Hydrocortisone Sodium Succinate Injection USP 500 mg

Hydrocortisone sodium succinate dosages administration:

• Solnac may be administered by intravenous injection, by intravenous infusion, or by intramuscular injection, the preferred method for initial emergency use being intravenous injection. Following the initial emergency period, consideration should be given to employing a longer-acting injectable preparation or an oral preparation.
• Dosage usually ranges from 100 mg to 500 mg depending on the severity of the condition, administered by intravenous injection over a period of one to ten minutes. This dose may be repeated at intervals of 2, 4 or 6 hours as indicated by the patient’s response and clinical condition.
• Dosage requirements are variable and must be individualized on the basis of the disease under treatment, its severity and the response of the patient over the entire duration of treatment. A risk/benefit decision must be made in each individual case on an ongoing basis.
• The proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage, which will maintain an adequate clinical response, is reached.
• In general high-dose corticosteroid therapy should be continued only until the patient’s condition has stabilized – usually not beyond 48 to 72 hours. If hydrocortisone therapy must be continued beyond 48 to 72 hours hypernatraemia may occur, therefore it may be preferable to replace Solnac with a corticosteroid such as methylprednisolone sodium succinate as little or no sodium retention occurs.
• If after long-term therapy the drug is to be stopped, it needs to be withdrawn gradually rather than abruptly.
• Undesirable effects may be minimized by using the lowest effective dose for the minimum period.
• Corticosteroid therapy is an adjunct to, and not a replacement for, conventional therapy.
• In patients with liver disease, there may be an increased effect and reduced dosing may be considered.

Paediatric population:

• Dosage should be reduced for infants and children, but should be governed more by the severity of the condition and response of the patient, than by age of size.
• Dosage should not be less than 25 mg daily.

Elderly patients:

• Solnac is primarily used in acute short-term conditions. When used according to instructions, there is no information to suggest that a change in dosage is warranted in the elderly. However, treatment of elderly patients, particularly if long-term, should be planned bearing in mind the more serious consequences of the common side-effects of corticosteroids in old age and close clinical supervision is required.