The drug "Kortef": instructions for use, indications, contraindications, doses, reviews

Glucocorticosteroids (SCS) are called synthetic drugs, which are analogues of endogenous hormones produced by the adrenal cortex. SCS exerts on the human body a whole range of effects: anti-inflammatory and desensitizing, immunosuppressive, antitoxic and anti-shock.

Today on the pharmaceutical market of the Russian Federation there is a large list of such medicines. One of them is "Cortef". Instructions for use recommend taking it for a variety of diseases.

Composition and form of release

The medication is intended for oral administration. The main active ingredient of the drug "Cortef" (the instruction contains this information) is hydrocortisone - a hormone produced by the adrenal glands. For systemic and local use in a medical environment, natural hydrocortisone or its esters are used.

In the medication "Kortef" this hormone is contained in a volume of 10 mg. Additional substances include calcium stearate, corn starch and sucrose, lactose, mineral oil and sorbic acid.

The main form, which offers consumers "Kortef" - tablets. Instructions for use, reviews of health workers and patients indicate the high effectiveness of this tool. Round tablets with a risk on the surface and the "CORTEF10" inscription stamped on it are packaged in vials of darkened glass (each packed in 100 pieces). You can buy the medicine only by prescription.

Pharmacodynamics

As it was mentioned earlier, the medicine has a whole list of effects on the human body: anti-inflammatory and anti-shock, desensitizing and antiallergic, antitoxic, antimetabolic and immunosuppressive. Description of the preparation (instructions for use) contains information on the mass of the processes affected by the drug. It inhibits the release of inflammatory mediators and significantly slows the release of cytokines (interferon, interleukins) from microphages and lymphocytes.

Also, "Cortef" stimulates the accumulation of glycogen in the liver, increases the amount of glucose contained in the blood, slows the elimination of fluid and Na + from the body and increases K +. With the direct participation of this medication, the production of histamine (mediator, i.e., the mediator necessary for carrying out allergic reactions of immediate type) is reduced.

In addition, the preparation of Cortef "instructions for use as a means of reducing the number of cellular infiltrates (cells cells with a mixture of blood and lymph) and the overwhelming inflammatory focus of the motor activity of leukocytes and lymphocytes, contributing to a decrease in the permeability of capillaries. The drug inhibits synthesis and increases the rate of protein breakdown.

"Cortef" affects the pituitary gland and inhibits the production of corticotropin (ACTH), without which the functioning of the adrenal cortex can completely stop.

Medication "Kortef": instruction, application

The responses of experts say that the medicine we are considering is used in different fields of medicine. It is used to exclude a patient from toxic, traumatic, burn, cardiogenic, operational shock in those cases when standard anti-shock therapy did not bring results. Let us dwell on these points in more detail.

So, what are the categories of patients assigned to "Cortef"?

Instructions for use, the description of the drug, inform consumers about the possibility of using it in endocrinology. Here, the drug will be effective in such diseases as insufficiency of the functioning of the adrenal cortex, thyroiditis (subacute form), adrenal hyperplasia (congenital nature), hypercalcemia, appeared against the background of malignant neoplasms.

Further, in rheumatology, "Kortef" positively manifests itself in the treatment of bursitis, arthritis (gouty, psoriatic, rheumatoid), ankylosing spondylitis, nonspecific tendosinovitis. Good results are achieved by patients taking "Kortef" with systemic lupus erythematosus, acute rheumatic carditis, polymyositis, epicondylitis.

There are indications for the use of "Kortef" and in the field of dermatology. Here the medication is effective in the treatment of pemphigus, mushroom mycosis, herpetiform and exfoliative dermatitis. He is also prescribed for severe psoriasis, seborrheic dermatitis, erythema multiforme severe leakage.

Allergologists prescribe "Cortef" for serum sickness, rhinitis allergic origin, with atypical and contact dermatitis, with bronchial asthma and individual hypersensitivity to medicines.

Specialists-ophthalmologists also practice the appointment of "Cortef" in a number of diseases. The medication is effective in the ulcer of the cornea and conjunctivitis of allergic origin, with iritis and keratitis, with iridocyclitis, neuritis, uveitis, etc. In the field of oncology, the SC "Kortef" is prescribed for leukemia, in neurology for multiple sclerosis.

Where else is applied "Cortef"? The instructions for use contain information that pulmonologists (symptomatic sarcoidosis, lightning pulmonary tuberculosis, aspiration pneumonia) and hematologists (secondary thrombocytopenia, hemolytic or hypoplastic anemia, erythroblastopenia) can prescribe to his patients.

