Pharmacort Dosage/Direction for Use

Individualize dosage based on the condition being treated and the patient's response.
Corticosteroid therapy is an adjunct to, and not a replacement for conventional therapy.
This product may be administered by intravenous (IV) injection, IV infusion, or by intramuscular (IM) injection.
For initial emergency use IV injection is preferred. After the initial emergency period, consideration should be given to employing a longer-acting injectable preparation or an oral preparation.
Recommended Dose: Dosage usually ranges from 100 mg to 500 mg depending on the severity of the condition. Administer intravenously over a period of 30 seconds to 1 minute (e.g., 100 mg of hydrocortisone) to 10 minutes (e.g. 500 mg or more). The dose may be repeated at intervals of 2, 4 or 6 hours depending on the patient's response and clinical condition.
In general high-dose corticosteroid therapy should be continued only the patient's condition has stabilized usually not beyond 48 to 72 hours. Hypernatremia may result when high­-dose hydrocortisone therapy is administered beyond 48 to 72 hours: a corticoid product (e.g., methylprednisolone sodium succinate) which causes little or no sodium retention may be desirable.
Although adverse effects associated with high dose, short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be required.
Increased corticosteroid dosage is required in patients with adrenal insufficiency who are subjected to stress (eg., infection, surgery, trauma).
Patients subject to severe stress following corticosteroid therapy should be closely observed for signs and symptoms of adrenocortical insufficiency.
Treatment of Acute Exacerbations of Multiple Sclerosis: 800 mg per day of hydrocortisone for one week followed by 320 mg every other day for one month (see Precautions).
Use in Pediatric Patients: Hydrocortisone treatment should be based on seventy or the condition and response of the patient more than by age or body weight The range or initial doses is 0.56 to 8 mg/kg/day in three or four divided doses (20 to 240 mg/m² BSA/day).
Preparation of Solution: Whenever solution and container permit, inspect the solution for particulate and discoloration before administration.
Similar to other steroid formulations, this product is sensitive to heat. Therefore, the product should not be autoclaved when it is desirable to sterilize the exterior of the vial.
For IV or IM Injection: Prepare solution by aseptically adding not more than 2 mL of Bacteriostatic Water for Injection or Bacteriostatic Sodium Chloride Injection to the contents of one vial.
For IV Infusion: Prepare solution by aseptically adding not more than 2 mL of Bacteriostatic Water for Injection or Bacteriostatic Sodium chloride Injection to the contents of one vial. This solution may then be added to 100 to 1000 mL of the following 5% dextrose in water (or isotonic saline solution or 5% dextrose in isotonic saline solution if patient is not on sodium restriction).
After reconstitution, hydrocortisone sodium succinate injection has a pH of 7-8.
The reconstituted solution should be stored at temperatures not exceeding 30°C. Protect light. Use solution only if it is clear and any unused solution should be discarded after 3 days.