Cotson 100 mg/2 ml

Description

Indications:

Cotson (Hydrocortisone) is indicated for the treatment of various conditions, including:

• Endocrine Disorders:

  • Primary or secondary adrenocortical insufficiency
  • Acute adrenocortical insufficiency
  • Shock unresponsive to conventional therapy
  • Congenital adrenal hyperplasia
  • Hypercalcemia associated with cancer
  • Nonsuppurative thyroiditis

• Rheumatic Disorders:

  • Conditions involving inflammation, such as arthritis, bursitis, etc.

• Dermatologic Diseases:

  • Severe seborrheic dermatitis, severe psoriasis, pemphigus, and severe erythema multiforme

• Allergic Conditions:

  • Bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, seasonal or perennial allergic rhinitis, drug hypersensitivity reactions, urticarial transfusion reactions, and acute noninfectious laryngeal edema.

• Ophthalmic Diseases:

  • Herpes zoster ophthalmicus, iritis, iridocyclitis, chorioretinitis, diffuse posterior uveitis, choroiditis, optic neuritis

• Gastrointestinal Diseases:

  • Fulminating or disseminated pulmonary tuberculosis (with appropriate antituberculous chemotherapy)
  • Loeffler’s syndrome
  • Aspiration pneumonitis

• Hematologic Disorders:

  • Acquired autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura in adults, secondary thrombocytopenia, erythroblastopenia

• Neoplastic Diseases:

  • Leukemias and lymphomas in adults, acute leukemia in children

• Edematous States:

  • Conditions such as fluid retention or severe edema

• Neurological Conditions:

  • Acute exacerbations of multiple sclerosis

Pharmacology:

Hydrocortisone inhibits the synthesis of prostaglandins by inhibiting the enzyme phospholipase A2. This leads to a reduction in various vasoactive agents released during inflammation and controls the rate of protein synthesis. The pharmacological effects help reduce inflammation and manage immune responses.

Dosage & Administration:

• Oral (Tablet):

  • Initial dosage varies from 20 mg to 240 mg per day, depending on the condition being treated. Lower doses are used for less severe conditions, while higher doses may be required for more severe cases.
  • After achieving a satisfactory clinical response, the dosage is reduced gradually to determine the maintenance dose.
  • Note: The dosage should be individualized based on the disease and patient response, with monitoring required during therapy. For long-term therapy, hydrocortisone should be withdrawn gradually.

• Injection (IM/IV):

  • Adults: The initial dose ranges from 100 mg to 500 mg, depending on the severity of the condition. This dose may be repeated at intervals of 2-6 hours as needed.
  • Children: For slow IV injection:
    • Up to 1 year: 25 mg
    • 1-5 years: 50 mg
    • 6-12 years: 100 mg

Interactions:

• Increased Clearance: Drugs like Phenobarbital, Phenytoin, and Rifampin may increase the clearance of corticosteroids, requiring a higher dose to achieve the desired response.
• Decreased Clearance: Drugs such as Troleandomycin and Ketoconazole may inhibit the metabolism of corticosteroids, leading to reduced clearance and potential steroid toxicity. Dose adjustments are necessary to avoid toxicity.

Contraindications:

• Severe systemic fungal infections
• Hypersensitivity to any component of this product

Side Effects:

Common side effects of Cotson include:

• Cardiac: Arrhythmias
• Endocrine: Menstrual irregularities, decreased carbohydrate & glucose tolerance
• Metabolic: Fluid retention, increased appetite, weight gain
• Psychological: Euphoria, mood swings, depression, insomnia
• Skin: Acne, potential for delayed wound healing

Pregnancy & Lactation:

• Pregnancy: Should only be prescribed if absolutely required, as the risks to the fetus should be considered.
• Lactation: Should only be used if necessary as it may pass into breast milk and affect the baby.

Precautions & Warnings:

• Peptic Ulceration: Use with caution in patients with a history of peptic ulcers.
• Heart & Circulation: Use with caution in patients with congestive heart failure, hypertension, glaucoma, diabetes mellitus, and epilepsy.
• Withdrawal: Gradually taper the dose after long-term therapy to avoid withdrawal symptoms.

Therapeutic Class:

• Glucocorticoids

Storage Conditions:

• Store below 30°C, away from light and moisture.
• Keep out of reach of children.