This page shows what was measured, who it was measured in, and what that does not settle.
What Hydrocortisone does in the body
Replacing the cortisol the adrenal glands cannot make, and — at higher exposure — inflammation and allergy
Hydrocortisone is chemically identical to cortisol, the hormone your adrenal glands release every morning and whenever you are ill or injured. Given as a tablet or an injection it does exactly what your own cortisol does: it binds a receptor inside cells that then switches inflammatory genes off and metabolic genes on, and it also acts on the receptor that keeps blood pressure up by holding on to salt. In someone whose adrenal glands have failed, that is replacement — putting back a molecule the body cannot make. In someone with working adrenal glands, giving more of it is suppression, and the same hormone that keeps a person with Addison’s disease alive will thin their bones and raise their blood sugar if given in excess.
What happened in people
Septic shock 90-day mortality 27.9% against 28.8% in 3,658 analysed patients, odds ratio 0.95 (95% CI 0.82 to 1.10) — no benefit
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
That faster reversal of shock means more people survive it — the surrogate moves in every trial and the outcome does not
Where it acts
Every tissue. Cortisol is a systemic hormone and hydrocortisone is that hormone; the receptor is expressed in essentially all nucleated human cells.
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · WI4X0X7BPJ · read 2026-08-29
Its recorded molecular formula is C21H30O5, weighing 362.
US prescribing information · 26c13a5f-7119-4c6a-bf10-fda4e07d7682 · read 2026-08-30
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 168 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Healthy ageing
…Waiting for a reviewer3 registered study measure of this kind. No reviewed result yet.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Recovery
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Pain
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Healthy ageing
28 day mortality in all the non responders to acth; hospital mortality; all cause mortality
Recovery
time to marrow recovery
Pain
decrease in pain at 8 weeks post injection
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
… Waiting for a reviewer
3 registered study measure of this kind. No reviewed result yet.
∅ Nothing in the sources checked
No registered study lists a performance measure for this goal.
— Not recorded
Harms were not a registered measure for this goal.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
27.9% against 28.8%; odds ratio 0.95 (95% CI 0.82 to 1.10), P=0.50
Repeated elsewhere
Failed to Replicate
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Shock resolved a median day faster (hazard ratio 1.32, 95% CI 1.23 to 1.41) and the initial ventilation episode was shorter, but days alive and free of ventilation did not differ once recurrences were counted. Secondary findings that move without the primary endpoint moving are the ones most often quoted as if the trial were positive.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Phase 3, multicentre, randomised, double-blind, 2-by-2 factorial reduced to two groups
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
43.0% against 49.1%; relative risk 0.88 (95% CI 0.78 to 0.99), P=0.03
Repeated elsewhere
Failed to Replicate
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Day-28 mortality was not significantly different (33.7% against 38.9%, P=0.06). The regimen included fludrocortisone, the population was substantially sicker than in ADRENAL, and the factorial design collapsed mid-trial when drotrecogin alfa was withdrawn from the market.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
39.2% against 36.1% in non-responders, P=0.69; 34.3% against 31.5% overall, P=0.51
Repeated elsewhere
Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. More episodes of superinfection, including new sepsis and new septic shock, in the hydrocortisone group. The trial also under-recruited against its planned sample size.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
16.6% against 13.2%; adjusted rate ratio 1.27 (95% CI 0.93 to 1.74)
Repeated elsewhere
Partially Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Hypertension requiring medication occurred in 4.3% against 1.0%. The two-year safety outcome — survival without moderate or severe neurodevelopmental impairment — was flat at 36.9% against 37.3%.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.13 registered measures of this kind. 3 written-up studies measured this and did not show a benefit.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.2 registered measures of this kind.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.2 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.1 registered measure inside human tissue.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in Mouse, Rat. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Hydrocortisone
What a person takes: Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%.
The measurement behind this step
Absorbed rapidly and almost completely by mouth, with a short biological half-life of 8 to 12 hours that requires divided daily administration for replacement and makes it the most controllable systemic glucocorticoid. The water-soluble sodium succinate ester is the standard intravenous form. Rectal foams deliver it to the distal colon with reduced systemic exposure, and topical formulations exploit the fact that inflamed skin absorbs far more than intact skin.
Getting in
It is the hormone, not an imitation of it
Every other drug in this group is a modified version of cortisol. Hydrocortisone is cortisol. Swallowed or injected, the body cannot distinguish it from what the adrenal glands would have released.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Identical to endogenous cortisol, C21H30O5. Oral bioavailability is high and peak concentrations arrive within about an hour. Roughly 90% is protein bound, principally to corticosteroid-binding globulin, which saturates in the upper physiological range and makes free cortisol rise disproportionately once total cortisol exceeds it.
A gatekeeper enzyme decides which receptor it reaches
Cortisol binds two different receptors equally well. In the kidney and the colon an enzyme destroys it on arrival so it cannot reach the second one, which is reserved for a different hormone.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
11-beta-hydroxysteroid dehydrogenase type 2 oxidises cortisol to inactive cortisone in mineralocorticoid target tissues, protecting NR3C2, which binds cortisol and aldosterone with equal affinity. Inhibiting the enzyme — with glycyrrhetinic acid from liquorice, or by congenital deficiency — produces apparent mineralocorticoid excess: hypertension and low potassium driven by cortisol acting where aldosterone should.