Applications and dosing

Medication "Kortef" is intended for oral administration. However, the lyophilizate for the Solu-Cortef solution is prescribed for administration by intramuscular injection, intravenously (by drip or jet), and into the periarticular bag.

With regard to oral administration, the initial dosage can vary from 20 to 240 mg during the day, depending on the diagnosed pathology and severity of the patient's condition. The optimal dose in each particular case is selected by reducing the initially accepted to the lowest, which will provide the desired effect.

In acute conditions and the need for urgent therapy is recommended intravenous drug "Solu-Kortef." Instruction for use describes the following standard scheme. The first 100 mg of the solution (initial dose) are administered within half a minute. The next volume of the drug in 500 mg should be administered for 10 minutes. Then every 2-6 hours the procedure should be repeated, not forgetting to carry out constant monitoring of the patient's condition.

It should be remembered that in large dosages, "Solu-Cortef" is prescribed only for the period of stabilization of the patient's condition, but not longer than 3 days.

In / m "Kortef" is administered in the amount of 125-250 mg / day. Positive drug exposure occurs after 6-25 hours after the procedure and can last from several days to several weeks.

If necessary, injections of "Cortef" are made into an intraarticular or periarticular bag. Effective dosage for large joints (shoulder, knee, femur) is 25-50 mg, but in acute conditions can reach 100 mg. For small joints (elbows, wrists, phalanx of fingers), an injection of 10-20 mg will be sufficient, done once. Repeat procedures are recommended every 1-3 weeks (sometimes required and more often - every 3-5 days).

In general, with regard to therapy with the drug "Cortef", the method of application and dose can be chosen only by the attending physician. Suddenly stop treatment is undesirable, there is a high probability of exacerbation. The completion of treatment is by gradually reducing the dosage.

Contraindications to the use of "Cortef"

There is a certain list of diseases and conditions of the body, when it is unacceptable to take the medicine we are considering. These are parasitic and infectious diseases of viral, fungal or bacterial origin (carried over in the recent past, taking place at the moment).

It is not prescribed if the patient is diagnosed with acute psychosis, decompensated diabetes mellitus, or the person suffers from hypothyroidism, thyrotoxicosis, arterial hypertension, gastrointestinal ulcers and dermatological lesions having an infectious or ulcerative nature.

There is a whole list of contraindications for intra-articular administration of the drug "Solu-Kortef". Do not prescribe medication and with a number of problems with the cardiovascular system, including with the recently transferred myocardial infarction.

For a single admission, even for "vital" need, a contraindication to use is individual hypersensitivity to the components of the medication.

Undesirable manifestations

For several reasons, the frequency and brightness of the manifestation of side effects, the list of which contains for the preparation "Kortef" instructions for use, depends. The indications, doses, duration of the course prescribed by the attending physician must be observed without fail. A certain value is also attached to the observance of the circadian rhythm of the appointment (fluctuations in the intensity of various biological processes associated with the change of day and night).

Endocrine system in response to the reception of "Cortef" is able to respond to a decrease in susceptibility to glucose, the development of diabetes mellitus of steroid nature, suppression of the functioning of the adrenal glands. There is a possibility of developing the Itenko-Cushing syndrome, the main symptoms of which are the moon-shaped face, obesity in the pituitary type, the increase in the indices of blood pressure, myasthenia gravis, and various disorders of the menstrual cycle in women.

The reaction from the gastrointestinal tract can become such symptoms as nausea and vomiting, pancreatitis and steroid ulceration of various parts of the digestive tract, bleeding and perforation of its (GIT) walls, erosive esophagitis.

From the side of the cardiovascular system, adverse reactions to "Cortef" (the instruction confirms this information) are arrhythmia, bradycardia, thrombosis, an increase in BP indices. Against the backdrop of acute and subacute form of myocardial infarction "Cortef" can cause the spread of foci of necrosis, inhibition of the formation of scar tissue, which can cause a rupture of the heart muscle.

In general, a variety of organs and systems of the human body can negatively react to the application of "Cortef" in one way or another. There are manifestations from the side of the central nervous system and sensory organs, disturbances in the work of metabolism and the musculoskeletal system. A variety of allergic reactions may occur. The most complete information is contained in the instructions for the use of the drug "Cortef".

Pregnancy and lactemia

During the period of gestation and breastfeeding, the use of the drug "Kortef" is strictly forbidden. The description (the presence of benzyl alcohol in some forms of the drug speaks for itself) of the drug contains information on the possible effects of the use of "Cortef" in such periods as development of insufficiency of adrenal activity, dyspnea, death.

Children whose mothers during pregnancy were forced to take hydrocortisone should be under the careful supervision of medical personnel with the purpose of early detection of signs of development of adrenal insufficiency.

