This emergency pack contains one of each of the following:
Please check the expiry dates regularly. Ask for a replacement prescription from your doctor before the expiry date. Do not wait until you need to give an injection to check the expiry date.
Further information about hydrocortisone for injection
The following information describes hydrocortisone sodium phosphate for injection, how it is given and some of its possible side effects. Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned.
If you have any questions or concerns, please ask your doctor, nurse or pharmacist or telephone one of the contact numbers below.
What is hydrocortisone sodium phosphate?
Hydrocortisone sodium phosphate is a corticosteroid (steroid). Steroids are hormonal substances that are produced naturally in the body by the adrenal glands (which are just above each kidney) and by the reproductive organs.
There are many different types of steroids and they have different effects on the body. They are different to the anabolic steroids used by athletes to enhance their performance.
Hydrocortisone sodium phosphate is used to treat children who have cortisol deficiency. Cortisol deficiency occurs when the adrenal glands do not produce enough cortisol.
Cortisol deficiency is easily controlled with replacement therapy as hydrocortisone tablets given several times a day. However, if a person with cortisol deficiency becomes unwell, they are unable to increase the production of cortisol in their system to help the body cope and this could be life threatening. In these circumstances, the amount of hydrocortisone given needs to be increased quickly, either by increasing the number of tablets taken or by giving an injection.
At Great Ormond Street Hospital (GOSH), the brand of hydrocortisone sodium phosphate used is Efcortesol®. This information describes the injection only. More information about cortisol deficiency is available in Cortisol deficiency and steroid replacement therapy.
How is Efcortesol® given?
It is given as an injection into the muscle (intramuscularly). For instructions on giving intramuscular injections of hydrocortisone, please see How to give an emergency injection of Efcortesol®.
You must always telephone 999 for an ambulance, stating that the child is having an ‘adrenal crisis’, if they have had a hydrocortisone injection.
Who should not use Efcortesol® injections?
People with the following conditions should discuss using hydrocortisone with their doctor:
- known hypersensitivity to Efcortesol®, hydrocortisone or any of its ingredients
What are the side effects of Efcortesol®?
Allergic reaction
Some children receiving Efcortesol® may have an allergic reaction to the drug. This reaction may be mild to severe. Signs of a mild allergic reaction include skin rashes and itching, high temperature, shivering, redness of the face, a feeling of dizziness or a headache. If you see any of these signs, please report them to a doctor or nurse.
Signs of a severe allergic reaction include any of the above, as well as shortness of breath or chest pain. If you are in hospital and your child shows signs of a severe allergic reaction, call a doctor or nurse immediately.
If you are at home and your child shows signs of a severe allergic reaction, call an ambulance immediately. If your child has a severe reaction to Efcortesol®, the subsequent treatment will probably be changed.
Other side effects are likely to be related to your child’s everyday steroid treatment. For information about these side effects and how they will be monitored, please see our Long term steroid treatment information sheet.
Hydrocortisone and other medicines
Some medicines react with hydrocortisone, altering how well it works, although this is unlikely when hydrocortisone is given as an emergency dose. However, always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines.
Further information about glucose gel (Glucogel®)
Glucogel® is a glucose (dextrose) gel, which can be used when your child is showing signs of low blood sugar levels. It should always be used in addition to giving the hydrocortisone injections.
How to use Glucogel® after your child has had the hydrocortisone injection
Gradually squirt the Glucogel® into the side of your child’s mouth, between the gums and the cheek. Alternatively, squirt the Glucogel® onto your fingertip and apply it between your child’s gums and cheek. Up to one-third of a 25g tube may be needed.
- Massage your child’s cheek to allow the gel to be absorbed.
- This should raise your child’s blood sugar level within 10 minutes.
- Telephone 999 for an ambulance, stating that your child is having an ‘adrenal crisis’.
Important information about the emergency pack
- Keep the entire emergency pack together, in a safe place where children cannot reach it. Keep it at room temperature, out of direct sunlight or heat. The injection ampoules do not need to be kept in the fridge.
- If your doctor decides to stop treatment with hydrocortisone, return any unused ampoules to the pharmacist. Do not flush them down the toilet or throw them away.
Last reviewed by Great Ormond Street Hospital: June 2009
Ref: 09F0410 © GOSH Trust June 2009
Compiled by the Pharmacy & Endocrinology Departments in collaboration with the Child and Family Information Group
Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.
Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.
