HYDROCORTISONE HEMISUCCINATE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C25H34O8.H2O
Molecular Weight	480.5479
Optical Activity	UNSPECIFIED
Defined Stereocenters	7 / 7
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure of HYDROCORTISONE HEMISUCCINATE

Structure Search

SMILES

O.[H][C@@]12CC[C@](O)(C(=O)COC(=O)CCC(O)=O)[C@@]1(C)C[C@H](O)[C@@]3([H])[C@@]2([H])CCC4=CC(=O)CC[C@]34C

InChI

InChIKey=AFLWPAGYTPJSEY-CODXZCKSSA-N

InChI=1S/C25H34O8.H2O/c1-23-9-7-15(26)11-14(23)3-4-16-17-8-10-25(32,24(17,2)12-18(27)22(16)23)19(28)13-33-21(31)6-5-20(29)30;/h11,16-18,22,27,32H,3-10,12-13H2,1-2H3,(H,29,30);1H2/t16-,17-,18-,22+,23-,24-,25-;/m0./s1

HIDE SMILES / InChI

Molecular Formula	H2O
Molecular Weight	18.0153
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Molecular Formula	C25H34O8
Molecular Weight	462.5327
Charge	0
Count

Stereochemistry	ABSOLUTE
Additional Stereochemistry	No
Defined Stereocenters	7 / 7
E/Z Centers	0
Optical Activity	UNSPECIFIED

Description
Sources: http://www.drugbank.ca/drugs/DB00741
Curator's Comment: Description was created based on several sources, including http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008697s032_33lbl.pdf

Hydrocortisone is the main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. Topical hydrocortisone is used for its anti-inflammatory or immunosuppressive properties to treat inflammation due to corticosteroid-responsive dermatoses. Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In other words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding. For the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Also used to treat endocrine (hormonal) disorders (adrenal insufficiency, Addisons disease). Hydrocortisone is also used to treat many immune and allergic disorders, such as arthritis, lupus, severe psoriasis, severe asthma, ulcerative colitis, and Crohn's disease.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Potency
Glucocorticoid receptor 172 Target ID: CHEMBL2034 Sources: http://www.drugbank.ca/drugs/DB00741	Agonist 2678
Glucocorticoid receptor 172 Target ID: CHEMBL2034 Sources: https://www.genome.jp/dbget-bin/www_bget?dr:D01886\|http://drugcentral.org/drugcard/4569\|https://www.drugpatentwatch.com/p/generic-api/HYDROCORTISONE+PROBUTATE\|https://adisinsight.springer.com/drugs/800043715	Agonist 2678
Glucocorticoid receptor 172 Target ID: CHEMBL2034 Sources: https://www.drugbank.ca/drugs/DB14540 \| https://www.genome.jp/dbget-bin/www_bget?dr:D01619	Agonist 2678
apoptotic process 48 Target ID: GO:0006915 Sources: https://www.ncbi.nlm.nih.gov/pubmed/10455320	Inhibitor 8297	50.0 nM [IC50]
Annexin A1 17 Target ID: P04083 Gene ID: 301.0 Gene Symbol: ANXA1 Target Organism: Homo sapiens (Human) Sources: http://www.drugbank.ca/drugs/DB00741	Agonist 2678
Intercellular adhesion molecule-1 17 Target ID: CHEMBL3070 Sources: https://www.ncbi.nlm.nih.gov/pubmed/10669853	Inhibitor 8297	0.1 nM [IC50]

