Emergency pack for children with cortisol deficiency (hydrocortisone sodium phosphate)

This emergency pack contains:

• One ampoule of hydrocortisone sodium phosphate 100mg/ml
• Information leaflet on How to give an emergency injection of Hydrocortisone sodium phosphate 100mg/ml
• One tube of fast acting glucose gel for rubbing into gums or cheek
• Cotton wool ball
• Alcohol wipe
• Syringe
• Needle

Please check the expiry date of the pack 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.

The following information describes hydrocortisone 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.

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 with hydrocortisone tablets. 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.

More information about cortisol deficiency is available at Cortisol deficiency and steroid replacement therapy.

It is given as an injection into the muscle (intramuscularly). For instructions on giving intramuscular injections of hydrocortisone, please see the enclosed leaflet How to give an emergency injection of hydrocortisone sodium phosphate 100mg/ml: Information for families. You must always telephone 999 for an ambulance, stating that the child is having an ‘adrenal crisis’, if they have had a hydrocortisone injection.

People with the following conditions should discuss using hydrocortisone with their doctor:

• Known hypersensitivity to hydrocortisone or any of its ingredients.

Allergic reaction – Some children receiving hydrocortisone 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 hydrocortisone, the subsequent treatment will probably be changed.

Other side effects are likely to be related to your child’s everyday steroid treatment.

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.

Glucose gel 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.

Gradually squirt the glucose gel into the side of your child’s mouth, between the gums and the cheek. Alternatively, squirt the glucose gel onto your fingertip and apply it between your child’s gums and cheek.

• 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’.

• 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. Remember to check the expiry date of the pack before your hospital appointment so you can order a replacement if needed.
• If your doctor decides to stop treatment, return any unused pack to the pharmacist. Do not flush them down the toilet or throw them away.