Format

Send to

Choose Destination
See comment in PubMed Commons below
Eur J Endocrinol. 2013 Jun 29;169(2):147-54. doi: 10.1530/EJE-12-1057. Print 2013 Aug.

Subcutaneous hydrocortisone administration for emergency use in adrenal insufficiency.

Author information

1
Endocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, Oberdürrbacher Strasse 6, D-97080 Wuerzburg, Germany. hahner_s@medizin.uni-wuerzburg.de

Abstract

OBJECTIVE:

Evaluation of the pharmacokinetics and safety of s.c. hydrocortisone injection for use in adrenal emergency.

DESIGN:

Single-center, open-label, sequence-randomized, crossover study in a tertiary care center.

PATIENTS AND METHODS:

Twelve patients with chronic Addison's disease. Comparison of hydrocortisone pharmacokinetics after s.c. and i.m. injection (100 mg) and after s.c. administration of sodium chloride (0.9%) respectively at three different visits.

MAIN OUTCOME MEASURE:

maximum serum cortisol (Cmax), time to Cmax (tmax), and time to serum cortisol >36 μg/dl (tserum cortisol >36 μg/dl) after s.c. administration compared with i.m. administration, safety, and patient preference.

RESULTS:

Serum cortisol increased rapidly and substantially after both i.m. and s.c. injections (Cmax: 110±29 vs 97±28 μg/dl, P=0.27, tmax: 66±51 vs 91±34 min, P=0.17, and tserum cortisol >36 μg/dl: 11±5 vs 22±11 min, P=0.004 respectively). Both i.m. and s.c. injections were well tolerated. Eleven (91.7%) patients preferred s.c. injection, whereas one patient did not have any preference.

CONCLUSIONS:

S.c. administration of 100 mg hydrocortisone shows excellent pharmacokinetics for emergency use with only a short delay in cortisol increase compared with i.m. injection. It has a good safety profile and is preferred by patients over i.m. injection.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01450930.

PMID:
23672956
DOI:
10.1530/EJE-12-1057
[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center