Conditions

Condition	Modality	Highest Phase	Product
Congenital adrenal hyperplasia 41 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008697s032_33lbl.pdf	Primary	Approved 8429	Cortef Approved Use CORTEF Tablets are indicated in the following conditions. 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance) Congenital adrenal hyperplasia Non suppurative thyroiditis Hypercalcemia associated with cancer 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute gouty arthritis Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Bullous dermatitis herpetiformis Severe erythema multiforme (Stevens-Johnson syndrome) Exfoliative dermatitis Mycosis fungoides Severe psoriasis Severe seborrheic dermatitis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: Seasonal or perennial allergic rhinitis Serum sickness Bronchial asthma Contact dermatitis Atopic dermatitis Drug hypersensitivity reactions 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: Allergic conjunctivitis Keratitis Allergic corneal marginal ulcers Herpes zoster ophthalmicus Iritis and iridocyclitis Chorioretinitis Anterior segment inflammation Diffuse posterior uveitis and choroiditis Optic neuritis Sympathetic ophthalmia 7. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy Aspiration pneumonitis 8. Hematologic Disorders Idiopathic thrombocytopenic purpura in adults Secondary thrombocytopenia in adults Acquired (autoimmune) hemolytic anemia Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 9. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 10. Edematous States To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus. 11. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis Regional enteritis 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement Launch Date 1952
Rheumatoid arthritis 316 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008697s032_33lbl.pdf	Primary	Approved 8429	Cortef Approved Use CORTEF Tablets are indicated in the following conditions. 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance) Congenital adrenal hyperplasia Non suppurative thyroiditis Hypercalcemia associated with cancer 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute gouty arthritis Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Bullous dermatitis herpetiformis Severe erythema multiforme (Stevens-Johnson syndrome) Exfoliative dermatitis Mycosis fungoides Severe psoriasis Severe seborrheic dermatitis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: Seasonal or perennial allergic rhinitis Serum sickness Bronchial asthma Contact dermatitis Atopic dermatitis Drug hypersensitivity reactions 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: Allergic conjunctivitis Keratitis Allergic corneal marginal ulcers Herpes zoster ophthalmicus Iritis and iridocyclitis Chorioretinitis Anterior segment inflammation Diffuse posterior uveitis and choroiditis Optic neuritis Sympathetic ophthalmia 7. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy Aspiration pneumonitis 8. Hematologic Disorders Idiopathic thrombocytopenic purpura in adults Secondary thrombocytopenia in adults Acquired (autoimmune) hemolytic anemia Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 9. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 10. Edematous States To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus. 11. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis Regional enteritis 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement Launch Date 1952
Leukemia 87 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008697s032_33lbl.pdf	Palliative	Approved 8429	Cortef Approved Use CORTEF Tablets are indicated in the following conditions. 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance) Congenital adrenal hyperplasia Non suppurative thyroiditis Hypercalcemia associated with cancer 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute gouty arthritis Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Bullous dermatitis herpetiformis Severe erythema multiforme (Stevens-Johnson syndrome) Exfoliative dermatitis Mycosis fungoides Severe psoriasis Severe seborrheic dermatitis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: Seasonal or perennial allergic rhinitis Serum sickness Bronchial asthma Contact dermatitis Atopic dermatitis Drug hypersensitivity reactions 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: Allergic conjunctivitis Keratitis Allergic corneal marginal ulcers Herpes zoster ophthalmicus Iritis and iridocyclitis Chorioretinitis Anterior segment inflammation Diffuse posterior uveitis and choroiditis Optic neuritis Sympathetic ophthalmia 7. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy Aspiration pneumonitis 8. Hematologic Disorders Idiopathic thrombocytopenic purpura in adults Secondary thrombocytopenia in adults Acquired (autoimmune) hemolytic anemia Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 9. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 10. Edematous States To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus. 11. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis Regional enteritis 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement Launch Date 1952
Bronchial asthma 50 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008697s032_33lbl.pdf	Primary	Approved 8429	Cortef Approved Use CORTEF Tablets are indicated in the following conditions. 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance) Congenital adrenal hyperplasia Non suppurative thyroiditis Hypercalcemia associated with cancer 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute gouty arthritis Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Bullous dermatitis herpetiformis Severe erythema multiforme (Stevens-Johnson syndrome) Exfoliative dermatitis Mycosis fungoides Severe psoriasis Severe seborrheic dermatitis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: Seasonal or perennial allergic rhinitis Serum sickness Bronchial asthma Contact dermatitis Atopic dermatitis Drug hypersensitivity reactions 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: Allergic conjunctivitis Keratitis Allergic corneal marginal ulcers Herpes zoster ophthalmicus Iritis and iridocyclitis Chorioretinitis Anterior segment inflammation Diffuse posterior uveitis and choroiditis Optic neuritis Sympathetic ophthalmia 7. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy Aspiration pneumonitis 8. Hematologic Disorders Idiopathic thrombocytopenic purpura in adults Secondary thrombocytopenia in adults Acquired (autoimmune) hemolytic anemia Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 9. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 10. Edematous States To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus. 11. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis Regional enteritis 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement Launch Date 1952

C_max

Value	Dose	Co-administered	Analyte	Population
258 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/2050835	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:		HYDROCORTISONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