The glucocorticoid receptor is released and moves to the nucleus
Where the enzyme does not intervene, cortisol binds the receptor waiting in the cytoplasm, frees it from its chaperones, and it travels into the nucleus.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Dissociation of the HSP90-HSP70-p23-immunophilin complex on NR3C1, FKBP51 to FKBP52 exchange, dynein-mediated nuclear import. The same pathway as every other glucocorticoid on this site, driven by the endogenous ligand.
It sets the metabolic baseline as well as suppressing inflammation
Cortisol does not only quieten inflammation. It tells the liver to make glucose, tells fat and muscle to release fuel, and keeps blood vessels responsive to the signals that maintain blood pressure. Losing all of that at once is what makes adrenal failure fatal.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Transactivation induces PEPCK and glucose-6-phosphatase for hepatic gluconeogenesis, and permits catecholamine-mediated vasoconstriction by maintaining adrenergic receptor expression and inhibiting inducible nitric oxide synthase. Transrepression of NF-kappaB and AP-1 produces the anti-inflammatory effect. In adrenal insufficiency the failure is of both arms, plus aldosterone, which is why replacement needs a mineralocorticoid alongside.
In replacement, the goal is normality; in shock, it is a haemodynamic effect
Given to someone whose adrenal glands have failed, the aim is to reproduce a normal day. Given to someone in septic shock, the aim is to get their blood pressure back — and that part works consistently.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Across ADRENAL, CORTICUS and APROCCHSS, faster shock reversal is the one finding all three share; ADRENAL measured a hazard ratio of 1.32 (95% CI 1.23 to 1.41) for resolution of shock. The mechanism is the mineralocorticoid and vascular arm rather than the anti-inflammatory one, and it acts within hours.
Blood pressure recovering faster did not mean fewer people died in the largest trial. The two things came apart, and the field has not agreed on why.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
90-day mortality odds ratio 0.95 (95% CI 0.82 to 1.10) in 3,658 patients in ADRENAL against a relative risk of 0.88 (0.78 to 0.99) in 1,241 patients in APROCCHSS. CORTICUS additionally recorded more superinfection, including new sepsis and septic shock — the predictable cost of suppressing an immune response during an infection.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
decrease in pain at 8 weeks post injection
immunologic markers health care related quality of life ptsd
Measured
Things only a test, a scale or a device shows.
total cerebral volume as measured by volumetric brain mri
serum 17 ohp concentration in the morning
blood pressure
Meaningful
Things that change how a life goes, not only a number.
event free survival
complete remission at the end of consolidation therapy
survival following consolidation
event free survival following consolidation
overall survival
toxic death
remission re induction rate
event free survival rate
disease free survival
28 day mortality in all the non responders to acth
and 3 more.
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (22)
adult height relative to general population
dying or residual disease during induction therapy
time to marrow recovery
frequency of toxicities including infectious complications
marrow status
blasts
time to progression
early marrow cr plus pr rate at day 21
grade 3 stomatitis
response rate
minimal residual disease
improvement in jet lag symptoms
rate of minimal residual disease 0 01
overall response rate
experiencing grade 3 5 toxicity
asparaginase completion rate
chronic graft vs host disease
response
incidence of absolute and relative adrenal insufficiency
grade 3 or worse toxicity
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What it would be like to take◇Read from sources, not yet reviewed
How long anything takes
Nine different lengths of time that get confused with each other. None of them is worked out from another.
Before anything is noticed.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before a test result moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before performance moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
How long the result was watched.No finished study window is recorded for a study that tested this substance.
How long people took it.How long people actually took it is not stored. The study window is not the same thing.
How long people were followed.Follow-up length is not stored separately. It is never read off the study window, which would be a different thing.
How fast the body clears it. 1.5 hours hours
Read from the label, which states: “The terminal half-life of hydrocortisone is about 1.5 hours following intravenous and oral dosing of hydrocortisone tablets and ALKINDI SPRINKLE in dexamethasone-suppressed healthy adult male volunteers. 12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Hydrocortisone is a glucocorticoid.”
How long effects linger.RNAWiki does not store this separately, and never works it out from another figure on this page.
Beyond the studies. Nothing is recorded about the long term.
The longest finished study sets the edge of what anyone measured.
A study window is not how long people took it, and neither is how long they were followed. Where RNAWiki holds only one of the three, it shows one.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
People with Addison’s disease, with pituitary failure, with congenital adrenal hyperplasia, and anyone whose own cortisol production has been suppressed by prolonged treatment with another glucocorticoid. Separately, patients in septic shock, and anyone reaching for a 1% cream for an insect bite.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of ALKINDI SPRINKLE have been established in pediatric patients for replacement therapy of adrenocortical insufficiency and the information on this use is discussed throughout the labeling.”
US prescribing information · 26c13a5f-7119-4c6a-bf10-fda4e07d7682 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary Untreated adrenocortical insufficiency in pregnancy can result in a high rate of complications, including maternal mortality.”
US prescribing information · 26c13a5f-7119-4c6a-bf10-fda4e07d7682 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary Cortisol is present in human milk.”
