prostaglandin E(2) and prostaglandin F(2-alpha), L-carnitine, and the therapeutic drugs allopurinol, 6-mercaptopurine (6-MP) and 5-fluorouracil (5-FU) (By similarity). Mediates the transport of PAH, PCG, and the statins pravastatin and pitavastatin, from the cerebrum into the blood circulation across the blood-brain barrier (BBB).
In summary, plays a role in the efflux of drugs and xenobiotics, helping reduce their undesired toxicological effects on the body (By similarity)
PMID:14586168 PMID:15644426 PMID:15846473 PMID:16455804 PMID:31553721
Transports organic anions such as estrone 3-sulfate (E1S) and urate in exchange for dicarboxylates such as glutarate or ketoglutarate (2-oxoglutarate) .
PMID:14586168 PMID:15846473 PMID:15864504 PMID:22108572 PMID:23832370
Plays an important role in the excretion of endogenous and exogenous organic anions, especially from the kidney and the brain .
PMID:11306713 PMID:14586168 PMID:15846473
E1S transport is pH- and chloride-dependent and may also involve E1S/cGMP exchange .
PMID:26377792
Responsible for the transport of prostaglandin E2 (PGE2) and prostaglandin F2(alpha) (PGF2(alpha)) in the basolateral side of the renal tubule .
PMID:11907186
Involved in the transport of neuroactive tryptophan metabolites kynurenate and xanthurenate .
PMID:22108572 PMID:23832370
Functions as a biopterin transporters involved in the uptake and the secretion of coenzymes tetrahydrobiopterin (BH4), dihydrobiopterin (BH2) and sepiapterin to urine, thereby determining baseline levels of blood biopterins .
PMID:28534121
May be involved in the basolateral transport of steviol, a metabolite of the popular sugar substitute stevioside .
PMID:15644426
May participate in the detoxification/ renal excretion of drugs and xenobiotics, such as the histamine H(2)-receptor antagonists fexofenadine and cimetidine, the antibiotic benzylpenicillin (PCG), the anionic herbicide 2,4-dichloro-phenoxyacetate (2,4-D), the diagnostic agent p-aminohippurate (PAH), the antiviral acyclovir (ACV), and the mycotoxin ochratoxin (OTA), by transporting these exogenous organic anions across the cell membrane in exchange for dicarboxylates such as 2-oxoglutarate .
PMID:11669456 PMID:15846473 PMID:16455804
Contributes to the renal uptake of potent uremic toxins (indoxyl sulfate (IS), indole acetate (IA), hippurate/N-benzoylglycine (HA) and 3-carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF)), pravastatin, PCG, E1S and dehydroepiandrosterone sulfate (DHEAS), and is partly involved in the renal uptake of temocaprilat (an angiotensin-converting enzyme (ACE) inhibitor) .
PMID:14675047
May contribute to the release of cortisol in the adrenals .
PMID:15864504
Involved in one of the detoxification systems on the choroid plexus (CP), removes substrates such as E1S or taurocholate (TC), PCG, 2,4-D and PAH, from the cerebrospinal fluid (CSF) to the blood for eventual excretion in urine and bile (By similarity). Also contributes to the uptake of several other organic compounds such as the prostanoids prostaglandin E(2) and prostaglandin F(2-alpha), L-carnitine, and the therapeutic drugs allopurinol, 6-mercaptopurine (6-MP) and 5-fluorouracil (5-FU) (By similarity). Mediates the transport of PAH, PCG, and the statins pravastatin and pitavastatin, from the cerebrum into the blood circulation across the blood-brain barrier (BBB).
In summary, plays a role in the efflux of drugs and xenobiotics, helping reduce their undesired toxicological effects on the body (By similarity)
Carriers(2)
Proteins that carry this drug through the body
Sex hormone-binding globulin
SHBG
binder
Specific functionandrogen binding
Cellular location
Secreted
General function & pharmacology
Functions as an androgen transport protein, but may also be involved in receptor mediated processes. Each dimer binds one molecule of steroid. Specific for 5-alpha-dihydrotestosterone, testosterone, and 17-beta-estradiol.
Regulates the plasma metabolic clearance rate of steroid hormones by controlling their plasma concentration
Regulates the plasma metabolic clearance rate of steroid hormones by controlling their plasma concentration
Corticosteroid-binding globulin
SERPINA6
binder
Specific functionmolecular carrier activity
Cellular location
Secreted
General function & pharmacology
Major transport protein for glucocorticoids and progestins in the blood of almost all vertebrate species
Biological pathways(12)
metabolic
disease
disease
Scientific references(13)
Werumeus Buning J., Touw D.J., Brummelman P., Dullaart R.P.F., van den Berg G., van der Klauw M.M., Kamp J., Wolffenbuttel B.H.R., van Beek A.P.
Pharmacokinetics of oral hydrocortisone - Results and implications from a randomized controlled trial.
Metabolism
2017 Jun71:7-16. doi: 10.1016/j.metabol.2017.02.005. Epub 2017 Feb 13
Aalto-Korte K., Turpeinen M.
Pharmacokinetics of topical hydrocortisone at plasma level after applications once or twice daily in patients with widespread dermatitis.
British Journal Dermatology
1995 Aug133(2):259-63. doi: 10.1111/j.1365-2133.1995.tb02625.x
Aalto-Korte K., Turpeinen M.