AUC

Value	Dose	Co-administered	Analyte	Population
1162 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/2050835	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:		HYDROCORTISONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

T_1/2

Value	Dose	Co-administered	Analyte	Population
1.82 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/2050835	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:		HYDROCORTISONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

F_unbound

Value	Dose	Co-administered	Analyte	Population
9.9% EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/13700365			HYDROCORTISONE plasma	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN

Doses

Dose	Population	Adverse events
200 mg 4 times / day multiple, intramuscular Highest studied dose Dose: 200 mg, 4 times / day Route: intramuscular Route: multiple Dose: 200 mg, 4 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	unhealthy, 56 years (tange: 40-64 years) n = 10 Health Status: unhealthy Condition: primary adrenal insufficiency Age Group: 56 years (tange: 40-64 years) Sex: M+F Population Size: 10 Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	Sources: https://pubmed.ncbi.nlm.nih.gov/32170323
200 mg 4 times / day multiple, intravenous Highest studied dose Dose: 200 mg, 4 times / day Route: intravenous Route: multiple Dose: 200 mg, 4 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	unhealthy, 56 years (tange: 40-64 years) n = 10 Health Status: unhealthy Condition: primary adrenal insufficiency Age Group: 56 years (tange: 40-64 years) Sex: M+F Population Size: 10 Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	Sources: https://pubmed.ncbi.nlm.nih.gov/32170323
200 mg 4 times / day multiple, oral Highest studied dose Dose: 200 mg, 4 times / day Route: oral Route: multiple Dose: 200 mg, 4 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	unhealthy, 56 years (tange: 40-64 years) n = 10 Health Status: unhealthy Condition: primary adrenal insufficiency Age Group: 56 years (tange: 40-64 years) Sex: M+F Population Size: 10 Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	Sources: https://pubmed.ncbi.nlm.nih.gov/32170323
200 mg single, intravenous Highest studied dose Dose: 200 mg Route: intravenous Route: single Dose: 200 mg Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	unhealthy, 56 years (tange: 40-64 years) n = 10 Health Status: unhealthy Condition: primary adrenal insufficiency Age Group: 56 years (tange: 40-64 years) Sex: M+F Population Size: 10 Sources: https://pubmed.ncbi.nlm.nih.gov/32170323	Sources: https://pubmed.ncbi.nlm.nih.gov/32170323
2.5 % 4 times / day multiple, topical Dose: 2.5 %, 4 times / day Route: topical Route: multiple Dose: 2.5 %, 4 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/anda/2000/40310_Hydrocortisone_Prntlbl.pdf	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/anda/2000/40310_Hydrocortisone_Prntlbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/anda/2000/40310_Hydrocortisone_Prntlbl.pdf
1 mg/kg 4 times / day multiple, intravenous Dose: 1 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 1 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT02044159	unhealthy, children n = 23 Health Status: unhealthy Condition: vasoactive infusion Age Group: children Population Size: 23 Sources: https://clinicaltrials.gov/ct2/show/NCT02044159	Other AEs: Infection... Other AEs: Infection (below serious, 6 patients) Sources: https://clinicaltrials.gov/ct2/show/NCT02044159
0.5 mg/kg 4 times / day multiple, intravenous Dose: 0.5 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 0.5 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT01954056	unhealthy, neonate n = 6 Health Status: unhealthy Condition: Cardiovascular Insufficiency Age Group: neonate Population Size: 6 Sources: https://clinicaltrials.gov/ct2/show/NCT01954056	Other AEs: Hyperbilirubinemia, Hypertension... Other AEs: Hyperbilirubinemia (serious, 1 patient) Hypertension (serious, 1 patient) Adrenal insufficiency (serious, 1 patient) Sources: https://clinicaltrials.gov/ct2/show/NCT01954056