US prescribing information · 26c13a5f-7119-4c6a-bf10-fda4e07d7682 · read 2026-08-30
Where the result stopped carrying
ADRENAL, the largest septic shock steroid trial ever run, found no mortality difference at 90 days or 28 days
CORTICUS found no benefit in any group and more superinfection, and eliminated the corticotropin test from guidance
Hydrocortisone in ventilated preterm infants did not improve survival free of bronchopulmonary dysplasia or of neurodevelopmental impairment
The two definitive septic shock trials published within weeks of each other reached opposite conclusions and the discrepancy is unresolved
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
Absorbed rapidly and almost completely by mouth, with a short biological half-life of 8 to 12 hours that requires divided daily administration for replacement and makes it the most controllable systemic glucocorticoid.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: The water-soluble sodium succinate ester is the standard intravenous form. Rectal foams deliver it to the distal colon with reduced systemic exposure, and topical formulations exploit the fact that inflamed skin absorbs far more than intact skin.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
At replacement exposure the risks are of too little rather than too much: adrenal crisis during intercurrent illness or surgery is the principal cause of avoidable death, and treated Addison’s disease still carries more than double the expected mortality. At pharmacological exposure the full class profile applies — infection risk and masking, hyperglycaemia, hypertension and fluid retention (more prominent than with any other systemic glucocorticoid because of its mineralocorticoid activity), osteoporosis, myopathy, cataract, psychiatric disturbance. In CORTICUS, superinfection including new sepsis was more common on hydrocortisone.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Hydrocortisone appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 7608 reaction mentions were counted. One report can name several reactions.
The recorded terms (10)
drug hypersensitivity — 1441 reaction mentions
pain — 907 reaction mentions
fatigue — 879 reaction mentions
rash — 751 reaction mentions
arthralgia — 632 reaction mentions
hypersensitivity — 615 reaction mentions
condition aggravated — 612 reaction mentions
alopecia — 599 reaction mentions
abdominal discomfort — 592 reaction mentions
swelling — 580 reaction mentions
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral tablet, taste-masked oral granules for infants and children, sodium succinate powder for intravenous and intramuscular injection, sodium phosphate injection, rectal foam and enema, and topical creams and ointments including over-the-counter 1%
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
The water-soluble sodium succinate ester is the standard intravenous form. Rectal foams deliver it to the distal colon with reduced systemic exposure, and topical formulations exploit the fact that inflamed skin absorbs far more than intact skin.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
729 products list this as an active ingredient in the United States drug directory. 627 of them contain it and nothing else.
FDA National Drug Code directory · 71335-2918 · read 2026-08-29
They are sold as aerosol, foam, aerosol, spray, capsule, cream, enema and gel, taken auricular (otic), cutaneous, intramuscular and intravenous.
FDA National Drug Code directory · 71335-2918 · read 2026-08-29
The regulator's established pharmacologic class for it is corticosteroid hormone receptor agonists [moa] and corticosteroid [epc].
FDA National Drug Code directory · 71335-2918 · read 2026-08-29
620 published labels name it as an active ingredient. 519 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 931ed426-89a1-4877-a4a5-cb963d51e717 · read 2026-08-29
Those labels are classed as human otc drug and human prescription drug.
US prescribing information · 931ed426-89a1-4877-a4a5-cb963d51e717 · read 2026-08-29
37 marketed supplement labels list this ingredient, classed as non-nutrient/non-botanical and other combinations.
Those labels carry all other, nutrient and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.
Recorded price in US: 0.0402–0.56866 USD per one gram, across 31 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 0.13695–0.31266 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 32 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 0.14006–5.48033 USD per one millilitre, across 8 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Hydrocortisone studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That faster reversal of shock means more people survive it — the surrogate moves in every trial and the outcome does not
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That current replacement regimens are optimal; that replacement is necessary is certain, that any particular schedule is best has never been tested
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That replacement restores normal life expectancy — the Swedish cohort found more than double the expected mortality
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the corticotropin stimulation test identifies patients who will benefit, an idea CORTICUS tested directly and refuted
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Hydrocortisone are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
The replacement indication has no randomised evidence and never will
In plain words
Addison’s disease killed almost everyone who had it before 1949. After cortisone became available, it stopped doing so. That is the entire evidence base for the most important use of this drug: a before-and-after comparison, not a randomised trial, because randomising someone with adrenal failure to placebo would kill them.
What was measured
That current replacement regimens are optimal — the fact that replacement is necessary is beyond doubt, and the fact that any particular regimen is the best one has not been tested
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
No placebo-controlled trial of glucocorticoid replacement in primary adrenal insufficiency exists, and none can be conducted: withholding cortisol from a person who cannot make it is lethal within days to weeks under physiological stress. The evidence is the historical case fatality of untreated Addison’s disease, the dose-response of the cortisol requirement during illness, and the reproducible physiological effect on blood pressure, sodium and glucose. This is one of the strongest inferences in medicine and it is still an inference. It matters because the same absence of trial data extends to questions that could be answered: which glucocorticoid, what exposure profile, and whether modified-release formulations improve outcomes rather than curves.
