Cortef
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 385 rub.
Buy
Cortef is a glucocorticosteroid (GCS) drug with anti-inflammatory action.
Release form and composition
Dosage form - tablets: round, white, with a dividing line and engraving "CORTEF10" (100 pcs. In dark glass bottles, 1 bottle in a cardboard box).
The active ingredient of Cortefa is hydrocortisone, in 1 tablet - 10 mg.
Auxiliary components: corn starch, calcium stearate, sucrose, lactose, sorbic acid, mineral oil.
Indications for use
Application of Cortef is shown:
- Endocrinology: subacute thyroiditis, hypercalcemia against the background of malignant neoplasms, congenital adrenal hyperplasia, adrenal cortex insufficiency (with replacement therapy as the drug of choice): primary (Addison's disease) - more often in combination with mineralocorticoid drugs, secondary - usually without mineralocorticoids;
- Dermatology: bullous dermatitis herpetiformis, pemphigus, exfoliative dermatitis, severe erythema multiforme (Stevens-Johnson syndrome), fungal mycosis (Aliber's disease), severe seborrheic dermatitis, severe psoriasis;
- Rheumatology: additional short-term therapy during an exacerbation or acute attack: rheumatoid arthritis (including juvenile rheumatoid arthritis), psoriatic arthritis, ankylosing spondylitis, bursitis (acute and subacute), acute gouty arthritis, acute nonspecific tendosynovitis, osteoarthritis, osteoarthritis acute sinusitis, posttraumatic arthritis; supportive therapy: acute rheumatic heart disease, systemic dermatomyositis (polymyositis), systemic lupus erythematosus;
- Allergology: for the control of severe or disabling conditions, in the absence of an adequate effect of the corresponding drugs: serum sickness, contact dermatitis, perennial or seasonal allergic rhinitis, bronchial asthma, atopic dermatitis, drug hypersensitivity reactions;
- Pulmonology: Leffler's syndrome (in the absence of clinical effect in the treatment of other drugs), symptomatic sarcoidosis, beryllium disease, aspiration pneumonia, disseminated or fulminant pulmonary tuberculosis in combination with anti-tuberculosis chemotherapy;
- Ophthalmology: chronic and severe acute diseases of allergic and inflammatory genesis: eye lesions in Herpes zoster, keratitis, allergic conjunctivitis, iritis and iridocyclitis, allergic corneal ulcers, chorioretinitis, diffuse posterior choroiditis and uveitis, inflammatory pathologies of the anterior segment of the eye, sympathetic nerve;
- Oncology: palliative therapy: acute leukemia in children, leukemia and lymphomas in adults;
- Hematology: secondary thrombocytopenia in adults, idiopathic thrombocytopenic purpura in adults, congenital (erythroid) hypoplastic anemia, autoimmune (acquired) hemolytic anemia, erythrocytic anemia (erythroblastopenia);
- Neurology: exacerbation of multiple sclerosis;
- Nephrology: nephrotic syndrome without uremia, idiopathic type or against the background of systemic lupus erythematosus - stimulation of diuresis or remission of proteinuria;
- Others: tuberculous meningitis in the presence or threat of a subarachnoid block (in combination with anti-tuberculosis chemotherapy).
Contraindications
- Systemic fungal infections;
- An indication of a history of hypersensitivity to the components of the drug.
With extreme caution, Cortef should be prescribed for confirmed or suspected strongyloidiasis.
In addition, care should be taken when prescribing the drug to patients with hypertension, diverticulitis, ulcerative colitis, fresh intestinal anastomoses, latent or active peptic ulcer, osteoporosis, renal failure, myasthenia gravis.
Prescribing the drug to women of childbearing age, during pregnancy or breastfeeding requires an assessment of the expected positive effect for the mother and the potential risk of therapy for the fetus or child.
Method of administration and dosage
Cortef tablets are taken orally.
The dosage regimen is prescribed by the attending physician based on clinical indications and the severity of the disease.
The initial dose is from 20 mg to 240 mg per day, in order to achieve a therapeutic effect during treatment, it is possible to carry out an individual dose adjustment. After an adequate response is achieved, a maintenance dose is established, gradually reducing it to the lowest effective dose (during this period, the patient needs careful medical supervision).
Dose adjustment should be carried out in case of changes in the clinical picture (remission or exacerbation of the disease), individual hypersensitivity. During the period of stressful situations not related to the initial disease, the dose of the drug must be increased.
If there is no clinical effect after long-term use of Cortef, the drug should be canceled. It is recommended to discontinue the drug after prolonged therapy by gradually reducing the dose.
Since with an exacerbation of multiple sclerosis, the daily dose of GCS during the first week of therapy is 200 mg of prednisolone, then 80 mg per day for a month, when prescribing a dose of the drug, it should be borne in mind that 5 mg of prednisolone is equivalent to 20 mg of hydrocortisone.