AEs

AE	Significance	Dose	Population
Infection	below serious, 6 patients	1 mg/kg 4 times / day multiple, intravenous Dose: 1 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 1 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT02044159	unhealthy, children n = 23 Health Status: unhealthy Condition: vasoactive infusion Age Group: children Population Size: 23 Sources: https://clinicaltrials.gov/ct2/show/NCT02044159
Adrenal insufficiency	serious, 1 patient	0.5 mg/kg 4 times / day multiple, intravenous Dose: 0.5 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 0.5 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT01954056	unhealthy, neonate n = 6 Health Status: unhealthy Condition: Cardiovascular Insufficiency Age Group: neonate Population Size: 6 Sources: https://clinicaltrials.gov/ct2/show/NCT01954056
Hyperbilirubinemia	serious, 1 patient	0.5 mg/kg 4 times / day multiple, intravenous Dose: 0.5 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 0.5 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT01954056	unhealthy, neonate n = 6 Health Status: unhealthy Condition: Cardiovascular Insufficiency Age Group: neonate Population Size: 6 Sources: https://clinicaltrials.gov/ct2/show/NCT01954056
Hypertension	serious, 1 patient	0.5 mg/kg 4 times / day multiple, intravenous Dose: 0.5 mg/kg, 4 times / day Route: intravenous Route: multiple Dose: 0.5 mg/kg, 4 times / day Sources: https://clinicaltrials.gov/ct2/show/NCT01954056	unhealthy, neonate n = 6 Health Status: unhealthy Condition: Cardiovascular Insufficiency Age Group: neonate Population Size: 6 Sources: https://clinicaltrials.gov/ct2/show/NCT01954056

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
inducer 781			inducer 23

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
	11-beta-HSD2 27	MRP2 111 MRP3 53

Drug as perpetrator

Target	Modality	Activity
MRP2 475	inducer 1573 Sources: https://pubmed.ncbi.nlm.nih.gov/15979871/ Page: -	no
CYP3A4 1925	inducer 1573 Sources: https://dmd.aspetjournals.org/content/30/9/1029.long Page: -	yes [EC50 0.6 uM]
Kv1.3 32	supressor 155 Sources: https://www.sciencedirect.com/science/article/pii/S0014299914007730 Page: -	yes [IC50 33.4 uM]
Kv1.5 41	supressor 155 Sources: https://www.sciencedirect.com/science/article/pii/S0014299914007730 Page: -	yes [IC50 33.4 uM]
GLUT4 17	supressor 155 Sources: https://pubmed.ncbi.nlm.nih.gov/26387653/ Page: -	yes
MRP3 207	inducer 1573 Sources: https://pubmed.ncbi.nlm.nih.gov/15979871/ Page: -	yes

Drug as victim

Target	Modality	Activity	Metabolite	Clinical evidence
11-beta-HSD2 27	substrate 3367 Sources: https://rep.bioscientifica.com/view/journals/rep/126/4/425.xml Page: -	major

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 1647	inducer 27 Sources: https://www.sciencedirect.com/science/article/pii/S030372071930190X Page: -