Source
United States prescribing information for hydrocortisone tablets (CORTEF), Indications section 1, "Endocrine Disorders"; historical case-fatality record of untreated primary adrenal insufficiency
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
Treated Addison’s disease still carries more than double the expected mortality
In plain words
Replacement therapy is usually described as returning life expectancy to normal. A Swedish study followed every diagnosed case in the country for fourteen years and found more than twice as many deaths as expected, from heart disease, cancer and infection.
What was measured
All-cause mortality risk ratio against the matched national background population
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A population-based retrospective study using the Swedish National Hospital and Cause of Death registers identified 1,675 patients with primary adrenal insufficiency between 1987 and 2001, followed for an average of 6.5 years from diagnosis. There were 507 deaths against 199 expected. The all-cause mortality risk ratio was 2.19 (95% CI 1.91 to 2.51) in men and 2.86 (95% CI 2.54 to 3.20) in women. The excess was attributed to cardiovascular, malignant and infectious disease. Concomitant diabetes was present in 12% and contributed only slightly.
Written into the record, not signed off as a reviewed claim
ADRENAL: no mortality benefit in 3,800 patients with septic shock
In plain words
The largest trial of steroids in septic shock ever run gave hydrocortisone or a placebo to nearly four thousand ventilated patients. The same proportion died in each group. Shock reversed a day faster on the drug, and that did not translate into anyone surviving who would not have.
What was measured
All-cause mortality at 90 days, against placebo
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
ADRENAL randomised 3,800 patients with septic shock undergoing mechanical ventilation to a continuous infusion of hydrocortisone 200 mg per day for 7 days or placebo, with primary outcome ascertained in 3,658. Death from any cause at 90 days was 511 (27.9%) against 526 (28.8%), odds ratio 0.95 (95% CI 0.82 to 1.10, P=0.50), with a similar effect across all six prespecified subgroups. Shock resolved faster (median 3 against 4 days, hazard ratio 1.32, 95% CI 1.23 to 1.41, P<0.001) and the initial ventilation episode was shorter, but days alive and free of ventilation did not differ once recurrences were counted. Fewer patients received a transfusion (37.0% against 41.7%). There was no difference in 28-day mortality, shock recurrence, ICU or hospital days, renal replacement, or new bacteraemia or fungaemia.
Written into the record, not signed off as a reviewed claim
APROCCHSS reached the opposite conclusion in the same month
In plain words
Three weeks after the trial that found nothing, a French trial of 1,241 patients found hydrocortisone with a second hormone cut deaths at ninety days from 49.1% to 43.0%. The two trials were published in the same journal in the same year and the field has not fully reconciled them.
What was measured
That one of the two trials is simply right — the honest reading is that hydrocortisone reliably reverses shock faster and unreliably changes whether people die, and the conditions separating the two results have not been identified
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
APROCCHSS randomised 1,241 patients with septic shock in a 2-by-2 factorial design that became a two-group comparison after drotrecogin alfa was withdrawn. Ninety-day mortality was 43.0% (264 of 614) with hydrocortisone plus fludrocortisone against 49.1% (308 of 627) with placebo, relative risk 0.88 (95% CI 0.78 to 0.99, P=0.03). Mortality was also lower at ICU discharge (35.4% against 41.0%, P=0.04), hospital discharge (39.0% against 45.3%, P=0.02) and day 180 (46.6% against 52.5%, P=0.04), but not at day 28 (33.7% against 38.9%, P=0.06). Vasopressor-free and organ-failure-free days both favoured treatment. Hyperglycaemia was more common. Three differences from ADRENAL are usually offered: APROCCHSS added fludrocortisone, enrolled a sicker population with a placebo mortality of 49.1% against 28.8%, and used bolus rather than continuous infusion. None of the three has been tested as the explanation.
Written into the record, not signed off as a reviewed claim
CORTICUS: no survival benefit, faster shock reversal, more superinfection
In plain words
The trial that came ten years before both of the others tested whether a cortisol stimulation test could identify who would benefit. It could not. Nobody survived at a different rate, and there were more new infections in the steroid group.
What was measured
Death at 28 days among corticotropin non-responders, and overall, against placebo
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
CORTICUS randomised 499 patients with septic shock to hydrocortisone 50 mg intravenously every 6 hours for 5 days then tapered, or placebo. At 28 days there was no significant difference in mortality among the 233 patients who did not respond to corticotropin (39.2% against 36.1%, P=0.69), among those who did respond (28.8% against 28.7%, P=1.00), or overall (34.3% against 31.5%, P=0.51). Shock reversed more quickly on hydrocortisone. There were more episodes of superinfection, including new sepsis and septic shock. The trial closed the question of whether the corticotropin test selects responders: it does not, and the test was subsequently dropped from guidance.
Written into the record, not signed off as a reviewed claim
Preterm infants: no improvement in survival without lung disease in 800 babies
In plain words
Extremely premature babies still on a ventilator after two weeks were given hydrocortisone or a placebo. Slightly more survived without serious lung disease on the drug, but not enough to be a real difference, and at two years there was no difference in survival free of disability either.
