Primacort injection (Hydrocortisone)

Primacort injection (Hydrocortisone) is an injectable corticosteroid that helps calm the immune system and reduce inflammation fast. In the United States, it is most often used in urgent situations like severe allergic reactions after epinephrine, adrenal crisis in people with adrenal insufficiency, severe asthma or COPD flare-ups, and as an add-on in certain cases of septic shock when blood pressure is not responding well to fluids and vasopressors.

It can also be used for short-term control of serious inflammatory conditions affecting the skin, joints, gut, lungs, or other organs when oral medicines are not an option.

What it is and how it works

• Active ingredient: Hydrocortisone, usually supplied as hydrocortisone sodium succinate for injection.
• Drug class: Corticosteroid.
• How it works: Hydrocortisone mimics cortisol, a hormone your body makes in the adrenal glands. It helps control inflammation, immune activity, blood pressure response, and stress balance. When administered by injection, it acts quickly to reduce swelling, redness, itching, and other immune-driven symptoms.

Where it is used

• Emergency care: For adrenal crisis, severe allergy or anaphylaxis support after epinephrine, and serious asthma flares. It is not a substitute for epinephrine in anaphylaxis.
• Inpatient care: For certain inflammatory or autoimmune conditions, to treat severe flare-ups when oral therapy is not practical, or as a part of a septic shock protocol when indicated.
• Outpatient settings: Occasionally used in clinics for acute flares of conditions such as severe dermatitis or arthritis when rapid relief is needed and the clinician chooses an injectable approach.

Who might be prescribed Primacort injection?

• People with known adrenal insufficiency who require urgent steroid support during illness, injury, or surgery.
• Individuals having a severe allergic reaction where the medical team needs an anti-inflammatory after epinephrine and other first-line treatments.
• Patients with severe asthma or COPD exacerbations who need fast-acting anti-inflammatory support.
• People with severe inflammatory conditions for whom oral steroids are not suitable at the moment.

Who should not use it?

• Anyone with a known allergy to hydrocortisone or any component of the injection.
• People with certain active fungal or untreated systemic infections, unless the benefit outweighs the risk, as decided by a clinician.
• Those scheduled for live vaccines in the near term may need to delay vaccination if receiving high-dose corticosteroids. Always check with your healthcare provider.

Primacort Injection Side Effects

Like all steroids, hydrocortisone can cause side effects, especially with repeated doses or longer courses. Not everyone will experience these effects, and many are temporary in nature. If something does not feel right, contact your healthcare provider.

Commonly reported effects:

• Increased blood sugar, especially if you have diabetes
• Fluid retention or swelling, possible rise in blood pressure
• Mood changes, anxiety, restlessness, or trouble sleeping
• Stomach upset, nausea
• Headache, dizziness
• Flushing, sweating

Less common but important:

• Weakened immune response and higher risk of infection
• Eye pressure changes or vision issues
• Thinning skin or slow wound healing with longer-term use
• Electrolyte changes, such as low potassium
• Elevated risk of stomach bleeding if taken with certain pain relievers

Serious reactions that need urgent help:

• Signs of severe allergic reaction, like hives, swelling of the face or throat, wheezing, trouble breathing
• Severe or persistent fever, chills, or signs of infection
• Severe stomach pain, black stools, or vomiting blood
• Sudden vision changes or severe headache

Available strengths section

Hydrocortisone injection strengths commonly available in the United States include:

• Primacort injection 100mg (Hydrocortisone)
• Primacort injection 200mg (Hydrocortisone)
• Primacort injection 400mg (Hydrocortisone)

Availability can vary, and packaging may be single-dose or multi-dose depending on the manufacturer. Always review the label or ask your pharmacist to confirm what you are receiving.

Interactions to be aware of

• Vaccines: High-dose steroids can reduce the effectiveness of vaccines. Live vaccines may be delayed until steroid therapy is lowered or completed.
• Diabetes medications: Blood sugar levels may run higher, which may require temporary adjustments.
• Blood thinners, such as warfarin and other anticoagulants, may require closer monitoring and adjustment.
• NSAIDs and aspirin: Increased risk of stomach irritation or bleeding when used together.
• Diuretics or other drugs that lower potassium levels: The risk of low potassium may increase.
• Certain antibiotics, antifungals, seizure medications, and TB drugs can alter steroid levels in the body. Inform your healthcare provider about rifampin, phenytoin, ketoconazole, and other similar medications.

FAQs About Primacort injection