Sourcing

Vendor/Aggregator	ID	URL
3B Scientific (Wuhan) Corp	3B2-0945	http://www.3bsc.com/index/pro_info.php?id=41850
AK Scientific, Inc. (AKSCI)	67481	http://www.aksci.com/item_detail.php?cat=67481
AK Scientific, Inc. (AKSCI)	J10114	http://www.aksci.com/item_detail.php?cat=J10114
Aaron Chemicals	AR003AZY	http://www.aaronchem.com/50-23-7
AbMole Bioscience	M3451	http://www.abmole.com/products/hydrocortisone.html
Acadechem	ACDS-063892	http://www.acadechemical.com/product/138591
Achemtek	0101-001579	http://www.achemtek.com/50-23-7
Acorn PharmaTech	ACN-036928	http://www.acornpharmatech.com/
Acros Organics	AC352450010	https://www.fishersci.com/shop/products/hydrocortisone-98-acros-organics-2/AC352450010
Acros Organics	AC352450050	https://www.fishersci.com/shop/products/hydrocortisone-98-acros-organics-2/AC352450050
Acros Organics	AC352450250	https://www.fishersci.com/shop/products/hydrocortisone-98-acros-organics/AC352450250
Acros Organics	AC352451000	https://www.fishersci.com/shop/products/hydrocortisone-98-acros-organics/AC352451000
Alfa Aesar	A16292	https://www.alfa.com/en/catalog/A16292/
Alfa Chemistry	ACM50237	https://www.alfa-chemistry.com/hydrocortisone-cas-50-23-7-item-74438.htm
Alsachim	2289	http://www.alsachim.com/product-C3349-glo.bal-view.html
ApexBio Technology	B1951	http://www.apexbt.com/hydrocortisone.html
Aurora Fine Chemicals LLC	A13.139.530	http://online.aurorafinechemicals.com/info?ID=A13.139.530
Avantor Inc	101183-298	https://us.vwr.com/store/catalog/product.jsp?catalog_number=101183-298
Avantor Inc	700009-464	https://us.vwr.com/store/product/21572989/hydrocortisone-97-0-micronized-usp
BioChemPartner	BCP09054	http://www.biochempartner.com/50-23-7-BCP09054
BioSynth	Q-201211	https://www.biosynth.com/en/products/life-science/other-biochemicals/products/Q-201211.html
BroadPharm	BP-20390	https://www.broadpharm.com/web/product.php?catalog=BP-20390
Chem Scene	CS-2226	http://www.chemscene.com/50-23-7.html
ChemFaces	CFN90033	http://www.chemfaces.com/natural/Hydrocortisone-CFN90033.html
ChemMol	30102583	http://www.chemmol.com/chemmol/30102583.html
ChemMol	83603530	http://www.chemmol.com/chemmol/83603530.html
ChemMol	99097707	http://www.chemmol.com/chemmol/99097707.html
Chemenu	CM110490	http://www.chemenu.com/products/CM110490
Chemspace	CSSB00000694520	https://chem-space.com/CSSB00000694520
DC Chemicals	DCAPI1198	http://www.dcchemicals.com//product_show-Hydrocortisone_Cortisol_.html
Glentham Life Sciences	GP8860	http://www.glentham.com/products/product/GP8860/
LGC Standards	DRE-C14224000	https://www.lgcstandards.com/US/en/p/DRE-C14224000
LGC Standards	LGCFOR0185.00	https://www.lgcstandards.com/US/en/p/LGCFOR0185.00
LGC Standards	MM0185.00-0250	https://www.lgcstandards.com/US/en/p/MM0185.00-0250
Lab Network	LN00830918	https://labnetwork.com/frontend-app/p/#!/moleculedetails/LN00830918
Matrix Scientific	157252	https://www.matrixscientific.com/157252.html
MedChem Express	HY-N0583	https://www.medchemexpress.com/Hydrocortisone.html
MuseChem	A000475	https://www.musechem.com/product/A000475.html
OChem	1792	http://www.ocheminc.com/index.php?act=psearch&pid=50H237
Octagon Chemicals	API Hydrocortisone 50-23-7	https://octagonchem.com/
Parchem	12166	http://www.parchem.com/chemical-supplier-distributor/Hydrocortisone-002166.aspx
Sigma-Aldrich	286095_ALDRICH	https://www.sigmaaldrich.com/catalog/product/aldrich/286095?utm_source=pubchem&utm_campaign=pubchem_2017&utm_medium=referral
Sigma-Aldrich	C-106_CERILLIAN	https://www.sigmaaldrich.com/catalog/product/cerillian/c106?utm_source=pubchem&utm_campaign=pubchem_2017&utm_medium=referral
Sigma-Aldrich	31719_SIAL	https://www.sigmaaldrich.com/catalog/product/sial/31719?utm_source=pubchem&utm_campaign=pubchem_2017&utm_medium=referral
Sigma-Aldrich	BP576_SIAL	https://www.sigmaaldrich.com/catalog/product/sial/bp576?utm_source=pubchem&utm_campaign=pubchem_2017&utm_medium=referral
Sigma-Aldrich	1316004_USP	https://www.sigmaaldrich.com/catalog/product/usp/1316004?utm_source=pubchem&utm_campaign=pubchem_2017&utm_medium=referral
Sinfoo Biotech	S048235	http://www.sinfoobiotech.com/product/1051633
Smolecule	S530146	http://www.smolecule.com/products/s530146
THE BioTek	bt-271253	https://www.thebiotek.com/product/inhibitors/bt-271253
Tocris	4093	https://www.tocris.com/products/hydrocortisone_4093
VladaChem	VL142667	https://www.vladachem.com/product.php?products=50-23-7
VladaChem	VL163299	https://www.vladachem.com/product.php?products=50-23-7
VladaChem	VL281332-1G	https://www.vladachem.com/product.php?products=50-23-7
W&J PharmaChem	100374	http://www.wjpharmachem.com/new/100985.html
Yuhao Chemical	LT1240	http://www.chemyuhao.com/50-23-7.html
abcr GmbH	AB117075	http://www.abcr.com/shop/en/AB117075
eNovation Chemicals	D489409	https://www.enovationchem.com/ProductDetails.asp?ProductID=D489409
eNovation Chemicals	D518752	https://www.enovationchem.com/ProductDetails.asp?ProductID=D518752
iChemical	EBD2157864	http://www.ichemical.com/products/50-23-7.html?utm_source=PubChem&utm_medium=website&utm_campaign=product%20catalogs
mcule	MCULE-8953627920	https://mcule.com/MCULE-8953627920/