What was measured
Survival without moderate or severe bronchopulmonary dysplasia at 36 weeks, and survival without neurodevelopmental impairment at 22 to 26 months
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
A National Institutes of Health trial enrolled 800 infants under 30 weeks’ gestation intubated for at least 7 days at age 14 to 28 days, randomised to hydrocortisone 4 mg/kg/day tapered over 10 days or placebo. Survival without moderate or severe bronchopulmonary dysplasia at 36 weeks postmenstrual age was 66 of 398 (16.6%) against 53 of 402 (13.2%), adjusted rate ratio 1.27 (95% CI 0.93 to 1.74). Survival without moderate or severe neurodevelopmental impairment at 22 to 26 months was 132 of 358 (36.9%) against 134 of 359 (37.3%), adjusted rate ratio 0.98 (95% CI 0.81 to 1.18). Hypertension requiring treatment was more frequent on hydrocortisone (4.3% against 1.0%).
Written into the record, not signed off as a reviewed claim
Faster shock reversal is not the same as a life saved, and this is where they diverge
In plain words
Every large trial of hydrocortisone in septic shock agrees on one thing: blood pressure recovers faster on the drug. The trials disagree about whether anyone lives longer as a result. The surrogate is consistent; the outcome is not.
What was measured
That reversing shock faster means saving lives — the haemodynamic effect is reproducible across every trial and the mortality effect is not
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
ADRENAL found shock resolution a median day faster (hazard ratio 1.32, 95% CI 1.23 to 1.41, P<0.001) with a 90-day mortality odds ratio of 0.95 (0.82 to 1.10). CORTICUS found faster shock reversal with no mortality difference at 28 days and more superinfection. APROCCHSS found both faster vasopressor withdrawal and a mortality benefit. A surrogate that moves reliably while the outcome moves inconsistently is the definition of an unvalidated surrogate, and haemodynamic response to steroid in septic shock is one — mechanistically the mineralocorticoid effect on vascular tone and catecholamine sensitivity is straightforward and immediate, and it does not by itself determine survival.
Written into the record, not signed off as a reviewed claim
The 1952 fermentation step is why the whole class costs cents
In plain words
The first cortisone was made through a 31-step chemical synthesis and was one of the most expensive substances on earth. A single fungal enzyme that could add one oxygen atom to the right carbon replaced most of those steps, and the price collapsed. Every drug in this class exists at its current price because of that.
What was measured
United States pharmacy acquisition cost per tablet, median across 122 listed generic products
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Introducing an 11-beta hydroxyl group into a steroid nucleus chemically requires selective functionalisation of an unactivated carbon and was the bottleneck in Sarett’s original synthesis. The Upjohn discovery that Rhizopus and later Curvularia species perform this hydroxylation in a single fermentation step converted the problem into a biotransformation. Hydrocortisone is now among the cheapest prescription medicines available, at a median United States pharmacy acquisition cost of US$0.1824 per tablet across 122 listed products, and the topical 1% preparation is sold without prescription. The measured claim here is the price, not the history: what the fermentation route made possible is visible in the NADAC file today.
This order is fixed in code and does not count clicks or time on the page.
What is not here
3 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
Cortisol itself, made in a factory: it binds both the glucocorticoid and the mineralocorticoid receptor and is the only drug here that replaces a hormone rather than suppressing a system — the replacement indication rests on the disappearance of a uniformly fatal disease after 1949 and on no randomised trial at all, while the septic shock indication has two trials of 3,800 and 1,241 patients that reached opposite conclusions.
Recorded evidence blocks (14)
Q1
What did Hydrocortisone's largest trial (16000 people) and its longest (29 years) measure?
16000 people in Hydrocortisone's largest registered study, 29 years in its longest registered window, measuring 28 day mortality in all the non-responders to ACTH (< or = 9 mcg/dl or 250 nmol/L post ACTH). ClinicalTrials.gov · 2026-09-01
87 phase2, 66 phase3, 59 phase4, 49 na, 43 phase1, 15 early phase1, 14 na or unstated; NCT00001521; 2024-04-01; no ageing endpoint recorded. Last human test completed 2026, NCT06430580.
Interpretation These counts include studies where Hydrocortisone was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
phase2
87
phase3
66
phase4
59
na
49
phase1
43
early phase1
15
2 more recorded rows
na or unstated
14
Last recorded human testNCT06430580
2026-08-13
recorded 2026-09-01 · last checked 2026-09-04
Q2
From mouse to human: where has Hydrocortisone shown lifespan?
oral; hydrocortisone (modified release), oral tablet 20 and 5 mg
NCT00915343
oral; Hydrocortisone, oral tablet, 10 mg
14 more recorded rows
humanNCT01063569
Cortef 5 mg
humanNCT01453686
Hydrocortisone 1%
humanNCT01718964
Cortisol 20 mg
humanNCT01782859
IV; 2. 100 mg hydrocortisone IV 8 hours after first dose of prednisone followed by
humanNCT01782859
IV; 3. Another dose of 100 mg hydrocortisone IV 8 hours after
humanNCT01874860
Hydrocortisone 1% cream
humanNCT02196142
Cortisol 20mg
humanNCT02230930
Hydrocortisone cream 1%
humanNCT02230930
Subcutaneous hydrocortisone 10mg
humanNCT02760862
hydrocortisone 100mg.
humanNCT02760862
(Hydrocortisone as sodium succinate, vial, equivalent to hydrocortisone 100mg, Egyptian INT, Pharmaceutical Industries CO. ARE,EIPICO.EGYPT)
humanNCT03358082
Hydrocortisone Acetate 1% Ointment
humanNCT04615962
Hydrocortisone Acetate 1% Cream
humanNCT04896489
Hydrocortisone 20 MG
recorded 2026-09-01 · last checked 2026-09-04
Q5
Hydrocortisone's half-life is 1.5 hours — which schedules were studied?