What you should pay attention to?

During the treatment with the use of the drug "Kortef" instructions for use recommend a diet that limits the intake of salt. In addition, the body should receive a sufficient amount of protein. Also during this period it is unacceptable to carry out any kinds of vaccination. It is necessary to maintain constant monitoring of blood pressure, glucose concentration in the blood and its coagulability. It is also important to monitor diuresis and weight of the patient.

In case of any stressful situations, people undergoing a therapeutic course using "Cortef" need to increase the dosage of GCS. As for patients suffering from tuberculosis, those who are in an active stage should take "Kortef" only in parallel with the appropriate therapy aimed at treating the underlying disease. If tuberculosis occurs in a latent form, or in the process of bending tuberculin samples, the medical staff should closely monitor the patient's condition and, if necessary, prescribe appropriate chemoprophylaxis.

If the purpose of the medication provoked the development of secondary insufficiency of the adrenal cortex, then the situation can be normalized by gradually reducing the dose. After the course of therapy is over, this type of insufficiency can be observed for several months. Stressful situations that occurred during this period are an indication for the resumption of the appointment of the SCS.

As for simple herpetic infection of the eye, the "Cortef" (instruction, application, reviews of specialists are discussed in the article) and any other SCS should be administered with great care, as it is possible to develop corneal perforation.

Medical workers should be aware of the fact that, against the backdrop of treatment by Cortef, certain infectious diseases can occur asymptomatically, in a latent form and have varying degrees of severity. With the increase in the applied doses of GCS, the probability of developing hidden infections increases. That is, under the influence of "Cortef" the resistance to infections decreases, the ability to localize the infectious focus diminishes.

Those who are prescribed immunosuppressive doses of "Cortef" or any other SCS, it is recommended not to contact people suffering from chicken pox or measles. If such contacts are still held, you should immediately contact your doctor.

SCS can cause mental disorders or exacerbate existing psychotic manifestations, increase emotional instability.

There is information that in some patients, against the backdrop of "Kortef" (or other SCS), Kaposi's sarcoma developed. However, after the withdrawal of the drug, clinical remission was observed.

Due to the fact that complications after taking the drug directly depend on the duration of the course and dosage, the doctor decides whether to start the treatment course, its duration and the allowable dosages after assessing the intended benefit for his patient and the potential risks from the drug.

Interaction with other drugs

So, we discussed what "Cortef" is. Instructions for use, indications and contraindications to the use and side effects of this drug are also considered. It remains to note that specialists in prescribing patients should take into account that hydrocortisone can interact with a variety of substances, and these compounds can cause serious damage to the body.

First, hydrocortisone is pharmaceutically incompatible with other drugs and, when trying to bind, it can form insoluble substances. Secondly, it increases the toxicity of cardiac glycosides, which can lead to hypokalemia, and then there is a risk of arrhythmia.

With the direct participation of "Cortef" (in particular, its main component), the rate of excretion of acetylsalicylic acid (ASA) increases, and the level of its content in the blood falls.

The use of live antiviral vaccines against the background of hydrocortisone can give an impetus to the activation of viruses and the development of infection.

Paracetamol in tandem with "Cortef" can become hepatotoxic. With prolonged courses of use, the concentration of folic acid in the body increases. In high dosages, hydrocortisone reduces the effectiveness of somatropin (growth hormone).

In addition, the main active substance reduces the effectiveness of hypoglycemic medicines, but increases the anticoagulant effect of coumarin derivatives. "Cortef" suppresses the effect of vitamin D on the absorption of Ca ₂ + in the lumen of the intestine. Under the influence of hydrocortisone, the toxicity of cyclosporine and ketoconazole increases.

In the presence of substances such as ephedrine, theophylline, rifampicin, any barbiturates, the therapeutic effect of the effect of GCS decreases. The appearance of blackheads and the development of hirsutism (excessive growth of terminal - hard and dark - hair in women in the male type) is preceded by the reception in parallel with hydrocortisone of other steroid hormones (anabolic, estrogen, oral contraceptives).

Opinion of consumers about the drug "Kortef"

"Cortef" is too complicated a drug, so as not to have negative reviews. Although positive at times more. Description of the drug "Kortef" (reviews of health workers confirm this fact) allows us to understand: how wide its scope, the list of side effects is also long. Judging by the opinions of the patients themselves, someone quickly relieved them of suffering, which resulted in improved quality of life, and someone caused a lot of negative impressions, and the feelings of the patients did not have any effect.

Whether this drug is bad or good is too narrow a question for such a tool as "Cortef". The main thing here is to rely on the experience and knowledge of the attending physician and to follow all his recommendations.