PubMed

Title	Date	PubMed
Endocrine and metabolic effects of insulin sensitizers in the treatment of patients with polycystic ovary syndrome and hyperinsulinaemia.	2001	11150875
Effect of ruminations on the saliva cortisol response to a social stressor.	2001 Apr	11166494
Enhanced memory for emotional material following stress-level cortisol treatment in humans.	2001 Apr	11166493
Individual differences in the diurnal cycle of salivary free cortisol: a replication of flattened cycles for some individuals.	2001 Apr	11166492
Gender differences in age-related changes in HPA axis reactivity.	2001 Apr	11166486
Interactions among paternal behavior, steroid hormones, and parental experience in male marmosets (Callithrix kuhlii).	2001 Feb	11161885
Menstrual cycle variation in spatial ability: relation to salivary cortisol levels.	2001 Feb	11161881
Modulation of P450 CYP3A4-dependent metabolism by P-glycoprotein: implications for P450 phenotyping.	2001 Feb	11160617
Glucocorticoids upregulate CD40 ligand expression and induce CD40L-dependent immunoglobulin isotype switching.	2001 Feb	11160161
Glucocorticoids protect against apoptosis induced by serum deprivation, cyclic adenosine 3',5'-monophosphate and p53 activation in immortalized human granulosa cells: involvement of Bcl-2.	2001 Feb	11159853
PTH and PTH-related peptide enhance steroid secretion from human adrenocortical cells.	2001 Feb	11158922
Postnatal glucocorticoids in very preterm infants: "the good, the bad, and the ugly"?	2001 Feb	11158479
Cooperative effects of STAT5 (signal transducer and activator of transcription 5) and C/EBPbeta (CCAAT/enhancer-binding protein-beta) on beta-casein gene transcription are mediated by the glucocorticoid receptor.	2001 Feb	11158330
Time course of 21-hydroxylase antibodies and long-term remission of subclinical autoimmune adrenalitis after corticosteroid therapy: case report.	2001 Feb	11158030
Aromatase p450 expression in a feminizing adrenal adenoma presenting as isosexual precocious puberty.	2001 Feb	11158024
Oral glucose augments the counterregulatory hormone response during insulin-induced hypoglycemia in humans.	2001 Feb	11158023
Human glucocorticoid feedback inhibition is reduced in older individuals: evening study.	2001 Feb	11158007
Troglitazone amplifies counterregulatory responses to hypoglycemia in nondiabetic subjects.	2001 Feb	11158003
Assessment of growth hormone dynamics in human immunodeficiency virus-related lipodystrophy.	2001 Feb	11158000
Fertility and body composition after laparoscopic bilateral adrenalectomy in a 30-year-old female with congenital adrenal hyperplasia.	2001 Feb	11157995
Electrophysiological effects of corticosteroids on the retinal pigment epithelium.	2001 Feb	11157885
Switch from systemic steroids to budesonide in steroid dependent patients with inactive Crohn's disease.	2001 Feb	11156638
Dose response of arginine vasopressin to the CCK-B agonist pentagastrin.	2001 Feb	11120398
Neuroendocrine and behavioral responses to mCPP in Obsessive-Compulsive Disorder.	2001 Feb	11087965
Green fluorescent protein mutant as label in homogeneous assays for biomolecules.	2001 Feb 1	11161294
Hormonal regulation of mitochondrial Tim23 gene expression in the mouse mammary gland.	2001 Feb 14	11165051
Carbachol induces homologous steroidogenic refractoriness of bovine fasciculata-reticularis cells.	2001 Feb 14	11165048
Thapsigargin inhibits angiogenesis in the rat isolated aorta: studies on the role of intracellular calcium pools.	2001 Feb 16	11166281
Inhibition of cortisol secretion in dispersed head kidney cells of rainbow trout (Oncorhynchus mykiss) by endosulfan, an organochlorine pesticide.	2001 Jan	11161769
Human cervical tissue metabolizes the tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, via alpha-hydroxylation and carbonyl reduction pathways.	2001 Jan	11159748
Serum allopregnanolone in women with postpartum "blues".	2001 Jan	11152912
Net amino acid flux across the fetal liver and placenta during spontaneous ovine parturition.	2001 Jan	11150831
Growth hormone deficiency caused by pituitary stalk interruption in Fanconi's anemia.	2001 Jan	11148528
Serum thyrotropin concentrations and bioactivity during sleep deprivation in depression.	2001 Jan	11146761
Intracellular regeneration of glucocorticoids by 11beta-hydroxysteroid dehydrogenase (11beta-HSD)-1 plays a key role in regulation of the hypothalamic-pituitary-adrenal axis: analysis of 11beta-HSD-1-deficient mice.	2001 Jan	11145573
Effects of cortisol on chloride cells in the gill epithelium of Japanese eel, Anguilla japonica.	2001 Jan	11139782
Diabetes insipidus and anterior pituitary insufficiency as presenting features of Wegener's granulomatosis.	2001 Jan	11136194
Short-term 17beta-estradiol decreases glucose R(a) but not whole body metabolism during endurance exercise.	2001 Jan	11133904
Reference intervals for glucose, beta-cell polypeptides, and counterregulatory factors during prolonged fasting.	2001 Jan	11120658
Gluconeogenesis in moderately and severely hyperglycemic patients with type 2 diabetes mellitus.	2001 Jan	11120655
Hydrocortisone abolishes the angiotensin II-mediated potentiation of endothelin-1 in bovine bronchi.	2001 Jan	11115413
Ultrarapid opioid detoxification: effects on cardiopulmonary physiology, stress hormones and clinical outcomes.	2001 Jan 1	11137281
Neural correlates of maternal separation in rhesus monkeys.	2001 Jan 15	11164761
Altered levels of hypothalamic-pituitary-adrenocortical axis hormones in baboons and mice during the course of infection with Schistosoma mansoni.	2001 Jan 15	11110642
Crystallization of hydrocortisone acetate: influence of polymers.	2001 Jan 16	11165079
Monohydroxylation and esterification as determinants of the effects of cis- and trans-9-octadecenoic acids on the permeation of hydrocortisone and 5-fluorouracil across hairless mouse skin in vitro.	2001 Jan 16	11165072
The use of chitosan gels as matrices for electrically-modulated drug delivery.	2001 Jan 29	11166412
Fetal hypothalamus-pituitary-adrenal axis on the road to parturition.	2001 Jan-Feb	11153525
Dynamics of circadian fluctuations in serum concentration of cortisol and TNF-alpha soluble receptors in gastrointestinal cancer patients.	2001 Jan-Feb	11115600
Patterns of integrin expression in a human mandibular explant model of osteoblast differentiation.	2001 Mar	11165569