1.5 hours, the half-life Hydrocortisone's label states. openfda-label · 5f055f94-b213-431b-897e-1c439660f158 · 2026-08-30
Show the evidence
half life
1.5 hours hours; The terminal half-life of hydrocortisone is about 1.5 hours following intravenous and oral dosing of hydrocortisone tablets and ALKINDI SPRINKLE in dexamethasone-suppressed healthy adult male volunteers. 12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Hydrocortisone is a glucocorticoid.
recorded 2026-08-30 · last checked 2026-09-04
Q6
Could one person measure Hydrocortisone's effect on adult height relative to general population?
Adult height relative to general population: measured in Hydrocortisone's trials.
Interpretation adult height relative to general population is the recorded endpoint.
Show the evidence
biomarkers
adult height relative to general population; 2026-09-01
event free survival; 2026-09-01
dying or residual disease during induction therapy; 2026-09-01
time to marrow recovery; 2026-09-01
frequency of toxicities including infectious complications; 2026-09-01
marrow status; 2026-09-01
14 more recorded rows
biomarkers
blasts; 2026-09-01
biomarkers
complete remission at the end of consolidation therapy; 2026-09-01
biomarkers
survival following consolidation; 2026-09-01
biomarkers
event free survival following consolidation; 2026-09-01
biomarkers
overall survival; 2026-09-01
biomarkers
time to progression; 2026-09-01
biomarkers
early marrow cr plus pr rate at day 21; 2026-09-01
0; NCT00368381; PHASE4; the smallest recorded human enrolment at or below 30; the registry states no direction of its result; WITHDRAWN
Q7
Which of 28 day mortality in all the non responders to acth, adult height relative to general population and all cause mortality did Hydrocortisone's trials measure?
28 day mortality in all the non responders to acth, adult height relative to general population and all cause mortality lead 40 outcome terms across Hydrocortisone's trials. ClinicalTrials.gov · 2026-09-01
Interpretation time to marrow recovery, frequency of toxicities including infectious complications, marrow status, blasts, complete remission at the end of consolidation therapy and survival following consolidation follow.
Show the evidence
adult height relative to general population
1
event free survival
1
dying or residual disease during induction therapy
1
time to marrow recovery
1
frequency of toxicities including infectious complications
1
marrow status
1
14 more recorded rows
blasts
1
complete remission at the end of consolidation therapy
1
survival following consolidation
1
event free survival following consolidation
1
overall survival
1
time to progression
1
early marrow cr plus pr rate at day 21
1
grade 3 stomatitis
1
response rate
1
minimal residual disease
1
toxic death
1
improvement in jet lag symptoms
1
remission re induction rate
1
event free survival rate
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Hydrocortisone's 48 ongoing trials reports first?
Proportion of Participants Free of Radiographically Evident Metastases From Baseline to 18 Months After Study Drug Administration; Disease Free Survival (DFS) of High-risk (HR) and Intermediate-risk (IR) Relapse Patients; latest 2036-05-30
Show the evidence
Trial
NCT00859781
"177Lu Radiolabeled Monoclonal Antibody HuJ591 (177Lu-J591) and Ketoconazole in Patients With Prostate Cancer"; n 55; "Proportion of Participants Free of Radiographically Evident Metastases From Baseline to 18 Months After Study Drug Administration"; 2026-09
NCT02101853
"Blinatumomab in Treating Younger Patients With Relapsed B-cell Acute Lymphoblastic Leukemia"; n 669; "Disease Free Survival (DFS) of High-risk (HR) and Intermediate-risk (IR) Relapse Patients"; 2026-09-16
NCT02112916
"Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma"; n 847; "Event-free Survival (EFS) for Modified Augmented Berlin-Frankfurt-Munster Backbone With or Without Bortezomib in All Randomized Patients"; 2026-09-16
NCT02196155
"Botulinum Toxin A Versus Steroids for the Treatment of Chronic Plantar Fasciitis"; n 54; "Change from baseline in foot pain"; 2026-12
NCT02775227
"HYPAR Trial - Hydrocortisone vs. Pasireotide in Reducing Pancreatic Surgery Complications"; n 126; "Comprehensive Complication Index"; 2029-12
NCT03007147
"Imatinib Mesylate and Combination Chemotherapy in Treating Patients With Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia"; n 352; "Disease free survival (DFS) of Randomized Arms (standard risk [SR] Philadelphia chromosome [Ph+] acute lymphoblastic leukemia [ALL] patients)"; 2027-08-14
14 further recorded trials
NCT03020030
"Treatment of Newly Diagnosed Acute Lymphoblastic Leukemia in Children and Adolescents"; n 560; "Complete Remission Rate"; 2034-11
NCT03142893
"Hormonal Mechanisms of Sleep Restriction - Axis Study"; n 80; "Average Blood Cortisol Concentration"; 2026-06-30
NCT03286634
