What Is Hydrocortisone? Uses, Dosage, and What You Need to Know in 2026

Hydrocortisone is the pharmaceutical name for cortisol — the hormone your adrenal glands naturally produce every day. It is one of the most important and versatile medications in medicine, used to treat everything from life-threatening hormonal deficiencies to everyday skin rashes. Understanding what hydrocortisone is and how it's used will help you use it safely and effectively.

What Is Hydrocortisone?

Hydrocortisone belongs to the class of drugs called glucocorticoids (or corticosteroids). It is chemically identical to cortisol — the body's own stress hormone, produced by the adrenal cortex in response to ACTH signals from the pituitary gland.

Cortisol plays essential roles in your body: it regulates metabolism, controls inflammation, affects immune function, supports blood pressure, and helps the body respond to stress. When the adrenal glands cannot produce enough cortisol (as in Addison's disease), hydrocortisone replaces what the body is missing.

Brand Names for Hydrocortisone

Cortef: Brand-name oral tablets (5 mg, 10 mg, 20 mg) — made by Pfizer

Solu-Cortef: Injectable form (hydrocortisone sodium succinate) for IV and IM use

Alkindi Sprinkle / Khindivi: Pediatric sprinkle capsules in 0.5 mg, 1 mg, 2 mg, and 5 mg strengths for children with adrenal insufficiency

Cortenema / Cortifoam: Rectal formulations for ulcerative colitis and proctitis

Various OTC brands: Topical creams and ointments (0.5%, 1%) available without a prescription for skin conditions

What Is Hydrocortisone Used For?

Hydrocortisone has a remarkably broad range of uses:

Adrenal Insufficiency (Addison's Disease, CAH)

This is the most critical use. Patients with Addison's disease (primary adrenal insufficiency) or congenital adrenal hyperplasia (CAH) cannot produce enough cortisol on their own. Hydrocortisone replaces what the adrenal glands would normally make. This is a lifelong, life-sustaining medication for these patients — without it, they risk adrenal crisis.

Anti-Inflammatory and Immunosuppressive Uses

Hydrocortisone is prescribed for many inflammatory and autoimmune conditions:

Rheumatoid arthritis and other inflammatory arthritis

Systemic lupus erythematosus (SLE)

Severe allergic reactions and anaphylaxis

Asthma and chronic obstructive pulmonary disease (COPD) exacerbations

Inflammatory bowel disease (ulcerative colitis)

Skin conditions: eczema, psoriasis, contact dermatitis (topical)

Certain cancers and cancer-related inflammation

Hydrocortisone Dosage Forms and Strengths

Oral tablets: 5 mg, 10 mg, 20 mg (currently in shortage)

Sprinkle capsules: 0.5 mg, 1 mg, 2 mg, 5 mg (Alkindi Sprinkle — for children)

Injectable: 100 mg, 250 mg, 500 mg, 1,000 mg (Solu-Cortef for IV/IM use)

Topical cream/ointment: 0.5% (OTC), 1% (OTC and Rx), 2.5% (Rx)

Rectal: 100 mg/60 mL enema (Cortenema), 10% rectal aerosol (Cortifoam)

Typical Hydrocortisone Doses

Adrenal insufficiency replacement: 15-25 mg per day in 2-3 divided doses (e.g., 10 mg morning, 5 mg afternoon, 5 mg late afternoon)

Anti-inflammatory use: 20-240 mg per day depending on condition severity; typically higher than replacement doses

Sick day dosing (adrenal insufficiency): Double or triple the usual dose during illness, fever, surgery, or significant injury

Is Hydrocortisone a Controlled Substance?

No. Hydrocortisone is not a controlled substance under the DEA. It does not require special prescription handling, does not need to be called in to the pharmacy within a specific time window, and can be prescribed for any number of refills at the prescriber's discretion. Any licensed physician, NP, or PA can prescribe it.

Note: While hydrocortisone itself is not controlled, the tablet form is currently in shortage. Use medfinder to find a pharmacy near you that has it in stock. For a deeper explanation of how hydrocortisone works in the body, see our guide:

How Does Hydrocortisone Work? Mechanism of Action Explained in Plain English.