Patents

Sample Use Guides

In Vivo Use Guide

The initial dosage of CORTEF (Hydrocortisone) Tablets may vary from 20 mg to 240 mg of hydrocortisone per day depending on the specific disease entity being treated.

Route of Administration: Oral

In Vitro Use Guide

Hydrocortisone concentration-dependently inhibited the current induced by 3 x 10(-5) M ACh with a half maximum inhibitory concentration (IC50) of 2.1 x 10(-4) M (in rats).

Substance Class	Chemical Created by `admin` on `Fri Dec 15 15:01:47 GMT 2023` Edited by `admin` on `Fri Dec 15 15:01:47 GMT 2023`
Record UNII	LIU00Z1Z84
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

HYDROCORTISONE HEMISUCCINATE

Common Name

English

PREGN-4-ENE-3,20-DIONE, 21-(3-CARBOXY-1-OXOPROPOXY)-11,17-DIHYDROXY-, (11.BETA.)-, MONOHYDRATE

Systematic Name

English

Cortisol 21-(hydrogen succinate) monohydrate

Common Name

English

HYDROCORTISONE HYDROGEN SUCCINATE [MART.]

Common Name

English

HYDROCORTISONE HEMISUCCINATE [USP-RS]

Common Name

English

HYDROCORTISONE HEMISUCCINATE [USP MONOGRAPH]

Common Name

English

NSC-757049

Code

English

Hydrocortisone-21 hemisuccinate monohydrate

Common Name

English

Classification Tree Code System Code

NCI_THESAURUS

C521