"ASIA Down Syndrome Acute Lymphoblastic Leukemia 2016"; n 60; "Event Free Survival"; 2033-03-31
NCT03401398
"Stress Hydrocortisone In Pediatric Septic Shock"; n 500; "New or progressive multiple organ dysfunction syndrome as assessed utilizing the Pediatric Logistic Organ Dysfunction (PELOD-2) instrument."; 2026-12-31
NCT04037605
"Hormonal Mechanisms of Sleep Restriction - Axis Study in Older Men and Postmenopausal Women"; n 5; "Average Blood Cortisol Concentration"; 2026-06-24
NCT04082533
"Intravenous (IV) Hydrocortisone for TKA (Total Knee Arthroplasty)"; n 65; "Postoperative Range of Motion (ROM)"; 2027-07
NCT04278404
"Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs Administered to Children Per Standard of Care (POPS)"; n 5000; "Clearance (CL) or apparent oral clearance (CL/F) as measured by PK sampling"; 2026-12
NCT04293562
"A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations"; n 1186; "Event-free survival (EFS)"; 2029-06-30
NCT04546399
"A Study to Compare Blinatumomab Alone to Blinatumomab With Nivolumab in Patients Diagnosed With First Relapse B-Cell Acute Lymphoblastic Leukemia (B-ALL)"; n 461; "Minimal residual disease (MRD) negative second remission (Rem-2) rate with blinatumomab vs with blinatumomab + nivolumab (Group 1)"; 2028-06-30
NCT05008146
"Imaging CRF X NOP Interactions in CUD"; n 80; "DELTA VT"; 2028-09-01
NCT05160506
"Corticosteroids to Treat Pancreatitis"; n 86; "Severity of Illness Measure"; 2027-04
NCT05193396
"Hydrocortisone and Placebo in Patients With Symptoms of Adrenal Insufficiency After Cessation of Glucocorticoid Treatment"; n 100; "Adrenal insufficiency symptoms"; 2026-01
NCT05292664
"Venetoclax Basket Trial for High Risk Hematologic Malignancies"; n 30; "Maximum tolerated dose (MTD)"; 2030-07-02
NCT05435781
"Effect of Supplemental Hydrocortisone During Stress in Prednisolone-induced Adrenal Insufficiency"; n 250; "ecological momentary assessments (EMA) of the Multidimensional Fatigue Inventory (MFI-20) General Fatigue scale, adjusted for EMA"; 2028-03-01
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which running trial of Hydrocortisone could settle lifespan?
NCT06723626 measures 28-d Mortality, reading out 2025-11-30.
12 open trials; n 40; "Effects of Intravenous Metabolic Recovery Agent in Elderly Septic Patients on Prognosis and Microcirculation."
Show the evidence
Trial
NCT06723626
"Effects of Intravenous Metabolic Recovery Agent in Elderly Septic Patients on Prognosis and Microcirculation."; n 40; "28-d Mortality"; 2025-11-30
NCT02101853
"Blinatumomab in Treating Younger Patients With Relapsed B-cell Acute Lymphoblastic Leukemia"; n 669; "Disease Free Survival (DFS) of High-risk (HR) and Intermediate-risk (IR) Relapse Patients"; 2026-09-16
NCT02112916
"Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma"; n 847; "Event-free Survival (EFS) for Modified Augmented Berlin-Frankfurt-Munster Backbone With or Without Bortezomib in All Randomized Patients"; 2026-09-16
NCT03007147
"Imatinib Mesylate and Combination Chemotherapy in Treating Patients With Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia"; n 352; "Disease free survival (DFS) of Randomized Arms (standard risk [SR] Philadelphia chromosome [Ph+] acute lymphoblastic leukemia [ALL] patients)"; 2027-08-14
NCT07383103
"Hydrocortisone and Fludrocortisone for the Treatment of Septic Shock"; n 336; "90-day mortality"; 2028-12-31
NCT04293562
"A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations"; n 1186; "Event-free survival (EFS)"; 2029-06-30
6 further recorded trials
NCT06136624
"Study of Opevesostat (MK-5684) Versus Alternative NHA in mCRPC (MK-5684-003)"; n 1310; "Overall Survival (OS) in Androgen Receptor Ligand Binding Domain (AR LBD) Mutation-Positive Participants"; 2030-02-15
NCT06892197
"Comparing Hydrocortisone and Prednisolone for Community Acquired Pneumonia (CAP)"; n 1600; "All-cause mortality"; 2030-11-01
NCT06136650
"A Study of Opevesostat (MK-5684) Versus Alternative Next-generation Hormonal Agent (NHA) in Metastatic Castration-resistant Prostate Cancer (mCRPC) Post One NHA (MK-5684-004)"; n 1314; "Radiographic Progression-Free Survival (rPFS)"; 2030-12-02
NCT06381661
"Adaptive Platform Trial for Personnalisation of Sepsis Treatment in Children and Adults: a Multi-national, Treatable Traits-guided, Adaptive, Exploratory, Bayesian Basket Trial"; n 2000; "All-cause mortality"; 2031-07-09
NCT03286634
"ASIA Down Syndrome Acute Lymphoblastic Leukemia 2016"; n 60; "Event Free Survival"; 2033-03-31
NCT07072585
"Testing the Addition of Daratumumab to Chemotherapy for Treating Patients With Newly-Diagnosed T-Cell Lymphoblastic Leukemia (T-ALL) and T-Cell Lymphoblastic Lymphoma (T-LL)"; n 1708; "Event-free survival (EFS) in patients with newly diagnosed T-cell lymphoblastic leukemia (T-ALL)"; 2035-09-01
Q10
Which 108 trials of Hydrocortisone posted no result?