Quantifying systemic absorption of topical hydrocortisone in erythroderma.
British Journal Dermatology
1995 Sep133(3):403-8. doi: 10.1111/j.1365-2133.1995.tb02668.x
Lima J.J., Jusko W.J.
Bioavailability of hydrocortisone retention enemas in relation to absorption kinetics.
Clinical Pharmacology Therapeutics
1980 Aug28(2):262-9. doi: 10.1038/clpt.1980.159
FLORINI J.R., BUYSKE D.A.
Plasma Protein Binding of Triamcinolone-H3 and Hydrocortisone-4-C14.
Journal of Biological Chemistry
1961236(1):247-251. doi: 10.1016/s0021-9258(18)64465-5
Derendorf H., Mollmann H., Barth J., Mollmann C., Tunn S., Krieg M.
Pharmacokinetics and oral bioavailability of hydrocortisone.
Journal of Clinical Pharmacology
1991 May31(5):473-6. doi: 10.1002/j.1552-4604.1991.tb01906.x
Jung C., Greco S., Nguyen H.H., Ho J.T., Lewis J.G., Torpy D.J., Inder W.J.
Plasma, salivary and urinary cortisol levels following physiological and stress doses of hydrocortisone in normal volunteers.
BMC Endocr Disord
2014 Nov 2614:91. doi: 10.1186/1472-6823-14-91
Ciriaco M., Ventrice P., Russo G., Scicchitano M., Mazzitello G., Scicchitano F., Russo E.
Corticosteroid-related central nervous system side effects.
Journal Pharmacology Pharmacother
2013 Dec4(Suppl 1):S94-8. doi: 10.4103/0976-500X.120975
Simoni R., Hill R., Vaughan M.
The Isolation of Thyroxine and Cortisone: the Work of Edward C.
Kendall
Journal of Biological Chemistry. 2002277(21):21-22. doi: 10.1016/s0021-9258(20)85219-3
Yasir M., Sonthalia S.
Adverse effects of systemic corticosteroid therapy.
Reactions
1986139(1):2-3. doi: 10.1007/bf03267706
Gardill B.R., Vogl M.R., Lin H.Y., Hammond G.L., Muller Y.A.
Corticosteroid-binding globulin: structure-function implications from species differences.
PLoS One
20127(12):e52759. doi: 10.1371/journal.pone.0052759. Epub 2012 Dec 26
Czock D., Keller F., Rasche F.M., Haussler U.
Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids.
Clinical Pharmacokinetics
200544(1):61-98. doi: 10.2165/00003088-200544010-00003
Sarkar U., Rivera-Burgos D., Large E.M., Hughes D.J., Ravindra K.C., Dyer R.L., Ebrahimkhani M.R., Wishnok J.S., Griffith L.G., Tannenbaum S.R.
Metabolite profiling and pharmacokinetic evaluation of hydrocortisone in a perfused three-dimensional human liver bioreactor.
Drug Metabolism and Disposition
2015 Jul43(7):1091-9. doi: 10.1124/dmd.115.063495. Epub 2015 Apr 29
ATC classification(16 codes)
ATC S01CB03
ATC A01AC03
ATC S01BA02
ATC S01CA03
ATC D07AA02
ATC S01BB01
ATC D07XA01
ATC D07BA04
ATC S02CA03
ATC A07EA02
ATC S02BA01
ATC R01AD60
ATC H02AB09
ATC D07CA01
ATC S03CA04
ATC C05AA01
Affected organisms(1)
Humans and other mammals
Experimental properties(5)
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Show
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
Knox C., Wilson M., Klinger C.M., et al
DrugBank 6.
0: the DrugBank Knowledgebase for 2024
Nucleic Acids Res. 2024 Jan 552(D1):D1265-D1275
Wishart D.S., Feunang Y.D., Guo A.C., et al
DrugBank 5.
0: a major update to the DrugBank database for 2018
Nucleic Acids Res. 2017 Nov 846(D1):D1074-D1082
Show earlier publications
Law V., Knox C., Djoumbou Y., et al
DrugBank 4.
0: shedding new light on drug metabolism
Nucleic Acids Res. 2014 Jan 142(1):D1091-7
Knox C., Law V., Jewison T., et al
DrugBank 3.
0: a comprehensive resource for 'omics' research on drugs
Nucleic Acids Res. 2011 Jan39(Database issue):D1035-41
Wishart D.S., Knox C., Guo A.C., et al
DrugBank: a knowledgebase for drugs, drug actions and drug targets.
Nucleic Acids Research
2008 Jan36(Database issue):D901-6
Wishart D.S., Knox C., Guo A.C., et al
DrugBank: a comprehensive resource for in silico drug discovery and exploration.
Nucleic Acids Research
2006 Jan 134(Database issue):D668-72
Source: go.drugbank.comCC BY-NC 4.0
Updated 4 months ago(8 Mar 2026)Structured knowledge from the free knowledge base
Wikipedia article
steroid hormone, in the glucocorticoid class of hormones; when used as a medication
Read on WikipediaWHO INN:hydrocortisone
International Nonproprietary Name
Linked open data from Wikidata (Q190875), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication. WHO INN from the World Health Organization.