Side effects
- Cardiovascular system: in some cases - arterial hypertension, manifestations of congestive heart failure;
- Digestive system: flatulence, pancreatitis, peptic ulcer with a risk of perforation and bleeding, ulcerative esophagitis; possibly - a transient increase in the activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP);
- Musculoskeletal system: loss of muscle mass, muscle weakness, osteoporosis, steroid myopathy, tendon rupture (usually Achilles tendon), compressional vertebral fractures, aseptic necrosis of the humerus and femur heads, pathological fractures of the tubular bones;
- Endocrine system: Cushing's syndrome, growth retardation in children, secondary unresponsiveness of the pituitary and adrenal glands of various origins, decreased carbohydrate tolerance, menstrual irregularities, latent diabetes mellitus, increased need for insulin or oral hypoglycemic agents;
- Nervous system: headache, development of edema of the optic nerve head against the background of increased intracranial pressure (pseudotumor of the brain), dizziness, convulsions;
- Organs of vision: increased intraocular pressure, glaucoma, posterior subcapsular cataract, exophthalmos;
- Metabolism: negative nitrogen balance due to protein catabolism;
- Water and electrolyte balance: fluid retention in the body, sodium retention, decreased potassium content, hypokalemic alkalosis;
- Dermatological reactions: slow wound healing, decreased strength and thinning of the skin, ecchymosis, petechiae, increased sweating, facial erythema; possibly - suppression of the reaction of skin tests.
special instructions
When secondary adrenal cortex insufficiency appears while using Cortef, it is recommended to gradually reduce the dose of the drug. Since secondary relative insufficiency after the end of treatment can persist for several months, during this period, if stressful situations arise, the patient must be re-prescribed GCS. Due to the risk of impaired mineralocorticoid secretion, concomitant use of mineralocorticoids and / or electrolytes is necessary.
The drug reduces the body's resistance to infections, its ability to localize the infectious process. Against the background of taking GCS (monotherapy and combination with other immunosuppressants), viral, fungal, bacterial infections may appear, some infectious pathologies can occur in an erased form. The likelihood of developing infectious complications is dose-dependent and increases with increasing doses of the drug.
The risk of developing posterior subcapsular cataract, glaucoma, optic nerve damage, secondary viral or fungal infection increases with prolonged use of the drug.
For herpes simplex eye infection, Cortef should be administered with caution to prevent corneal perforation.
GCS increase the excretion of calcium.
Medium to high doses of hydrocortisone can cause an increase in blood pressure, increased excretion of potassium, and fluid retention. The patient should limit the consumption of table salt with food, appoint potassium supplements.
In the case of using doses that have an immunosuppressive effect, the administration of live or live attenuated vaccines to the patient is contraindicated, the administration of killed or inactivated vaccines is indicated, the response to which may be reduced. Immunization can be carried out for appropriate indications only when taking hydrocortisone in doses that do not have an immunosuppressive effect.
It is not recommended to prescribe corticosteroids for latent tuberculosis or positive tuberculin tests because of the risk of intensifying the disease. In the case of long-term drug therapy, patients need prophylaxis with anti-tuberculosis chemotherapy.
Patients receiving immunosuppressive doses of the drug should avoid contact with persons infected with measles or chickenpox, since these diseases can be severe or even fatal, especially in unimmunized children. In case of such contact, you should immediately consult a doctor.
When corticosteroids are prescribed to patients with ulcerative colitis, the risk of developing perforation, abscess, or purulent infections increases.
The effect of the drug is enhanced by cirrhosis and hypothyroidism of the liver.
The use of Cortef can increase the existing emotional instability or psychotic tendencies, cause a mental disorder in the patient (mood instability, euphoria, insomnia, personality change, severe depression, severe psychotic manifestations).
With the use of the drug, a transient development of Kaposi's sarcoma is possible.
To achieve a pronounced therapeutic effect in exacerbation of multiple sclerosis, it is necessary to prescribe relatively high doses of GCS.
Since the development of side effects of the drug depends on the dose and duration of treatment, the decision on the need for therapy and the dosage regimen is made individually after comparing the potential risk and the expected benefit from the use of GCS.
Long-term use of the drug in pediatrics should be accompanied by careful monitoring of the development and growth of the child, including the newborn.
In the case of taking significant doses of GCS by the mother during pregnancy, the newborn requires a thorough examination to identify symptoms of adrenal insufficiency.
Drug interactions
With simultaneous use with phenytoin, phenobarbital, rifampin (inducers of liver microsomal enzymes), the clearance of Cortef may increase, so an increase in its dose may be required.
When combined with ketoconazole and oleandomycin, the metabolism of hydrocortisone may be suppressed and its clearance may decrease (a decrease in the GCS dose is required).
Since corticosteroids can increase or decrease the effectiveness of oral anticoagulants, the combination with acetylsalicylic acid should be prescribed with caution in hypoprothrombinemia, and accompanied by regular determination of clotting indicators.
The drug can increase the clearance of high doses of acetylsalicylic acid used for a long period, which can cause a decrease in the level of salicylates in the serum or increase the likelihood of their toxic reactions when Cortef is discontinued.
Analogs
Analogs of the drug Cortef are: Acortin, Hydrocortisone, Dexamethasone, Metipred, Cortisone acetate, Cortineff.
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Cortef: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Cortef 10 mg tablets 100 pcs. 385 r Buy |
|
Cortef tablets 10mg 100 pcs. 414 RUB Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