Posted no result
108 of 108 completed trials
Registrations
NCT01453686, NCT00688987, NCT01230983, NCT00801957, NCT00526305 and NCT00002855, and 102 more
Completion dates
oldest 2003-08; newest 2024-04-30
Show the evidence
Trial
NCT01453686
2003-08
NCT00688987
2004-08
NCT01230983
2004-10
NCT00801957
2004-11
NCT00526305
2005-04
NCT00002855
2005-06
14 further recorded trials
NCT00451230
2005-06
NCT00147004
2005-11
NCT00181597
2006-01
NCT00186264
2006-04
NCT00172354
2006-05
NCT00236925
2007-06
NCT00396344
2007-11
NCT00097474
2007-11-14
NCT00002805
2008-06
NCT00279903
2008-08
NCT00490828
2008-08
NCT00529841
2008-09
NCT00709839
2008-12
NCT00320099
2009-02
Q11
At the median, Hydrocortisone's trials enrolled 54 people — anything larger?
Median enrolment
54
Largest enrolment
16000
Registered trials counted
305
Q12
What do 7608 spontaneous reports say about Hydrocortisone — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Hydrocortisone appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 7608 reaction mentions were counted: drug hypersensitivity 1441; pain 907; fatigue 879; rash 751. open-targets-adr · CHEMBL389621 · 2026-06-24
Show the evidence
drug hypersensitivity
1441
pain
907
fatigue
879
rash
751
arthralgia
632
hypersensitivity
615
4 more recorded rows
condition aggravated
612
alopecia
599
abdominal discomfort
592
swelling
580
recorded 2026-06-24 · last checked 2026-09-04
Q13
Was Hydrocortisone studied with fasting and exercise?
fasting and exercise are named in Hydrocortisone's label sentences: "A randomized double-blind cross-over design of overnight infusion of hydrocortisone or saline followed by a fasting morning perfusion magnetic resonance imaging to assess regional cerebral blood flow (CBF) was completed." openfda-label+europepmc · 2022-09-16
2 recorded statements; fasting, exercise
Show the evidence
fasting
A randomized double-blind cross-over design of overnight infusion of hydrocortisone or saline followed by a fasting morning perfusion magnetic resonance imaging to assess regional cerebral blood flow (CBF) was completed.
exercise
Itis caused by repeated injuries or surgical interventions, which is frequently managed by using certain medications such as glucocorticosteroids.The goal of our research was to study the effect of therapeutic exercise and hydrocortisone acetate (HA) phonophoresis combination therapy on the management of the rehabilitation process of knee joint functional limitations caused by arthrofibrosis and…
recorded 2022-09-16 · last checked 2026-09-04
Q14
What is recorded about Hydrocortisone and autophagy?
"Gumibao medicated serum markedly increased the viability and migration of BMECs, and also increased the levels of VEGF, t-PA, the content of NO, meanwhile decreased the level of PAI-1 in 0.3 mg/ml hydrocortisone treated BMECs; moreover, glucocorticoids inhibited the autophagy of BMECs, and Gumibao recipe significantly increased the…" — where Hydrocortisone and autophagy appear together. Europe PMC · pathway abstract search · 2024-08-31
autophagy, mTOR, IGF-1; PMID 39217879, 22808460
Show the evidence
autophagyPMID 39217879
"Gumibao medicated serum markedly increased the viability and migration of BMECs, and also increased the levels of VEGF, t-PA, the content of NO, meanwhile decreased the level of PAI-1 in 0.3 mg/ml hydrocortisone treated BMECs; moreover, glucocorticoids inhibited the autophagy of BMECs, and Gumibao recipe significantly increased the autophagy of BMECs; meanwhile, autophagy inhibitor 3-MA partially…"
mTOR
PMID 39217879
"Finally, gumibao recipe partially abrogated the inhibitory effects of hydrocortisone on the activation of PI3K/Akt/mTOR singling, and these effects were further counteracted by PI3K and mTOR inhibitor NVP-BEZ235."
"We identified potential therapeutic agents for mitigation of severe disease outcome, with several already being tested independently, including mTOR inhibitors (rapamycin and tacrolimus) and general immunosuppressants (dexamethasone and hydrocortisone)."
IGF-1PMID 22808460
"It was found that both IGF-1 and IGF-2 activate the expression of milk protein β-casein in the presence of prolactin and hydrocortisone."
recorded 2024-08-31 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
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